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Mr. Nicholas Winterton: Will my right hon. and learned Friend refer to what the hon. Member for Isle of Wight (Dr. Brand) said about how Dr. Harold Shipman was able to obtain such large quantities of diamorphine and to retain in storage such large amounts of the drug? My right hon. and learned Friend said, rightly, that Dr. Harold Shipman, not the medical profession, is to
Dr. Fox: Does my right hon. and learned Friend agree that a mechanism such as the NCAA is likely to pick up poorly performing doctors or those whose skills need to be upgraded, but that someone who purposefully kills his patients and hides the evidence is hardly likely to be picked up by such an audit?
Sir Nicholas Lyell: Yes, I agree entirely. I have not studied the Shipman case more than any other careful reader of the newspapers, but it comes through that Dr. Shipman presented himself to the world as a skilled and caring general practitioner, and I suspect that he might well have been able to bamboozle the NCAA, get quite a good chit--a high mark--as a GP, and keep his criminal misdeeds hidden.
The inquiry will want to question a range of authorities. The authorities responsible for the issuing, management and control of dangerous and lethal drugs such as diamorphine will be high on the list. The inquiry will examine the role of the employing authority in the case, and that of NHS management generally. It will consider the role of primary care groups under the new dispensations. It will certainly investigate the role of the coroner and the relevance of the register of deaths. It will look into the role of the police to some extent, although I am not suggesting that it would have been easy or even possible for the police to have discovered anything in advance.
Those authorities are all intended to work together, and we would hope that they could pick up such aberrant behaviour rather earlier. I do not know how long Dr. Shipman had been murdering people--nobody does--but it seems to have been many years. We need to end up with systems that, while not blocking the good work of medical practitioners, give a greater opportunity for the misuse of drugs, and for serial killing, to be brought to light comparatively early.
I am concerned about the length of inquiries. The Scott inquiry was deliberately not conducted under the 1921 Act, on the basis that that might cause it to become overlong. After it had lasted for three and a half years, people--perhaps including Lord Justice Scott--may have felt that that might not have been as much of a problem as had been feared.
We have recently had, or are having, three immensely long inquiries: the Scott inquiry; the very skilful BSE inquiry under Lord Phillips; and, currently, the careful and difficult, but none the less immensely long, Bloody Sunday inquiry. I very much hope that the Shipman inquiry chairman does not think--I am sure that she will not--that great length is a necessary feature of all public inquiries. Obviously, the inquiry must have a full opportunity to consider carefully what has gone on, but if public confidence in public inquiries is to be fully restored, it is to be hoped that it will be able to proceed at a reasonable pace, to report in a not overlengthy amount of time and, above all, to provide a report of reasonable length, so that ordinary members of the public and the press can read a decent summary.
I suggest that the report should not be over 150 pages long, with extra matter in appendices, so that the results do not moulder on shelves but are understood by the country at large and acted on by those who are responsible for trying to put things right.
Mr. Douglas Hogg (Sleaford and North Hykeham): It is a pleasure to follow my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell), who made several points that I had intended to make.
I have some experience of these matters, in that I represented Grantham when Beverley Allitt was working at Grantham hospital and killed several young patients there. Understandably, that caused immense distress in Grantham and triggered the same kind of anxiety that we see in the Shipman case.
I welcome the Secretary of State's decision to hold a public inquiry. That was greatly desired by the families affected by the Beverley Allitt killings, and I regret that it did not take place, although I understood the reasons. In such grave cases, a public inquiry is absolutely essential. I welcome the fact that the Secretary of State changed his original decision.
I agree entirely with my right hon. and learned Friend's points about having a relatively brief inquiry. He and I were both involved in the Scott inquiry, and I was involved yet more in the BSE inquiry. Both those inquiries were immensely long. With all respect to those who presided over them, I do not think that the length of the inquiries, or indeed the reports, added greatly to our knowledge. We need a sharply focused inquiry that is as brief as we can make it.
My right hon. and learned Friend made an important point about the nature of the ultimate report. It must be readable by the ordinary citizen. I do not know Dame Janet Smith, but I know that she is held in high respect on the north-eastern circuit and elsewhere, and I am sure that she will bear these points in mind.
Dr. Fox: Does my right hon. and learned Friend agree that the efficiency and speed of the inquiry must be balanced against the wishes of the relatives, who must at all times be assured that all matters have been appropriately considered, given the scope of the crimes involved?
Mr. Hogg: Indeed. There will be families of victims, or of possible victims, who do not want to give evidence, because they have none in the technical sense to give, but who none the less may feel that their relatives were murdered. It is desirable for the families to be represented at the hearings, so that, through their representatives, they can ask questions of witnesses, allowing avenues of concern to the families to be explored, even if they do not immediately occur to counsel for other parties. I hope that the Minister will seriously consider making public funds available for that representation.
I strongly hope--I believe that this will happen--that those whose competence and performance are likely to be called into question will also be represented and have the opportunity to ask questions. Many people's professional
My right hon. and learned Friend spoke about the difficulties in spotting crimes of this kind. Such crimes are so exceptional that they do not immediately occur to anyone who is investigating deaths occurring either in GPs' surgeries or in hospitals. One of the problems with the Beverley Allitt case was that it did not occur to people early enough that a nurse could be doing such things. It is understandable that such a thought did not occur. Similarly, it would not occur to most ordinary people--including coroners--that a GP could be murdering his or her patients. Therefore, one should be slow to criticise those who did not early on in that series of events think of murder.
It is important that we try to establish systems that throw up abnormal patterns of conduct or of fatality, so that those who take an overarching view--whether the coroner or those who sign the part 2 certificates--can tell from data that have already been accumulated that something out of the ordinary is occurring. I hope that Dame Janet Smith will address that matter.
The hon. Member for St. Helens, South (Mr. Bermingham) is entirely right to say that Dr. Shipman will not be prosecuted for any other offences. There are at least two reasons for that: first, because it has already been said on behalf of the prosecuting authority that he will not be prosecuted further, therefore he cannot be prosecuted; and, secondly, because the degree of the publicity that has been given to the cases means he could not get "a fair trial". I would strongly urge the prosecuting authorities not to attempt a further prosecution, which could certainly not go forward.
However, there is a consequence that is worth considering. My considerable experience of criminals garnered from practising at the criminal Bar and defending many criminals suggests that, sometimes, there comes a time when they are willing to talk because they have nothing left to lose. It might be worth considering the possibility of intensively questioning Dr. Shipman again. He has nothing more to lose. He is one person who might be able to tell the relatives what happened, and one should not exclude the possibility that he might be willing to do so. He is a whole-life case--he will be in prison all his days; that is certain. Although he is clearly not a man on whose words one could place any weight, he might be able to illuminate some matters that are of interest and importance to the inquiry and the families.
I anticipate many claims arising from the murders being made to the Criminal Injuries Compensation Board. Some of them may be fairly substantial, especially those involving the dependents of those who have been murdered, and some may be very large. I hope that officials at the Department of Health and the Home Office--I do not see a Home Office Minister present, but I am sure that the Under-Secretary of State for Health will draw my remarks to the attention of the Home Office--will consult the CICB on how best and most expeditiously to consider the claims that will emerge, which will be of considerable importance to individual dependents. I shall leave the Under-Secretary of State with that thought-- [Hon. Members: "The Minister of State"]. I apologise to the Minister of State, Department of Health, the hon. Member for Barrow and Furness (Mr. Hutton). I did not intend to slight him.