Page last updated at 00:11 GMT, Thursday, 12 February 2009

Shipman response 'lacks progress'


How Shipman shunned police interviewers

A "dishonest, malevolent doctor" could still get away with murder, five years after the inquiry into serial killer GP Harold Shipman, its chairwoman says.

In a BBC interview, Dame Janet Smith, who chaired the Harold Shipman Inquiry, criticised the system of death certification in England and Wales.

Shipman went undetected as he killed more than 200 patients, certifying their deaths as natural causes.

The government says its new Coroners and Justice Bill will prevent a repeat.

But speaking to BBC Radio 4, Dame Janet said "I really was shocked to find how totally our system of death certification is dependent upon the honesty and integrity of a single doctor."

"Once you realise that you can have a dishonest doctor and a malevolent doctor, then it is obvious that under our system that doctor can get away with murder," she added.


The inquiry into Shipman's crimes closed nearly five years ago. Yet the government did not publish its Bill setting out the proposed reform of the coroner's system in England and Wales until January 2009.

Bridget Prentice
The possibility of something as horrific as Shipman will have very, very little chance of happening again
Justice Minister Bridget Prentice

The Coroners and Justice Bill includes plans for the appointment of medical examiners who will scrutinise death certificates and liaise with coroners on any issues of concern.

Dame Janet welcomes some aspects of the new legislation, but has concerns about other parts which are "not so good".

She is encouraged by plans to modernise the coroner system.

However, she says the new arrangements for death certification remain unknown, and will require secondary legislation, which may lead to further delays.

Until the details are known, she says she cannot see how the system will work.

In addition, she is worried about the status of the medical examiners.

"It is said that he or she will be independent, but I fear that that will be very difficult.

"I do not see how an employee of the primary care trust can be independent of the National Health Service," she said.

"I wanted that person to work alongside the coroner."


It is now 10 years since Harold Shipman, a family doctor from Hyde near Manchester, was charged with the murder of 15 of his patients.

He was found guilty, and sentenced to life imprisonment.

Dr Shipman committed suicide in Wakefield prison in 2004.

The inquiry found he had murdered at least 215 of his patients and probably many more, making him Britain's worst serial killer.

Dame Janet Smith investigated why his catalogue of killing remained undetected for so long.

She made a series of recommendations about the lessons which needed to be learned to ensure nothing like it could ever happen again.

But progress in implementing those recommendations has been slow.

Laurence Buckman, chairman of the British Medical Association's GPs' Committee, says there have been some positive changes - for example in the use of controlled drugs.

But he believes there is still much more to be done.

"I'm not sure that many loopholes have changed apart from a few technical ones. I'm not sure that the ways that doctors are policed by external forces will actually improve everything.

"It'll just make doctors more defensive, and that is not in patients' interests," he added.


However, Justice Minister Bridget Prentice told the BBC she was confident real progress had been made.

"The possibility of something as horrific as Shipman will have very, very little chance of happening again," she said.

"There will be this need to have two doctors examining certificates, there will be the opportunity for families to query what's on the death certificate.

"I think a number of aspects like that will make sure that we don't see another Shipman."

But she conceded that reform of the death certification could have happened earlier.

"It is unfortunate that it's taken as long as it has," she said.

Could Shipman Happen Again? was broadcast on BBC Radio 4 on Thursday 12 February at 2000 GMT.

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