Shipman Inquiry
Background
Harold Fredrick Shipman was convicted at Preston Crown Court on 31 January 2000 of the murder of 15 of his patients while he was a General Practitioner at Market Street, Hyde, near Manchester and of one count of forging a will. He was sentenced to life imprisonment.
Police have also investigated allegations that he may have murdered many more patients while he was a GP in Hyde and Todmorden.
Inquiry
On 1 February 2000, the Secretary of State for Health announced that an independent private inquiry would take place to establish what changes to current systems should be made in order to safeguard patients in the future. Although it would be held in private its report would be made public. The private inquiry, under the chairmanship of Lord Laming of Tewin, began work on 10 March and was charged with reporting its findings and recommendations to the Secretary of State for Health and the Home Secretary by September 2000.
Many of the families and sections of the British media sought a Judicial Review in the High Court, which found in their favour and recommended that the Secretary of State for Health reconsider his decision that the Inquiry should be held in private.
In September 2000, the Secretary of State for Health announced that the Inquiry would be held in public under the terms of the Tribunals of Inquiry (Evidence) Act 1921. Both Houses of Parliament ratified this decision in January 2001.
Dame Janet Smith DBE, a High Court judge, was appointed Chairman of The Shipman Inquiry and the work of the independent public inquiry began in February 2001. The public hearings into Phase 1 began on 20 June 2001. The public hearings into Phase 2 began on 7 May 2002.
The Inquiry's First Report was published on 19 July 2002 and its Final Report on 27 January 2005.
The Shipman Inquiry web site can be accessed at: http://www.the-shipman-inquiry.org.uk/
Northern Ireland
On 12 January 2004, evidence was presented to the Shipman Inquiry by
Dr Mike Mawhinney, accompanied by Dr Norman Morrow, the Chief Pharmaceutical Officer (CPO) for the Department. Dr Mawhinney gave a presentation outlining the system of monitoring and inspection of controlled drugs arrangements in Northern Ireland and both he and Dr Morrow answered questions raised by participants to the seminars. A link to the summary of evidence provided by Northern Ireland can be viewed at: http://www.the-shipman-inquiry.org.uk/4r_page.asp?ID=3196
During the Inquiry, Dame Janet Smith positively acknowledged the existing arrangements in Northern Ireland.
She commented:
“I was very impressed with the way in which the system of inspection of arrangements for controlled drugs operates in Northern Ireland. The centralised nature of the Inspectorate, and its integration with the Department, confer undoubted benefits. I agree with Dr Grenville that the size of the province makes it suitable for a centralised Inspectorate, whereas England would require a regional Inspectorate.
It seems to me that the main advantage of the system in Northern Ireland is that the Inspectorate covers all aspects of the use and abuse of controlled drugs. On the mainland, the arrangements for inspection are fragmented. Although the HODI has overarching responsibility for controlled drugs, its efforts are focussed mainly on import and export control, the inspection of manufacturers and large-scale suppliers and the issue of licences. With its present resources, it cannot be closely involved with the issues that arise in connection with pharmacies, doctors and poor prescribing practice. In any event, the HODI has no medical or pharmaceutical expertise; it is an investigative organisation with law enforcement functions. Pharmacy inspections are carried out by police CIOs who, individually, may be very interested in and focussed on controlled drugs but are part of an organisation that is not particularly interested in such matters. They too have no real medical or pharmaceutical expertise. There is no proper arrangement for the inspection of GPs' surgeries or dispensaries or for the provision of advice to GPs. PCTs have a great number of other responsibilities and cannot be expected to focus on controlled drugs. The PPA does an excellent job but has no clearly defined links with inspection systems. It seems to me that there is
much to be said for an inspectorate, like that in Northern Ireland, which is focussed solely on its responsibility for the inspection and monitoring of all aspects of controlled drug use.”
The DHSSPS report to the recommendations contained in the Shipman Inquiry Reports 3, 4 and 5 entitled "Improving Patient Safety - Building Public Confidence" contained an Action Plan designed to take forward a number of proposals to improve quality of care and patient safety.
