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Ms Chris McCafferty (Calder Valley): I commend my right hon. Friend on his statement and particularly welcome the inquiry. He will be aware that Harold Shipman practised medicine in Todmorden, in my constituency, for some years. It was thanks only to the efficient and effective checks and balances that his partners had in place that his drug misuse was discovered and that he was subsequently prosecuted.
Like many hon. Members, I am particularly concerned that the West Pennine health authority was not aware of Harold Shipman's convictions while he was a GP in Todmorden. I am sure that my right hon. Friend will agree that this case highlights the importance of robust systems to monitor not just the death rates of GPs, but the quality of care that they are giving to patients. Will my right hon. Friend place a statutory duty on the GMC to be proactive in informing health authorities of all relevant information that relates to medical personnel, and consider whether GPs should have salaried status within the NHS, and all the accountability that that brings?
The facts revealed by this case have caused grave concern to my constituents also. Although there are no immediate concerns or suggestions that Harold Shipman started his activities in Todmorden, some of my constituents have concerns about relatives who were his patients. Will my right hon. Friend urgently establish a helpline to help those who are concerned about those matters, to dispense and gather information and to help alleviate worries? That would be very welcome.
Mr. Milburn:
I am extremely grateful to my hon. Friend, who makes an important point about the majority of GPs. In Todmorden and in Hyde, fellow GPs of Harold Shipman blew the whistle. We should not lose sight of that. A fellow GP in Hyde first raised suspicions about Dr. Shipman's practice and the excess levels of deaths among his largely elderly female patients. My hon. Friend is right to say that it was a fellow GP in her constituency who raised suspicions about the fact that Harold Shipman was forging prescription forms and had illegally obtained controlled drugs--in this case, pethidine. That is an important lesson to bear in mind as we consider the future of general practice and the role of individual GPs.
My hon. Friend is right to say that the crucial issue is not just better monitoring of mortality statistics, although that is needed. I was heartened to see the comments from Dr. John Chisholm, the chairman of the GPs' committee of the BMA. The BMA and the doctors themselves recognise that there must be greater accountability in terms of how GPs perform. That is a welcome recognition, and provides us with the basis to reach sensible agreements, to make progress and to ensure that we do not see a repetition of this sort of tragedy in future.
My hon. Friend referred to helplines. I will consider that issue. I know that, in Hyde, the health authority has worked closely with Victim Support, which has provided an absolutely sterling service to the relatives and friends of victims. They have that sort of help and support, and I will look into whether it is possible to extend that.
Mr. Peter Lilley (Hitchin and Harpenden):
Will the right hon. Gentleman confirm that the inquiry, the establishment of which I greatly welcome, will not be limited to the narrow question of trying to prevent a recurrence of this incredibly wicked but, one hopes, incredibly rare occurrence of a medical practitioner deliberately killing healthy patients, but will be able to look more broadly at what may be a greater risk--of death through the incompetence, carelessness and negligence of doctors, both in hospitals and in general practice--
Mr. Milburn:
I think that the right hon. Gentleman is aware that we will publish mortality statistics for the first time. It is a contentious issue, as he will recall from his time in office when the previous Government published the statistics in Scotland. We have extended that to England and I believe that that is the right thing to do. The issue is complex but, in the final analysis, the patient has the right to know. The patient is the recipient of what is a public service. The public pay for it and use it, and it is right and proper that the public should know what level and standard of service they are receiving. We may even need to go further than we have in the publication of such information.
As to the scope of the inquiry, it is right and proper that it should concentrate on the implications of the Shipman case. I have no doubt that it will have wider repercussions that will be considered by the inquiry team and reflected in its recommendations.
Dr. Howard Stoate (Dartford):
As a GP, I have been horrified and appalled by the havoc wreaked by that callous and brutal murderer. Patients and doctors will welcome my right hon. Friend's statement, especially his affirmation that trust is the cornerstone of the doctor- patient consultation. Without that trust, it would be difficult for doctors to do their work. I would hate to see a knee-jerk reaction to what has happened, and I welcome the long-term inquiry that he mentioned and the fact that he will consider carefully and calmly any recommendations, especially on death certification and the availability of controlled drugs. As my right hon. Friend is aware, without drugs such as morphine, doctors would not be able to save as many lives as they do. Will he ensure that the report is considered carefully when it is published and that we do not rush into any premature decisions that might do more harm than good?
Mr. Milburn:
My hon. Friend is right. We have tried to strike a balance today by taking action where appropriate and where there is an obvious gap in the processing systems. I hope that we have got the balance right. At the same time, I wish to empower the inquiry to examine the structures more broadly and to consider the specific lessons that can be learned. I have no doubt, given the chairmanship of Lord Laming, that the inquiry will undertake its proceedings carefully and sensitively, especially given the feelings of the relatives of the deceased. When it produces its recommendations, the Government will need some time to consider the implications and we will then report back to the House.
Dr. Julian Lewis (New Forest, East):
I congratulate the Secretary of State on the contents of his statement and on the sensitivity with which he delivered it and has answered questions. Does he agree that the peculiarity of this case, even compared with the cases of other serial murderers, is that there was no obvious financial, or apparent sexual, motivation for the crimes committed? Is it not to the credit of the police that, as soon as a financial motivation was drawn to their attention, they managed to investigate the case so thoroughly and unravel it so comprehensively? While I endorse what has been said
Mr. Milburn:
I am grateful to the hon. Gentleman for his support. He will be aware that in the judge's summing up yesterday in Preston he praised the performance of the local police in what was a difficult and lengthy investigation. Credit is of course due to the police, as it is to the relatives of the victims. In particular, I pay tribute--it is difficult to find the words to do so--to the daughter of Mrs. Grundy because, without her intervention and early investigation, I fear that Harold Shipman would have continued his killing ways.
Mr. Andrew F. Bennett (Denton and Reddish):
I echo the expressions of condolence to the families and friends of all those murdered, and I offer the sympathy of the House to all those in Tameside who are uncertain about what happened to their relatives or friends. I wish to press my right hon. Friend to consider carefully the appointment that he will shortly make to the chairmanship of the West Pennine health authority. Will he try to ensure that, through that appointment, he gives new direction to the health authority to try to restore confidence to all those people in Tameside and Oldham who use its services? Will he try to make sure that that new appointment gives a new direction to the health authority that will help to restore confidence to all those people in Tameside and Oldham who use its services?
Mr. Milburn:
We will give proper and due consideration to that appointment when it comes up. Inevitably, the health authority is in the spotlight at the moment, and it has acted to suspend its GP adviser. The health authority has produced its own internal report, which we at the Department of Health have received and which the authority published at its press conference last night. However, it is also appropriate that the inquiry considers the role and conduct of the authority, alongside that of the other statutory agencies, such as the police, the coroners service, the registrars service, and others.
Mr. Nigel Waterson (Eastbourne):
On a point of order, Madam Speaker. I gave you advance notice of this point of order, which concerns an apparently well-sourced piece in today's edition of The Daily Telegraph. It is entitled "Prescott cuts housing quota", and it mentions a meeting today of the Fabian Society. Apparently, the Deputy Prime Minister intends to make some major pronouncements about his policy for new house building in the south-east, in the light of the report by Professor Crow and his team. The article states that the right hon. Gentleman apparently will increase very significantly the number of new houses to be built in the south-east, over and above the number already recommended by Serplan. Clearly, that will be of enormous concern to many people in the south-east, and to their elected representatives.
4.21 pm
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