Shipman Inquiry reprimands medical profession
The medical profession’s culture of looking after its own and not reporting colleagues is putting patient safety at risk, the Shipman Inquiry warned today.
The inquiry’s fifth report into the 23-year killing spree of Manchester GP Harold Shipman found that the General Medical Council was not at fault in allowing him to continue practising, as it never received information indicating he was a danger to patients.
However, it criticised a culture of silence and over-protectiveness both among doctors and their representative body.
Dame Janet Smith, the inquiry head, said the GMC had heard charges in 1976 that Shipman was addicted to drugs, but had only warned him instead of erasing or suspending his registration.
However, in doing so it had handled Shipman’s case exactly as it handled other cases of a similar type.
“I do not consider that the GMC should be criticised for its decision to take a rehabilitative approach to Shipman rather than erase or suspend his registration,” she said.
“From the information available in 1976, the GMC could not have suspected Shipman’s true nature. It is not to be held responsible for the fact that Shipman remained free to practise.”
It appeared Shipman never returned to drug abuse, and Dame Janet believed that even placing him under supervision would not have prevented his future murders.
But she attacked the GMC for focussing too much on the rehabilitation of doctors and not enough on the interests of patients.
“The GMC has not safeguarded patients as it should have done. The culture focussed too much on being fair to doctors and not sufficiently on the need to protect patients,” she added.
“The balance was wrong.”
In addition, procedures for dealing with patient complaints had been unsatisfactory for a long time, although they were now “in a state of change” and the GMC had made changes that would make life better for patients.
Dame Janet recommended that a telephone helpline – on the lines of NHS Direct – be set up to give the public information about how to raise concerns about doctors. There should also be a central database of all doctors so that they could no longer conceal misdemeanours by moving from area to area.
She was also sharply critical of the medical profession in general, noting that Shipman’s fellow doctors had been reluctant to report him because of a culture that held that was not the done thing.
“The culture of unwillingness to report colleagues has not completely disappeared,” she said.
“It must go. There can be no room for the protection of colleagues where the safety and welfare of patients is at stake.”
Shipman’s patients had not been told of his past, she noted. It was ‘impossible’ to know whether, as relatives of some of Shipman’s victims claimed, knowing more about his past would have prevented them from trusting him so much.
However, patients should be entitled to know more about their doctors – there should be “a degree of choice”, she added.
Primary care organisations did not have monitoring systems in place that would detect aberrant behaviour, the inquiry found, and should in future do more to investigate complaints that might have a bearing on safety.
However, they were not to be criticised, Dame Janet said, as they had not had a disciplinary role.
