Should there be tighter checks on doctors?

The Shipman trial has left people questioning how a GP could have got away with so many murders for so long.

Why was he allowed to carry on practising after spending six months in a drug addiction clinic? Why was his conviction for forging prescriptions glossed over?

Has this case made you think twice about automatically trusting your own GP? Will the doctor-patient relationship ever be the same? What about the thousands of respected doctors who have spent years earning their patients' trust? Would tighter regulations prevent something like this happening again?

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Your Reaction

Sure like all professions we need to monitor and regulate their activities, but that doesn't mean it should be a witch hunt. After all where do we go when we get a simple cold...the GP of course (and some say we don't trust them!). All trees have a few bad apples (old/new English saying!)
Alex John, U.A.E

I think the institution of GPs is so very redundant in today's world of specialised medicine and well-informed patients. What do the GPs have to offer anyways besides Paracetamol and Antibiotics??
Actually, to some extent we patients are to be blamed for discussing matters pertaining to wills with doctors, aren't lawyers supposed to be dealing with that???
Asha, UK

We feel now that we cannot trust doctors and will tremble at the sight of one.

Selena, Hong Kong

How does a person know to trust a doctor unless he or she knows that the doctor is trustworthy, i.e. that the doctor has been checked on? This gives us a feeling of security - it's like life insurance. We are human beings, and we feel. We feel now that we cannot trust doctors and will tremble at the sight of one.
The country should assure people by having tighter checks on doctors. People pay so much to their doctors - and what do they get in return - insecurity and death? If doctors are allowed to go scott free people shall think 'What's a doctor for? I don't need him or her, I'll be in better health treating myself.' Doctors were made to do a good job in peoples health but now that excludes them of a job because they are not doing it!! If they are being suspected of not they should be checked on!
Selena, Hong Kong

Please try to remember that most doctors are like most people - normal, hard-working, conscientious and keen to do the proper thing.

Anon, UK

I am the wife of a GP and have been angered and astonished by some of the e-mails you have published. Every day, in every country in the world, doctors care for their patients, often in the most difficult and distressing circumstances. Everywhere, from the Balkans and Africa to your local GP's surgery, there are men and women who devote themselves to caring for you. They help you with everything from hideous war wounds to rubbing false teeth (and yes, you should go to the dentist with those!)
So, please try to remember that most doctors are like most people - normal, hard-working, conscientious and keen to do the proper thing.
Even Dr Shipman was all of the above for most of his patients for most of his time as a doctor. I know this is true because my husband was his partner for many years.
Clearly though, something was terribly wrong in his actions to a particular group of patients. 'Normal' people, in whatever walk of life, do not kill people, so we must consider Harold Shipman's personality to be outside the realms of normality. I certainly do and would like to take this opportunity to offer my sympathies to the families who have been bereaved.
Of course, there should be proper and appropriate procedures in place to monitor the treatment and care of patients. In many places, such procedures already exist. But it is foolish to believe that any number of procedures will protect all of us all of the time. The next serial killer may be a grocer with a personality disorder, intent on contamination of a food product. Are you going to stop eating? I thought not! So please stop abusing GPs.
Anon, UK

I am a medical student here in the US in my first year. Recent news stories piqued the interest of many here when a major medical journal reported that physicians' mistakes are a leading cause of death in US hospitals.
What safeguards are in place in the UK's health care system to prevent or punish such mistakes, and would any of these translate to effective measures in the United States?
Michael Montazeri, USA

Last I checked physicians are human. That means they make mistakes and are far from being perfect. Each patient is responsible for his own health and can never trust one single doctor absolutely. And the authorities are also responsible to make sure that no criminals get to work as doctors. It is a major failing to allow a former drug addict to practise without having extensively tested his personality and keeping check over his work.
Vivien Cooksley, Cyprus

I doubt if there is a single decent conscientious doctor who would not welcome any effective way of weeding out the lazy, incompetent and wickedness from their profession. I would be very suspicious of any professional who failed to support such an eminently reasonable proposition.
S Stevens, UK

The stark reality that there were fundamental failings in many areas upon whom we rely for protection from evil abuses such as this. Why was Shipman not struck off when he was convicted previously? I would certainly lose my job if I were convicted of anything. Why was there no monitoring of statistical information on death rates among GPs? There have been many instances of failure in recent years which should leave us anything but confident of the professional competence of doctors - these sorts of checks would surely have flushed Shipman out. At the very least, wouldn't you check if the person had a criminal record? This is obvious for goodness sake - you don't need police training to work it out.
James Maxwell, UK

My mother-in-law believed exclusively everything her GP told her. So much so that when we tried to suggest other ways of making life better for her we were ignored because the GP had advised otherwise. I found this most disconcerting. I can quite see that Dr. Shipman's patients were so easily influenced by what he said that he could not be wrong. I think that old people are extremely vulnerable in this regard and there should be some measures to guard against this blind faith.
Wendy Ford, Great Britain

Doctors like any other sector of society come in all forms. Some good some bad but most of them somewhere in between. What is really frightening about the Shipman case is that the appropriate authorities can't even detect the really evil ones. Heaven help anyone who has a doctor in any category less than 'SAINT'. I do not feel it is good enough to shrug off requests for performance data anymore. Following the Bristol fiasco at least there is an awareness in hospitals that poor performance can not be ignored.
Richard Stott, Scotland

It shouldn't be a question of putting total trust in a doctor. The sensible thing is to listen to what a doctor says, go to the library, and check the textbooks. In this way patients can ask pertinent questions and contribute in decisions affecting their treatment.
Mike Holmes, Scotland

Having had a good rapport with my doctors over the years of moving, bereavement, cancer in the elder members of my family, I feel it would be going backwards to bear a grudge against all medical professionals. For doctors are people inside a category while they work for a salary. Going forward is by outside policing, an army has it's court marital and also is accountable to the civilian police. In fairness the whole complaints system needs to be radically changed to be accountable and stop delaying schedules which hinder proper representation. Shipman is now the reviled man of the second millennium, lets make him the last and put this lesson on 'wait and see' monitoring onto a more supportive policing of those with the powers of criminology.
Anne Badger, UK

The Shipman case has not affected the Trust I place with my Doctor. I feel some of the views expressed about this case are similar to saying that all builders could be like Fred West!
Suzanne Horner, UK

This is hardly an issue of trust in doctors as such. No one questioned faith in civil engineers after that maniac attacked the MP and killed his aide with a sword. It is rather a question of trust in the authorities - as usual. There were catalogues of errors going as far back as the seventies, when Shipman was convicted of forging prescription scripts to feed his own addiction. He was not struck off, was not even suspended and was later allowed to run his own practice under a health authority who knew nothing of his past. The question we should be asking is do we trust the health authorities anymore? Shipman was obviously a disturbed individual from day one but would he really have got as far had he not been emboldened by the ineptness of Britain's authorities?
Trevor Blayney, N. Ireland

The Shipman trial - a testimony to the pervasive abuse of power. The doctors should be reminded: the hands that heal should not kill.
Tajudeen Isiaka, Nigeria

The UK needs to adopt a zero tolerance policy for the professions that have the power of life and death. Admittedly, a genuine mistake may be made, but that mistake may have cost a life.
Terri, UK

Although I have two doctors in the family, I do not trust them to always know what is best for me. Over-prescriptions, unnecessary procedures, and general incompetence are not uncommon. The medical profession will have it's share of the "bad eggs" just like any other, and possibly more, as the rewards are high.
John Atkins, Singapore

I'm a working General Practitioner in Britain. I am just so upset that this monster has been killing people. I feel guilty as a doctor, I feel betrayed, I feel most of all anguish at the pain, suffering and torment this psychopath has caused to the families of all those he killed. But this GP, he has betrayed us, by doing the unspeakable, by becoming the living incarnation of evil he has tainted us all in the medical profession.
Dr Sion Williams, Wales

I think this is the time for all institutions to wake up and tighten there checks not only doctors, but also those who work in Social Services, Education etc. I will continue to trust my doctor though.
Grace, UK

I agree with earlier comments - it is important to avoid over-reaction and hysteria in response to the extraordinary and extreme case. I fear that there might be unnecessary restrictions in the use of morphine-derived painkillers by doctors, leading to unnecessary suffering. Also, as a firm believer in the basic human right to decide when one has lived long enough, I regret anything which would make it even harder for a sympathetic doctor to help a patient seeking a painless end to his/her life. (Naturally I refer to the patient's free and rational choice, not imposed by the doctor.)
Soleil Smith, France

I think there should be periodical "audit" of doctors' practice and prescriptions. On a less serious note, a lot of doctors prescribe antibiotics unnecessarily causing problems of resistant strains. There ought to be some sort of periodic evaluations of doctors. This will cut cost, determine if doctors are up to date with the current medical literature and prevent tragedies such as this one.
M Vishnu, USA

I think that any institution that expects trust from the public and gives authority to its members (such as teaching) should be looking at it's procedures as an ongoing process. It's too easy to ask these questions AFTER such an event. The problem with doing it this way is that it's easy to get caught up in the ensuing media frenzy and hysteria. In such circumstances, it may be hard to find the correct solution. We need to approach these issues with a clear head, and come up with RATIONAL, PRACTICAL procedures. We should also bear in mind that such events are extremely rare and we can never eradicate them entirely. My GP still definitely has my trust.
Tristan O'Dwyer, England

This story sums up the highlights inefficiency and failure in co-operation of The GMC, the NHS and the police. It should not be too expensive to hold a complete database of Dr's and Dr's that have a Criminal Record. When Dr Shipman got caught for forgery and theft he should not have been allowed to carry on as a Doctor and should definitely not have been allowed to open up his own surgery!
Suzanne C, UK

The conviction of the most prolific serial killer in Britain and possibly the world has not damaged the trust I have in my doctor. Fortunately, he is a one in several million chance and hysteria to the contrary is ridiculous. However, I do believe he should not have continued as a doctor after his initial forgery and theft conviction.
On the other hand, this man would have become a killer whatever profession he had been in. He is clever, conniving and very evil man.
Sophie, UK

In this computer age it should be not difficult or expensive to keep a much closer check on the prescribing profile of any GP. Also this terrible tragedy for the people of Hyde shows how the Medical profession should no longer be allowed to regulate itself via the General Medical Council (aka the Doctors Protection Council!)
Alasdair Cameron, Scotland

The medical profession is another area like child-minding or teaching, that has potential to attract the wrong type of person. It's easy to say that there should be some kind of ongoing assessment for doctors and paramedics, but my gut reaction is that this is not the solution because I know how much these kind of practises interfere with getting on with the job.
In any case, I feel that doctors are overworked, overstressed and underpaid for what they do, and it's a shame to see such a wonderful and important profession tainted by acts like this.
David W, UK

I feel for all of the responsible GPs who may be tainted by this. Being a doctor is known for being a stressful profession with higher rates of depression and addictions; any structure leading (rightly) to punitive action for drug misuse or other professional irresponsibility should also address the question of support for good GPs. Those who feel the pressure of their work and will no doubt feel it more if stringent supervisory powers come into effect as a result of this dreadful man's terrible crimes. Remember also the NHS can ill-afford the time and money needed for supervision and re-training, but could more sensibly keep data files on GPs regarding previous crime, prescribing habits and death rates, where glaring irregularities like the ones in Hyde could be spotted and acted on
Helen H, UK

It would probably come as a surprise if I tell you that Dr. Shipman's story is just the tip of the iceberg. Even more atrocities are being committed in our hospitals and elsewhere in the name of medical science with the collusion of some of our doctors and medical professionals. There is a race for the next medical discovery, and for new drugs, which involve mega bucks and many, many, innocent, unsuspecting and vulnerable patients are being used as martyrs at the altar of science. The atrocities that have been and are being committed would make some of the ones that went on in Dachau seem like child's play. Only a thorough and independent PUBLIC investigation will uncover the extent of what is going on. I hope the BBC do put this up, and not censure it as only an open and frank discussion on the matter will uncover this racket.
Selva Appasawmy, Mauritius

Of course GP's rates of patient mortality should be monitored -simple, more or less perfect and a boon to some budding civil servant! In the end we all die, but when people in their middle years start popping off, all in one practice, who checks ? If the suspicions of the close relatives hadn't been aroused in one singular case, Shipman would be still killing
Colin Lake, Wales

Asking if we trust the system after a doctor has killed fifteen patients, is like asking if one would willingly fly on an airline that just had fifteen planes crash. This doctor was able to go on practicing after a bout of drug addiction, and he was able to go on obtaining unreasonable amounts of morphine, and he had an unusual number of patients die in his surgery, yet it took an alert relative - not the system - to catch him. It's obvious that the system is not adequate. There is no question about it. If people choose to continue to trust the system, that's their choice, but there is no rational reason to do so. This system would, and likely will, allow another doctor to do the same as Shipman in the future, especially since we all now know the mistakes that caught Shipman out.
jon livesey, USA

The immediate aftermath of the Shipman case has quite rightly concentrated on the need for more rigorous regulation arrangements for GP's. I think that part of the problem has been the contractual relationship with the Health Authority that enables GP's to be quasi-independent contractors for their services. Fundholding simply legitimised through financial independence, the lack of capacity for external scrutiny. Compare the proportionate rates of strike off with any other public service such as teachers or social workers and Local Government is seen to be a far more effective regulatory body than the BMA (the most effective Trade Union in the world a GP once remarked). I do think that the advent of Primary Care Groups/Trusts and mechanisms such as Clinical Governance should go some way to rectifying such regulatory anomolies. But the solution, I believe, lies in reconfiguring the contractual relationship such that there are far more salaried GP's as a proportion of the total workforce. We may then get GP's in general being far more interested than at present in issues that affect their localities that effect health, such as poverty and poor housing. This leads on to the final point - many single-handed GP's work in inner city areas where there are large vacancies and there will need to be some incentive arrangement to attract GP's to such areas if the inquiry expresses concern at the concept of single GP practices.
Andy Millward, England

I approach doctors now as if they are flawed until proven competent. They have to earn trust and faith. Trust and faith blindly given, is very dangerous. Doctors receive far too much clout in society and are far too egotistical for their own good. They're no different than people found in any other field of employ. Some are geniuses, some are skilled, some are average, some are substandard, some are drug addicts, some are total criminals... People place greater scrutiny on their plumber or auto mechanic than they do regarding their doctor. Always keep a close eye on what your doctor does, and if there seems to be something wrong, perhaps there is something wrong. You're the patient, you're the customer, you are the boss, the doctor is there to serve you and make certain that your doctor knows that. It is you who has to endure the consequences of the Doctor's behaviour.
Steve Kenney, USA

It's sad really. This man must have had a hatred for women above 50 years old as his own mum didn't make it there. It's too late to help him now, he's caused too much anger and pain. This is calculated murder, not the result of a broken being. The 'dodgy doctor' is best behind bars .
lynda garner, UK

These crimes were carried out by a man who is obviously insane. No doubt he would have found a different way to quench his bloodlust had he have been in a different profession so why tar all doctors with the same brush ?
Stephen P Anchor, UK

I am horrified at the facts of this case. With due respect to the relatives of the victims I would like to pay my respects and I have great sympathy for the victims. I hope no other cases like this ever happen again.
Ayub Khan,

It worries me somewhat that this man was allowed to continue practising even though other doctors had their suspicions about him. It worries me more that these doctors did not raise Dr Shipman's high number of patient deaths with the relevant authorities. The revelation that Dr Shipman may have killed up to 1500 people, coming a few weeks after a report from the US about a doctor who carved his initials into the stomach of a woman whose baby he had just delivered by caesarian, is disturbing indeed. Surely there should be some independent body, not necessarily medical, which could investigate issues of malpractice?
Grainne Phillips, Ireland

I can't believe that someone like a doctor could get away with murdering 15 people without anyone noticing. Doctors are people we are supposed to trust. This case just goes to show how much people can get away with without anyone realising. There needs to be more checks done on doctors, especially when it comes to a large amount of deaths.
Elaine Howard, England

A few years after the state or insurance sponsored medical welfare system appeared, I lost my trust in the interest of the doctors to do their work properly. When having to see a doctor for minor ailments have always counter checked their diagnosis and prescriptions. Some of them are still good. The less state interference in the compensation or insurance the greater portion of good doctors who really try to do what they are supposed to do. It is not the doctor's fault it is the fault of the sponsored medical welfare that has converted the medical industry into a relentless money-milking cow. The Shipman case is an exception and cannot be included into general discussion of a trust in the medical profession. There are exceptions in every profession. mikko toivonen, finland
mikko toivonen, finland

I've never had unquestioning confidence in any doctor. I always question the effects of medication and side effects. GP's are notoriously incompetent.
Jim Slip, Scotland

I don't know how this Doctor got away with this for so long. The best thing for him is to get the same treatment he gave his patients, except make it a longer death rather than short. I still trust my Doctor as don't see why I should see him as a threat just because of that idiot.
Babs, Scotland

I think that this is a shocking case but we must not generalise. Not all doctors are like this and we must trust our doctors as we have previously. Obviously this is an horrific case, which should never have had the chance to occur. Once Dr Shipman had previous convictions I think the public that he was serving and who trusted him and put their lives in his hands, had a right to know his past history. More stringent guidelines need to be introduced as to doctors and their professional conduct.
Amy, UK

I think all professions which deal with human life and death should be subject to strict scrutiny - the trouble is that it should not go so far as to persecute a person for an honest mistake. The question is where do we draw the line? Unfortunately I don't think doctors should be allowed to draw that line for themselves.
Kate, UK

I'm am shocked & horrified that this doctor was able to murder so many, all women. The question has to be asked how these murders went undetected. My sympathy and my prayers go out to all the families, friends and the people of Hyde in their grief, horror and anger. Why, why, I ask myself, how this man could kill and nearly got away with it.
Jenny Rothwell, England

GPs, as their name suggests - General Practitioners - only possess broad medical knowledge and are experts in no area. The public should be made more aware of this and therefore question their doctor vigorously at every stage of the treatment process. They should always get second opinions if they are unsure of any aspect of treatment he or she is offering. Many GPs are good but there is an equal number that are, at best complacent and patronising and at worst, downright dangerous by what they may or may not do. How many times have we heard about a family doctor missing cases of meningitis, or dismissing them as something trivial. Patients should be cynical of all GPs until proven otherwise, that's if they can get an appointment to see them. I recently had to wait ten days to see mine, which meant the problem had cleared up by the time the allotted date arrived.
Henry Nugent, UK

Yes there should, but not because of Dr Shipman. Dr Shipman, for all the hysteria heaped on this case, was a mad man working alone - a one-off. What happens much more frequently is malpractice (sexual, for example) and that the doctors who commit it do not get struck off the register, or punished, half as much as they should.
Wendy, UK

Perhaps there is some justification in calling for an end to "lone practice doctors"; GPs, like everyone else, can make mistakes, and some degree of cross-checking should be available in their day-to-day work. However, some of the comments appearing on this page are quite astounding. I think some advice is in order: if you "distrust your GP", and regard members of the medical profession with scepticism, then fine. Next time you're seriously ill, don't bother your already overworked GP - go to a faith healer, witch-doctor, or pray. Wait a year or so, then reassess the value of your doctor. I believe there is a trend in the UK, probably cultivated by our American colleagues, who are accustomed to suing doctors who leave scars after performing life-saving operations, to "knock down" highly skilled professionals, perhaps to make those who are less well qualified feel on more equal terms. We should not allow the activities of Shipman to open the floodgates to brainless US-style litigation and constrictive legislation for every GP in the land. If we all lived in the 17th century, we wouldn't have the luxury of criticising a medical profession which does so much to relieve illness and suffering. My GP is worth her weight in gold.
Mike Sander, UK

While this crime is clearly awful, one should be careful not to tighten up the systems of checks and balances too far. We are, after all, dealing with a complete aberration ... however disgusting and mind blowing it may be. A careful and considered review of the processes that vet our medical staff is necessary, but in the fullness of time ... knee jerk reactions, built on media sensationalism, would be equally wrong.
Mark M. Newdick, USA/UK

The anti-medical hysteria generated by the criminal actions of Shipman are getting completely out proportion. Our serial killers have been lorry-drivers, civil servants, builders and retired policemen, all of whom used "trust" to entrap their victims. To villify this country's overworked health professionals on the basis one criminal is ridiculous. "Zero tolerance" says one of your correspondents, presumably in relation to Shipman's previous drug conviction. Fine, perhaps we should seek state registration for all our plumbers, electricians, taxi drivers and journalists - and prevent them from ever working again if they are convicted of a criminal offence. Get a grip, please.
R.Aspinall, UK

I am a friend of the son of Dr Shipman and I feel the way that the BBC has reported the case has been unfair on Dr Shipman's family, as they have been hounded by reporters when it is not their fault what Dr Shipman has done. I also feel that if Mrs Shipman wishes to stand by her husband then that is her choice and she should not be front page news because of her choosing to stand by the man she loves. The next time a case like this occurs, if ever, the BBC should report it with more concern towards the family of the accused and of the victims. It also disappoints me that the people of Hyde who have been quite happy with Dr Shipman , are now accusing him of killing their relatives just because they died under the care of Dr Shipman.
Jonathan Whittle, england