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Harold Shipman Case Study

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Harold Shipman, was a British doctor and one of the most prolific serial killers in recorded history with up to 250 proven murders between 1971 and 1998. In total, 459 people died while under his care, but it is uncertain how many of those were Shipman’s victims, as he was often the only doctor to certify a death. On 31 January 2000, a jury found Shipman guilty of 15 murders. He was sentenced to life imprisonment and the judge recommended that he never be released. After his trial, The Shipman Inquiry began on 1st September 2000, lasting almost two years it was an investigation into all deaths certified by Shipman. About 80% of his victims were women, his youngest victim being a 41 year old man. Much of Britain’s legal structure concerning health care and medicine was reviewed and modified as a direct and indirect result of Shipman’s crimes. Shipman is the only British doctor who has been found guilty of murdering his patients. Shipman died on the 13th January 2004 after hanging himself in his cell at Wakefield Prison.

There has been a lot of concern over the Harold Shipman case especially in the public sector. People have responded with anger towards the Department of Health and towards the Government in the belief that they have taken advantage of public concerns following Shipman’s conviction to introduce tough controls over general practice. There have been attacks directed specifically at single handed practices. While there may be a tendency among some managers and policy-makers to regard single handed practices as undesirable, the use of Shipman as a reason for encouraging the end of single handed practice cannot be justified since he managed to kill approximately 80 patients whilst working in two different group practices.

It would be more appropriate to regard Shipman as a general failure of monitoring rather than a failure to single handed practice. Single-handed GP providers are partners who practise without any other partners, although the may work with trainees or salaried Gps. The number of providers fell from 2566 in 2002 to 1480 in 2012, a drop of 42%. Another response has been fatalism, it being argued that steps taken to reduce the risk of murder by doctors are bound to be of limited effectiveness. The determined murderer, its believed, will always find a way to evade whatever procedures and policies are put in place.

The Secretary of State for Health announced several changes the day after Shipman’s conviction. The Fundamental Review of death certification and investigation has made recommendations for the reform of the coronial service and death certification procedures. In its second report, the Inquiry, chaired by Dame Janet Smith, has also made recommendations about death investigation and certification. There are similarities between the recommendation of the Review and the Inquiry, both support the investigation of deaths due to medical error or negligence by the coronial service. If this recommendation is implemented, in future families will be more able to report concerns about medical care to coroners. While some doctors may be anxious about this proposal, its right that coroners should be able to give families an accurate judgement on the cause of death of the deceased. Actions and recommendations that are under way following Shipman’s conviction: Announced by The Secretary of State for Health, February 2000.

1. An inquiry into the issues raised by Shipman’s murders.
2. Requirement for doctors to disclose criminal convictions or action by professional regulatory bodies before appointment to medical lists. 3. General practitioners to report deaths in their surgeries and other serious incidents to health authorities.
4. A clinical audit of Shipman’s past clinical practice.

Recommendations of the Clinical Audi.
1. A review of systems to monitor general practitioners.
2. Monitoring of mortality of patients of general practitioners.
3. Revision of certification system.
4. Assessment of general practitioners’ records in revalidation.
5. Review of policy on retention of records of deceased patients.
6. Inspection of general practitioners’ controlled drugs registers.

Fundamental review of coronial service.
1. Sixty coronial districts in England and Wales.
2. One statutory medical assessor per district to oversee certification, investigate natural deaths and link with public health.
3. Two tier certification for all deaths.
4. Periodic audits of certification.

Inquiries Third Report.
1. Radical reform of the coronial service.
2. Medical coroners to work with judicial coroners.
3. Revised death certificates to be completed for all deaths.
4. General Medical Council to impose on doctors a duty to cooperate with certification system.
5. Random and targeted checks of certificates.
6. Deaths possibly due to medical error or negligence to be investigated by coronial service.

The public’s opinion is affected by issues caused in the health and social care sectors because its a mass system that everybody uses. If there’s an incident in any part of the health sector then its front page news and everybody knows about it, this could impact on how the people perceive the health sectors and tarnishes their trust in the health sector even further. Same with the social care sector, its always on the news about a new social case that’s come to light whether it be a care home or about a person, because that case is then in the news the public can keep up with it and its updates to see if the case gets resolved or gets worse, things like this also affect the people opinion of this sector.

The public can be very distrusting when it comes to things such as the health service because they think if something bad has happened to one person then it could happen to them, which is true but the likelihood of the same thing happening again nowadays is very unlikely. The media has a lot to do with the public’s opinion because they can influence it by what the write or what information they put on the news/website.

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