Joël Le Scouarnec was today found guilty of raping and sexually assaulting 299 children.

Judges followed the public prosecutor’s recommendations regarding the length of the sentence and the criminal court of Morbihan ordered that Le Scouarnec should serve at least two-thirds of the sentence before he can be eligible for release.

Le Scouarnec is already serving a 15-year prison sentence, for a conviction in 2020 for the rape and sexual assault of four children, including two nieces.

The new trial in Brittany, western France, began in February and laid bare a pattern of abuse between 1989 and 2014.

Most of the victims were unconscious or sedated hospital patients at the time of the assaults. The average age was 11. Among the victims were 158 boys and 141 girls.

During the trial, advocacy groups accused health authorities of inaction after they were notified as soon as 2005 of Le Scouarnec’s conviction for possessing child pornography pictures.

At the time, no measures were taken to suspend his medical licence or limit his contact with children and Le Scouarnec continued his abuse in hospitals until his arrest in 2017.

“Should Joël Le Scouarnec have been the only one in the defendant’s box?” prosecutor Stéphane Kellenberger asked during his closing arguments.

“More could have been done,” Kellenberger said.

“Things could have been done differently, even within the notorious layers of French bureaucracy, where responsibilities are so often passed from one authority to another until, eventually, that responsibility is lost, and hits innocent lives.”

Le Scouarnec confessed to all the sexual abuse alleged by the 299 civil parties, as well as to other assaults that are now beyond the statute of limitations. In a shocking admission during the trial, he also acknowledged sexually abusing his granddaughter — a statement made in front of her visibly distraught parents.

Le Scouarnec had been convicted in 2005 for possessing and importing child sexual abuse material and sentenced to four months of suspended prison time. Despite that conviction, he was appointed as a hospital practitioner the following year. Child protection groups that have joined the proceedings as civil parties hope that the case will help strengthen the legal framework to prevent such abuse.

In a separate case focusing on alleged abuse at a Catholic school, an inquiry commission of the National Assembly, France’s lower house of parliament, is investigating allegations of physical and sexual abuse over five decades.

Victims of Le Scouarnec have, however, complained of a perceived lack of attention.

“This trial, which could have served as an open-air laboratory to expose the serious failings of our institutions, seems to leave no mark on the government, the medical community, or society at large,” a group of victims said in a statement.

Not all victims were initially aware they had been abused. Some were contacted by investigators after their names appeared in journals kept by Le Scouarnec, in which he meticulously documented his crimes. Others only realised they had been hospitalised at the time after checking medical records. Two of his victims took their own lives some years before the trial.

Using the cover of medical procedures, the former abdominal and digestive surgeon took advantage of moments when children were alone in their hospital rooms. His method was to disguise sexual abuse as clinical care, targeting young patients who were unlikely to remember the encounters.

The notebooks, which detail the abuse in graphic language, have become central to the prosecution’s case.

Despite the scope of the allegations, Le Scouarnec has remained calm and composed throughout the trial.

“I didn’t see them as people,” he told the court.

“They were the destination of my fantasies. As the trial went on, I began to see them as individuals, with emotions, anger, suffering and distress.”

He said his first act of abuse occurred in 1985, when he raped his five-year-old niece.

While he offered apologies to some victims, his demeanour struck many as detached and emotionless.

“I don’t show emotion, that’s just how I am,” he said.

“That doesn’t mean I don’t feel it, but I don’t express it.”

The case first came to light in April 2017, when a six-year-old neighbour told her mother that the man next door had exposed himself and touched her through the fence separating their properties.

A search of his home uncovered more than 300,000 photos, 650 paedophilic, zoophilic and scatological video files, as well as notebooks where he described himself as a paedophile and detailed his actions.

“Joël Le Scouarnec says he no longer feels any sexual attraction to children, but there’s no way to verify that,” Kellenberger, the prosecutor, told the court.

“Experts concluded that we cannot rely on his word alone and that his potential for future danger remains significant.”

A third trial is expected in the coming years, following the emergence of new allegations during this trial, including further abuse involving his granddaughter.