The government, the General Medical Council, and the medical profession were criticised last week for failing to respond to the recommendations of the inquiry into the case of Harold Shipman, the GP who murdered more than 200 patients.

At a meeting convened at the Royal Society of Medicine in London to discuss trust between doctors and patients after the Shipman case, Janet Smith, chairwoman of the Shipman inquiry, said that the case had “disclosed a raft of flaws in professional governance” and that “inaction cannot be defended.”

The GMC's plan for revalidation was “stopped in its tracks,” she said, which was “good because as proposed it was merely a rubber stamping exercise, but 18 months on we are still waiting to learn what is to be done.”

Aneez Esmail, professor of general practice at Manchester University and an adviser to the inquiry, said that the “continued silence” of the chief medical officer indicates that an “unholy compromise is being worked out.”

“And when it does appear I predict it will be a fudge,” he said.

The inquiry's recommendation to revise death and cremation certification (BMJ 2002;325: 919) should already have been implemented, speakers underlined. It was the most effective way of “preventing another Shipman” and—unlike revalidation (which could not identify a serial killer)—was simple to implement.

When …