GMC Injustice

Harold Shipman trained at Leeds University, practised as a house officer at Pontifract Infirmary and then went into general practise at Todmorton. It was whilst at Todmorton that he was charged with drugs offences and received the maximum penalty that a magistrates court could give him. He spent some time in the Retreat in York as he was said to be addicted himself.

As a result he was referred for the first time to the GMC. In spite of the maximum sentence psychiatrists pleaded for him to be allowed to remain in practice and the GMC demured. Apparently no alarm bells rang then. Dame Janet Smith pointed out they ought to have done given the severity of the sentence whereas Robert Gray giving evidence for the GMC claimed that Harold Shipman was a young doctor who had temptation put in his way.

The Shipman Inquiry on investigation concluded that Harold Shipman had begun killing patients as early as in his house jobs at Pontifract.

In 1985 the parents of a young man who had died under Shipman's care made a complaint to the GMC. Dr John Walton, now Lord Walton was the screener. Again no alarm bells rang or if they did they were silenced in favour of Dr Shipman by Dr Walton.The account of the referral and Dr Walton's ineffective dealings as sole screener of the case have been highighted on the Shipman Inquiry website as an Annex to a witness statement from Finlay Scott former Chief Executive at the GMC.

The Annex reads as follows:

Part 1: History

1. On 23 August 1985 Mr XXXX made a complaint abour Dr Shipman to the GMC concerning the death of patient YYYY. In summary the complaint was as follows:

a. He did not perform a concientious assessment of the history, symptoms and signs of Mr YYYY's condition.

b. He did not make a sufficiently thorough examination/diagnostic investigation of Mr YYYY's condition.

c. He did not take prompt and appropriate action suggesting the existence of a condition requiring urgent medical intervention.

d. He failed to consult appropriate professional colleagues

e. He abused his professional position by breaching a confidence.

2. Mr XXXX's account of the facts was as follows:

a. Mr YYYY registered with Dr Shipman in about 1977

b. Over the next 7 years, he was treated from time to time for a troublesome cough in the winter. In 1984 and 1985 he suffered attacks of breathlessness, which Dr Shipman advised were psychosomatice. From February 1985, he became progressively more ill, losing weight and coughing blood, developing clubbing of fingers.

c. Mr YYYY saw a consultant privately on 20 June 1985. After conducting tests, he diagnosed viral pneumonia and possible TB. He was treated for pneumonia in hospital for a week. He was discharged on 2 July 1985.

d. He became ill again on 9 July 1985 and was admitted to hospital on 11 July 1985. He died on 19 July, age 29.

e. Another patient, Mrs ZZZZ, who was an acquaitance of Mr XXXXX approached Dr Shipman, with her husband, at a social event and said she was concerned that she had had contact with a suspected TB carrier and because of her pregnancy would be arranging a screening. Dr Shipman disclosed that he knew that they were talking about Mr YYYY and referred to matters which they already knew, but which were contained in Mr YYYY's medical records. Mr ZZZZ later visited Dr Shipman and they discussed the post mortem report. Since the ZZZZ's remained on Dr Shipman's panel they were not willing to substantiate Mr XXXX's allegation.

3. On 6 September 1985 Mrs Zincke, Administrative Assistant at the GMC, referred the matter to Mr Howes, Head of Conduct and Performance, who approved her draft of the letter sent on 9 September 1985.

4. On 9 September 1985 Mrs Zincke replied to Mr XXXX explaining that responsibility for the consideration of complaints about treatment or lack of treatment by a general practitioner should be addressed to the local Family Practitioner Committee. After investigation, the case might be referred to the GMC by the FPC or Mr XXXX could write again to the GMC. Although action by the GMC was not dependent upon the findings of a NHS authority, it was not the GMC's practice to undertake inquiries while investigations by an authority were in progress. The allegation of breach of confidence had been referred to the President of the GMC.

5. In an internal memorandum dated 14 Octopber 1985, Mrs Zincke referred the allegation of breach of confidence to Mrs Horne, Senior Administrative Officer at the GMC. Mrs Horne sent a memorandum to Mr Gray, Deputy Registrar of the GMC stating,

"It appears from the information that Mr and Mrs ZZZZ may be the only persons able to give direct evidence as opposed to hearsay evidence of the breach of confidence. It seems to me that the complaint could not proceed in the absence of their support. I have therefore revised the draft letter to Mr XXXX to draw his attention to this point."

6. Mr Gray agreed with Mrs Horne and referred the matter to the President, Mr Walton . The President wrote on 20 October 1985:

"I agree; without the ZZZZ,s the 'evidence' relating to breach of confiodence is hearsay only."

7. On 21 October 1985, Mrs Horne wrote to Mr XXXX stating:

"I am writing further to the Council's letter of 9 September concerning your allegation of a breach of confidence by Dr Shipman. The President of the Council has asked me to explain that it would be open to the Council to institute disciplinary proceedings against Dr Shipman only if you were able to provide evidence that he had breached professional confidence by improperly divulging to a third party information about Mr YYYY which he had obtained in the course of his professional work.

It appears from the information that you have provided that Mr and Mrs ZZZZ may be the only persons in a position to provide direct evidence of this matter. If Mr and Mrs ZZZZ would be prepared to make sworn statements in the form of statutory declarations to the Council, and if you also made a statutory declaration setting out a formal complaint against Dr Shipman, the President would consider whether your complaint would justify disciplinary action by the Council. A solicitor would advise you in the matter of preparing statutory declarations."

8. These matters were not brought back to the GMC by any of the parties involved.

A number of points arise from this referral and from the GMC's own account of it:

1. Alan Howes was not head of conduct and performance in 1985 as the GMC have claimed. He was an assistant registrar, i.e. a junior clerk under Robert Gray. The GMC appears to be seeking to bolster its postion to give authority to the decisions they made at this time and to also divert responsibility away from the screener.

2. A GP who considered the information in the Annex stated that Shipman was obviously negligent from the outset as was the GMC for failing to act at all on these facts. He failed to take a proper history and failed to properly examine a young man with a seven year history of returning to him with increasingly worsening symptoms. Any competent GP would have done differently and the young man would have had proper treatment at a much earlier stage.

In other words Shipman breached the GMC Blue Book rules and ought to have been dealt with by the screener if the screener was a competent doctor taking his responsibilities seriously rather than protecting Shipman. Any competent GMC clerk would have looked up Shipman's previous record when this complaint came in and flagged it up as an addendum to the complaint. It is surprising they did not unless they did so and the Annex has been doctored to protect Dr Walton as the screener.

3. It would have been useful to know whether this young man died in hospital and in a single room where anyone could visit unnoticed or at home. Shipman would have known by the time he saw the private consultant that he had been negligent. One wonders why Shipman never referred him to an NHS consultant unless he refused to do so and had formed the view that the patient was a general nuisance, which was not unusual so it is said of Shipman.

4. Whether or not the GMC's arguments for not dealing were right at the time they are not ethical. The GMC and Dr Walton in particular, as the man with the final word, made it to difficult for the complainant, who was the deceased father to raise a proper complaint. In effect the reply to the father was go to a solicitor and "it will cost you money".

5. The GMC and Walton in particular is known to sweep aside any hearsay rule when it suites them. The evidence for this is found in Dr Colman's screeening papers and also in the 1987 hearing when "witnesses" could not detail or date the supposed events they were paid to turn up and give an account of by the GMC.

6. Dr Walton did not give evidence at all to the Shipman Inquiry and the GMC and their solicitors continue to take extreme measures to protect him and at all costs although he left the GMC in 1989. Ultimately had John Walton have done his job properly then Shipman would have been apprehended earlier. People's lives might have been saved if John Walton had acted because we know that Shipman began his killing as a house officer some years earlier.

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