>I think this misses the point a little.  As I see it, the concern that is
>being
>addresses is not so much that a system external to Shipman's practice
>failed to
>pick up what was going on, but rather that the system within Shipman's
>practice
>failed to pick it up.
>
>On the other hand, I fail to see what might be achieved by any form of
>examination to ensure that there are adequate systems in place!
>
>
>Mike Wells

Mike

I see where you're coming from but equally feel you're missing the point.

Dame Janet was fairly open that she was using the Shipman enquiry to review
how the medical profession is regulated in the widest sense.  She stated
that she believed parliament supported her in this interpretation of her
terms of reference.  The regulation of the medical profession is a current
topic whether or not she is the right person, or the enquiry is the right
setting in which to review such regulation.

Shipman may have killed a couple of hundred over many years.  How many of
those deaths should be regarded as murder is not clear (I've not studied
the cases).  Premature deaths related to medical care (medical, nursing,
paramedical, pharmaceutical issues) perhaps top 20,000 per annum.  The
Department of Health itself estimates that there are approximately 850,000
medical accidents in English hospitals alone each year, half of which
should have been avoided.

Of course not all involve doctors, and no system involving human beings can
be foolproof.  However reasonable steps to encourage high standards and
detect situations where there is a significant and persistent increase in
material risk to patient welfare are likely to be supported inside and
outside the profession.

The detection of Shipman is and should remain a separate issue.  I think
even Dame Janet sees that.

Julian