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Saturday, 20 July, 2002, 14:49 GMT 15:49 UK
Death certificate rules 'must change'
Dame Janet Smith, who chairs the Shipman inquiry
Dame Janet Smith: safeguards were insufficient
The Shipman inquiry has prompted calls for changes in the way death certificates are issued.

The Liberal Democrat health spokesman, Evan Harris, told the BBC on Saturday the present system was unsafe and he called for more post-mortems.

A report published on Friday concluded the Greater Manchester GP Harold Shipman killed 215 patients.

In most of the cases, he covered his tracks by signing their death certificates and avoiding the involvement of a coroner.
Harold Shipman
Shipman: falsified death certificates

Dr Harris told BBC Radio 4's Today programme the current system helped the doctor, but not society.

He said: "Death certificates can be done and no coroner is involved, when the patient has been recently seen by the doctor.

"But in this case, recently being seen by the doctor was the cause of the foul play so that has to change and there has to be a much greater oversight of deaths."

Dr Harris also called for more post-mortems, which he said would have "huge benefits" in terms of checking a doctor's diagnosis.
Cases for a coroner:
Deceased not seen by doctor in past 14 days
Cause of death unknown
Cause of death unnatural or suspicious
Death during operation
Death due to industrial disease
No doctor available to sign

He also suggested relatives had a say in whether post-mortems were carried out.

A doctor should refer a suspicious death to a coroner for a post-mortem and investigation without issuing a certificate.

Strict guidelines govern the circumstances when a coroner should investigate.

For natural deaths, only one doctor's signature is needed for burial, while two are required when the dead person is to be cremated.

Shipman arranged for the cremation of the majority of his victims, which meant he obtained a second doctor's signature and a third doctor employed by the crematorium to check it.

'Betrayal'

High Court judge Dame Janet Smith's report on the deaths admitted: "In reality, the procedures provided no safeguard at all."

Shipman had also managed to avoid referring deaths to the coroner that should have been referred, in all but very few cases.


In reality, the procedures provided no safeguard at all.

Dame Janet Smith
Professor David Haslam, chairman of the Royal College of GPs, told Today the Shipman case had shattered confidence in the medical profession.

He said: "Doctors are desperately upset and hurt by the betrayal of trust Harold Shipman has caused."

But he said some measures, such as the new primary care groups, ensured GPs no longer worked in isolation.

Dame Janet found the former GP could have killed as many as 260 patients.

Shipman was convicted in January 2000 of killing 15 of his patients with lethal heroin injections.

 WATCH/LISTEN
 ON THIS STORY
Liberal Democrat health spokesman Evan Harris
"Death certificates can be done and no coroner is involved, when the patient has been recently seen by the doctor"

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