Doctor reforms to avoid another Shipman ‘must not be delayed’

Eleven years after the former Todmorden GP was jailed for murdering at least 215 patients, the Health Select Committee says the system of “revalidation” – under which doctors would be assessed through their career to weed out those who are not fit to practise – must be introduced by the end of 2012 after a series of delays.

Instead of allowing doctors to go through their entire career without any formal assessment of their competence, the new system would introduce annual appraisals and more thorough reviews every five years, doctors being expected to demonstrate they meet clinical standards and have kept up to speed with the latest medical developments.

Audits of how patients fare after seeing their doctor will also be included, while patients would be able to have their say, but MPs said the system had taken too long to implement by the General Medical Council (GMC) and questions still remain over how it will deal with doctors who cause concern.

Committee chairman Stephen Dorrell said: “You can never be sure, but in the Shipman case it was very clear in the statistics that there was something of a doctor who was an outlier, and questions should have been asked.”

His committee concludes: “Now that late 2012 has been set as the date of implementation, we look to the GMC to ensure that there are no further delays and that the current target date is achieved.”

Today’s report comes more than a decade after Shipman was jailed for life in January 2000 for murdering 15 patients while working in Hyde, Greater Manchester. An official report later concluded he killed between 215 and 260 people over a 23-year period, mainly in Hyde but also earlier as a GP in Todmorden, West Yorkshire.

Dame Janet Smith, who headed the inquiry into the killings, condemned the weaknesses which had allowed Shipman to cover-up his activities and failed to protect patients and was scathing of the GMC, whose culture, membership and methods of working were said to support the interests of doctors rather than protect patients.

During the MPs’ inquiry, Una Lane of the GMC was asked whether revalidation would stop “another Shipman”.

She replied: “I think there is a general view that good local systems and good robust systems, if they produce the right information, and if that information is monitored appropriately, can identify outliers and at least enable a further investigation to take place. Once revalidation is introduced, will that mean that no doctor will ever deliberately or negligently damage a patient again? Absolutely not. We absolutely cannot say that.

“Do we think it can contribute to lowering the risk? Do we think that it can contribute to helping identify poorly performing doctors at an earlier point in the process? Yes, we think it can.”

Niall Dickson, chief executive of the GMC, said introducing the system by the end of 2012 was the organisation’s “number one priority” and welcomed the report.

Today’s report also raises concern over the checks carried out before European doctors practise in the UK after German-based locum Robert Ubani, who was born in Nigeria, accidentally killed a patient with a massive overdose during an out-of-hours shift.

MPs said it was “fundamental to good medicine” that doctors could communicate effectively with patients amid claims from the GMC that European Union rules means the GMC is unable to check levels of English.

Mr Dorrell said: “To suggest you can operate as a doctor without being able to communicate with your patient frankly, to me, is absurd.

“If the GMC don’t feel they have the power to assert that principle then, in an adult world, they should say so publicly.”

The GMC said it is “determined to find a solution” and is working with Ministers and Department of Health officials to protect patients.