Stopping another Shipman
On 7 July, new legislation dealing with the handling of Controlled Drugs starts to come into force. It covers Scotland and Wales as well as England. However, different facets of the legislation will be enacted at different times in the three countries over the coming months. The main changes are outlined across five pages of this week's issue
beginning on p25. The legislation is designed to protect the public
and follows the fourth report of the Shipman Inquiry under the direction
of Dame Janet Smith.
So far, so good. If the changes will protect the public from another
Harold Shipman nobody will object. But The Journal also carries an Article this week (p13) whose author suggests that, if a person is really intent
on murder, the new legislation will not provide a fail-safe mechanism
that will prevent him (or her) getting up to no good. The new legislation
will make it easier to detect nefarious activity after it has happened — but
it will not stop it.
Can anything be done to bridge the gap between the public’s expectation — heightened
by Dame Janet’s inquiries — that they will in future be totally
protected from murderous health professionals and the reality of providing
care to patients who require CDs for therapeutic purposes? Systems that
the providers of care have to adopt must not be so onerous that patients
in need are denied appropriate care.
This sort of tension is not new and there is one simple reason for it:
it is impossible to legislate to remove completely the risks from the
world most of us inhabit. Take
drink-driving as a parallel example. People would still be killed by
drink-drivers even if the legislation were tightened to make it illegal
to drive after one alcoholic drink, if car immobilisers were linked to
breath alcohol detection devices, and if publicans faced fines if they
served alcohol to people who subsequently drove a car.
Some people might think such developments would be welcome but the systems
that would need to be put into place to make sure they worked would be
prohibitively expensive and would, arguably, distract the police and
the judiciary from other serious crimes.
Pharmacists will find the new CD rules time-consuming and burdensome.
So it would be unfortunate if members of the pharmacy profession, as
well as doctors and nurses and others who have access to CDs, were to
be harshly disciplined in the future if they inadvertently fail to jump
through all the new hoops which, after all, are not primarily designed
to improve their practice but to stop another Shipman. What has to be
realised is that, however strict the CD rules are, they can never be
watertight.
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