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Mr. Milburn: I am grateful to the hon. Gentleman for his support. Let me begin with his last point. Part of the review by my right hon. Friend the Home Secretary will involve examining the role and functions of the coroners service, and deciding what measures are needed to strengthen it. There are important lessons here for both the coroners service and the registrars service. Given the amount of information that comes their way, both coroners and registrars should be in a position to take an overview of what is happening in a particular locality--of, for instance, the rate and type of deaths, and the cluster of mortality statistics. That did not happen in this case, and I think the inquiry should consider why it did not happen, not necessarily in order to penalise anyone but to learn some lessons, and to ensure that we get the arrangements right for the future.

As for Harold Shipman's past practice, I said in my statement that the chief medical officer would undertake an audit. It will be an audit of all Harold Shipman's past practice, and the deaths that occurred during his time as a GP over two and a half decades. I think that that is the right thing to do: I think that the public, and former patients of Harold Shipman, deserve that reassurance. The chief medical officer will appoint expert clinicians to lead the process, and we will try to ensure that the audit is undertaken and completed as quickly as possible.

The hon. Gentleman mentioned pharmacists and controlled drugs. That is a terribly difficult area, and it is perhaps now clear that some of the practices, processes and procedures need to be examined again. The problem

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arises when a GP collects a controlled drug from the pharmacist, says that he is going to prescribe it to a patient and does not do so, or prescribes only part of it. We need a system that can deal with such potential problems, without denying the flexibility that GPs sometimes need. They may need access to controlled drugs if, for example, there has been a road traffic accident.

We must try to get the balance absolutely right. I do not pretend for a moment that it will be easy, but it is right for us to examine the issues now. As I said in my statement, I think that the inquiry will want to look very closely at the role and conduct of the General Medical Council, how it is constituted and its structures, processes and procedures.

Mr. David Hinchliffe (Wakefield): I welcome my right hon. Friend's statement. Those of us who know Lord Laming are well aware that he will do a thorough and sensitive job.

May I press my right hon. Friend on three key issues that I think should be included in the inquiry? He mentioned the role of the coroner. Will the inquiry examine the wider role of the coroners office in evaluating local trends in reported deaths? It seems astonishing that no one in the area where Shipman practised spotted what was going on. That is a key point, which we need to look at urgently.

Can we look not just at the role of the GMC, but at its wider relationships with other health bodies, which are crucial to understanding what went wrong in the 1970s? I remain to be convinced that the problems that occurred then could not reoccur. I support the comments by the hon. Member for North Devon (Mr. Harvey), the Liberal Democrat spokesman, on a lay majority on the GMC, which would bring increased public confidence.

As my right hon. Friend will probably be aware, in October, the Select Committee on Health produced a report of direct relevance to those issues. The Government have not responded to that yet. I hope that they will, bearing in mind some of the issues arising from the Shipman case.

As well as, obviously, addressing the issue of single-handed practices, will the inquiry look at the relevance of the independent contractor status of GPs, which has some direct connection to the issue of accountability and standards?

Mr. Milburn: I am grateful to my hon. Friend. I apologise for the delay in responding to the Select Committee's report. Clearly, we need to do that, and will respond in due course.

My hon. Friends's first question was about the coroners service. The answer to that question is yes. On the GMC's constitution and the way in which the GMC relates to the broader national health service, I am sure that that will be a matter for the inquiry and that it will look carefully at the GMC's role. As the Government have always made clear, professional self-regulation is under test. There is broad agreement now that professional self-regulation has to be more accountable, more open and more modern. The inquiry will look at how that can best be achieved in the light of the Shipman case.

I broadly take the view that independent contractor status has served the NHS pretty well over the past five or so decades. It is important that there are alternatives

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for GPs, particularly newly qualifying younger GPs who sometimes might want not to go into a practice and become a partner, but opt for the salaried route. As a matter of policy, we have been determined to open that as an option, but it is important that GPs, as they come through, train and come into the NHS, have a real choice about their future career and about the employment structure that best suits them.

Sir Brian Mawhinney (North-West Cambridgeshire): Does the Secretary of State accept that his decision to put in place an inquiry is entirely welcome and that his choice of Lord Laming, with whom I have worked, will command support and confidence among Members on both sides of the House? Will he accept the thanks to him from Members on both sides of the House for his differentiation between one evil man and the broad mass of GPs who serve their constituents and their patients with dedication, professionalism and care? Perhaps he would consider using existing communication mechanisms to draw to the individual attention of GPs throughout the country his supportive words, those of my hon. Friend the Member for Woodspring (Dr. Fox) and other right hon. and hon. Members.

Will the Secretary of State confirm that the inquiry will look at the role of the police relative to Dr. Shipman? What police force will conduct that part of the investigation on behalf of Lord Laming?

Mr. Milburn: I am grateful to the right hon. Gentleman. I am particularly grateful for his support for Lord Laming, with whom I know that he worked closely during his period at the Department of Health. I am sure that he is right to say that GPs will be looking at, and listening carefully to, the comments in the House today. Rightly, they will want to feel that their interests are being protected alongside those of the patients. Although it is sometimes tempting to differentiate between the interests of patients and those of GPs, I prefer to think that, if we can make some changes, that will benefit both GPs and patients. I am sure that his sentiment--that the overwhelming majority of family doctors will be as appalled as hon. Members are about the activities of one evil GP--is absolutely right.

We have to ensure that it does not happen again, and that, together, we--the Government, the other parties in the House and the medical profession--take the appropriate action and get on with it. In my view, the worst thing that could happen would be to pretend that it can be business as usual; it cannot. We cannot stick our heads in the sand or pretend that this awful set of events has not happened, because it has. We must take whatever action is necessary to ensure that it does not happen again.

We have not contemplated bringing in an outside police force, which is more properly an issue for my right hon. Friend the Home Secretary. However, alongside Lord Laming, expert assessors--one from a medical background and one from a legal background--will be charged with examining the role played by the various statutory agencies, including police, in the investigation of the Shipman case.

Mr. Kevin Barron (Rother Valley): Will my right hon. Friend confirm that the public inquiry will examine not

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only the role of the General Medical Council in this dreadful affair, but its current responsibilities and whether there have to be any changes?

Mr. Milburn: Yes, the inquiry will. I am sure that the GMC itself will have heard, and I hope will respond positively to, the views that have been expressed today in the House, and I think that it will recognise that there are some important lessons to be learned about how it behaves in such situations. The Government stand ready to listen not only to the inquiry's recommendations, but to the views of the GMC on how its performance could be reshaped after the Shipman case.

Mr. Douglas Hogg (Sleaford and North Hykeham): The right hon. Gentleman has spoken of the possibility of trying Dr. Shipman for other offences. Will he keep in mind the fact that, in view of everything that has been said in the past 24 hours, it will be very difficult to give him a fair trial?

Although it must be right to strip Dr. Shipman of his pension entitlements, will the right hon. Gentleman keep in mind the separate position of his wife? It must be fair to consider her separately.

It is obviously right to hold an inquiry, but will the right hon. Gentleman be cautious about scapegoating? The truth is that great evil, like great good, is not all that easy to recognise. Furthermore, a propensity to take drugs is not the same as a propensity to kill.

Mr. Milburn: I certainly agree with the right hon. and learned Gentleman on the issue of scapegoating. Obviously, there are questions to answer in the matter, and that is right and proper. The case has been an horrendous set of events and, with the great benefit of hindsight, it is crystal clear that something was going enormously wrong with Harold Shipman's practice. Ultimately, the agencies that are constituted in statute are accountable to the House, and it is right that they should account for how they performed and dealt with a set of very difficult and complex matters in Greater Manchester. That is part of the purpose of the inquiry.

I stress again, however, that I really do not want the inquiry simply to turn into an investigation of past events. We already have a public inquiry, we have had a lengthy and difficult court case and we have had a trial. It is right that the inquiry should investigate the failures that may well have occurred in the systems, but it should also look forward and make positive recommendations about how we can strengthen and change those systems for the future.

I have to bear in mind the issue of pension requirements and Harold Shipman's wife. I have a judicial role in pension forfeiture, and I shall perform my duties accordingly.

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