GMC must protect patients says government ministerBMJ 2005; 330 doi: http://dx.doi.org/10.1136/bmj.330.7486.271 (Published 03 February 2005) Cite this as: BMJ 2005;330:271
Harold Shipman probably began to kill patients within a year of leaving medical school, taking his full toll of murders to 250 patients, the inquiry into Shipman's 30 year career concluded last week.
Dame Janet Smith, the appeal court judge who carried out the three year inquiry, reached the conclusion in her sixth and final report, which looked at his earliest years in practice as a junior hospital doctor.
On the day she released her findings, the health secretary, John Reid, announced a major review of the way doctors are assessed for their fitness to practise, and the role of their regulatory body, the General Medical Council.
The review, to be conducted by the chief medical officer, Professor Liam Donaldson, aims to strengthen the procedures for protecting patients in situations where a doctor poses a risk to patient safety. It will also identify measures to modify the role, structure, and functions of the GMC, and could result in the loss of the council's powers to discipline doctors. These could be handed over to an independent tribunal.
The review is a response to recommendations by Dame Janet, who strongly criticised the GMC in an earlier report.
Dr Reid said: “We take what Dame Janet Smith has said very seriously. We will not settle for a quick and weak response to her inquiry.
“We want to put an end to the idea that the GMC is a representative body for doctors. It is not. Its primary role must be to protect patients.”
The GMC welcomed the review's terms of reference. It also said it was willing to host the central database recommended by the Shipman inquiry, which would hold information about every doctor working in the United Kingdom. Dame Janet proposed that this should include records of disciplinary action by employers, information held by the GMC and the Criminal Records Bureau and adverse findings by the Healthcare Commission or the health service ombudsman.
The GMC is to put the full register of doctors online, along with undertakings and conditions attached to a doctor's registration. Undertakings are given in advance of GMC hearings if a doctor's health or performance is in question and conditions are imposed by fitness to practise panels.
Shipman, Britain's most prolific serial killer, hanged himself in his prison cell a year ago. He was serving a life sentence for the murder of 15 patients.
In an earlier report Dame Janet investigated the deaths of Shipman's patients while he was in general practice in Hyde, Greater Manchester, and Todmorden, West Yorkshire. She decided to look at his years as a junior hospital doctor at Pontefract General Infirmary, West Yorkshire, after she had been contacted by a former student nurse who worked with him there.
Dame Janet concluded that he first killed a patient only six months after starting at Pontefract General Infirmary, when he was 25. Of 24 suspicious deaths, between 10 and 15 patients, including a 4 year old girl, were probable victims, she said.
She estimates that he was responsible for 250 deaths during his career until his arrest in 1998, although the total could be as high as 284.
It was probably during his time at Pontefract, she concluded, that he became addicted to pethidine. He was convicted in 1976 of forging prescriptions for his own use. The GMC gave him a warning and allowed him to rehabilitate himself instead of striking him off the medical register.
Dame Janet said she believed that an early fascination with drugs and his wish to “push the boundaries” regarding their use was the catalyst for his career as a murderer.