Shipman report finds doctors put own interests ahead of patients'

Britain's doctors are still imbued with a club culture that puts their interests before the patient, a damning report into the activities of the serial killer Harold Shipman declared yesterday.

The watchdog that is supposed to regulate doctors was accused of operating a closed shop for the mutual protection of colleagues instead of acting to protect the public.

The inquiry into the crimes committed by Shipman, a Manchester GP who murdered at least 215 patients, concluded that there were fundamental flaws in the General Medical Council (GMC), which was heavily criticised for failing to protect patients from rogue doctors. Although it was cleared of blame for the deaths of Shipman's victims, because no one gave it the information that might have led to the discovery of his crimes, the GMC was still too focused on being "looking after its own", the report said.

In a clinical dissection of its failings, the High Court judge Dame Janet Smith, who chaired the inquiry, said despite efforts to change, the organisation remained too reactive, with a culture described as something between an old boys' club and a trade union for medics.

"The old culture of protecting the interests of doctors lingers on for the majority of GMC members," Dame Janet said. "A significant change of culture is necessary ... However, I do not feel confident that it will do so."

The 1,300-page report lists more than 100 recommendations for change of which more than half are targeted at the GMC. It is the fifth report from the inquiry into the GP serial killer, jailed in 2000, which was set up by the Government to try to protect patients in the future.

It only just stops short of recommending the abolition of the GMC, but says its investigatory and judicial functions must be separated, with an independent body set up to hear disciplinary cases.

It should have a majority of lay members, up from the current 40 per cent, and there should be more lay members on its disciplinary committees. The GMC should also be accountable to Parliament, the report said. Dame Janet implied that the GMC was living on borrowed time, recommending an independent review of its fitness-to-practice regime within three to four years.

"Having examined the evidence, I have been driven to the conclusion that the GMC has not, in the past, succeeded in its primary purpose of protecting patients," Dame Janet said. "Instead, it has, to a very significant degree, acted in the interests of doctors."

The GMC said it had put in place the biggest reform programme in its 150-year history, with big changes to the way it investigates and disciplines doctors brought in last month, and new five-year checks on doctors to come in next April.

But Dame Janet said the reforms did not go far enough. "I am by no means convinced that the new GMC procedures will adequately protect patients from dysfunctional or under-performing doctors," the report states. "I have concluded there has not yet been the change of culture within the GMC that will ensure that patient protection is given the priority it deserves."

Shipman, who worked at a one-man practice in Hyde, Greater Manchester, murdered patients by lethal morphine injections. He was allowed to carry on practising by the GMC despite being convicted of drug offences in 1976 after becoming addicted to pethidine as a young doctor. Although he had a very high death rate among his patients, other doctors did not raise concerns to stop his 23-year killing spree.

Dame Janet said: "One of the fundamental problems for the GMC is the perception, shared by many doctors, that it is supposed to be 'representing' them. It is not - it is regulating them."

She praised proposals for regular checks on doctors' performance - the five-yearly "MoT for medics" known as revalidation - but said the GMC had been "in retreat" since they were put forward and they were now so watered down they would not be effective. The report said there should be a whistleblowing hotline so members of the public can raise concerns about doctors.

Dame Janet said the "prevalent" attitude among doctors was that "it was not done" to question and report a fellow doctor to the GMC. "The culture of unwillingness to report doctors is still there," she said. "It must go. There can be no room today for protection of colleagues when the safety and welfare of patients are at stake."

The reportSafeguarding Patients: Lessons from the Past - Proposals for the Future will be sent to the Department of Health.


* Investigation and judicial functions of GMC to be separated

* New independent tribunal to be set up to adjudicate on disciplinary cases

* More lay members on the GMC so doctors no longer have majority

* More lay members on disciplinary panels

* GMC to be accountable to Parliament

* Five yearly "MoT" checks of a doctor's performance, called revalidation, to be strengthened

* Telephone helpline for whistleblowers so the public can raise concerns about a doctor

* Strengthened arrangements for complaints handling and investigation by GP practices

* Central database of information for the public on doctors

* Improved monitoring of prescribed drugs

* Department of Health to set up a system for monitoring GPs' death rates

Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Project Implementation Executive

    £18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Chiropractic Assistant

    £16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

    Recruitment Genius: Digital Account Executive - Midlands

    £18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Web Developer

    £28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

    Day In a Page

    NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

    Who's monitoring the outsourced NHS services?

    A report finds that private firms are not being properly assessed for their quality of care
    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
    How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

    How do Greeks feel about Syriza?

    Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
    From Iraq to Libya and Syria: The wars that come back to haunt us

    The wars that come back to haunt us

    David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
    Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

    Too busy to surf? Head to The Pool

    A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
    Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

    UK's Major Tum to blast off on a spice odyssey

    Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
    John Harrison's 'longitude' clock sets new record - 300 years on

    ‘Longitude’ clock sets new record - 300 years on

    Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
    Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

    Let the propaganda wars begin - again

    'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
    Why Japan's incredible long-distance runners will never win the London Marathon

    Japan's incredible long-distance runners

    Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
    Why does Tom Drury remain the greatest writer you've never heard of?

    Tom Drury: The quiet American

    His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
    You should judge a person by how they peel a potato

    You should judge a person by how they peel a potato

    Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
    Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

    Bill Granger cooks with fresh cheeses

    More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
    Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

    Shay Given: 'This FA Cup run has been wonderful'

    The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
    Timeless drama of Championship race in league of its own - Michael Calvin

    Michael Calvin's Last Word

    Timeless drama of Championship race in league of its own