Tighter control on GPs to follow doctor's murder convictions
With tighter controls, would Dr Harold Shipman have been able to kill these women?
(PA)
Tighter controls on the way
that GPs practise are certain to
follow the conviction this week
of Dr Harold Shipman, the
most prolific serial killer in
British criminal history. The
health secretary, Alan Milburn,
announced an inquiry into failures in the system that allowed
the 54 year old doctor to murder his patients at will.
The Greater Manchester
family doctor will die in prison
after receiving 15 life sentences
for murdering 15 of his middle
aged and elderly women
patients by lethal injections of
diamorphine.
Police have sent dossiers on
a further 23 deaths to the
Crown Prosecution Service and
believe he may have killed as
many as 150 patients during his
30 year career.
His motive for wreaking mass
murder on his patients was as
mysterious at the end of the
lengthy trial as it was at the beginning. The prosecution postulated
that he enjoyed exercising the
ultimate power of life and death.
Dr Shipman stood to gain
financially from only one of the
deaths, that of 81 year old Kathleen Grundy. It was his clumsy
attempt to forge her will, making
himself the sole beneficiary of her
£386 000 ($617 000) estate, that
eventually led to his discovery.
Together with the Bristol
children's heart surgery debacle,
the Shipman case has shaken
public confidence in the medical
profession and is likely to lead to
widespread reform.
Changes expected to follow
include closer monitoring of
GPs - particularly singlehanded
Practitioners - by health authorities; greater controls to prevent the stockpiling of drugs
(Dr Shipman had enough
diamorphine to kill 1500
patients); more stringent
requirements on GPs who
countersign other doctors' cremation certificates; and wider
powers for coroners.
New duties may be placed
on the General Medical Council to pass on information about
doctors who come before it.
West Pennine Health Authority,
which covers Hyde, where Dr
Shipman practised, was
unaware that he had been
addicted to pethidine and had a
1976 conviction for forging
prescriptions for the drug. He
was allowed to rehabilitate himself, and he returned to private
practice after working in community health.
The GMC said that it had
received no information to suggest any misuse of drugs by Dr
Shipman between 1976 and his
arrest in 1998. There were complaints about three separate incidents, but none suggested a fundamental problem in the GP's practice.
The GMC's president, Sir
Donald Irvine, said: "We will
work with NHS management
and others to ensure that
lessons are learned from this
tragic case."
Clare Dyer legal correspondent, BMJ
studentBMJ 2000;08:45-88 March ISSN 0966-6494
