Patients still not protected

Doctors are today accused of "looking after their own" rather than protecting patients.

The damning criticism is contained in an inquiry into Harold Shipman.

A lack of proper checks left the GP free to kill at least 215 patients over 23 years despite mounting concerns.

A report says he went undetected because the General Medical Council is biased in favour of GPs and fails in its primary role which is to protect patients from rogue doctors.

Dame Janet Smith, who is conducting the Shipman Inquiry, calls for a major shake-up of the GMC to prevent a repeat of the case.

She also said more information about doctors should be made available to patients by the NHS. Shipman was convicted of 15 murders, mainly of elderly patients belonging to his practice in Hyde, Manchester. But the inquiry has ruled that he murdered 200 more, usually by injecting them with diamorphine. Shipman committed suicide in his prison cell in January.

The inquiry criticises the GMC, the doctors' governing body, for failing to act. It says the GMC procedures and culture has "fundamental" flaws. And despite changes brought in by the GMC to get its own house in order, it has not gone far enough to protect patients.

The 1,300 page report by High Court judge Dame Janet lists more than 100 recommendations for change.

She says: "Having examined the evidence, I have been driven to the conclusion that the GMC has not, in the past, succeeded in its primary purpose of protecting patients.

"Instead it has, to a very significant degree, acted in the interests of doctors."

In the report Dame Janet says: "I am by no means convinced that the new GMC procedures will adequately protect patients from dysfunctional or underperforming doctors."

The report only just stops short of recommending the abolition of the GMC but says its constitution should be changed to include more lay people and fewer doctors and it should be directly accountable to Parliament.

Dame Janet says: "It seems to me that one of the fundamental problems for the GMC is the perception, shared by many doctors, that it is supposed to be ' representing' them. It is not - it is regulating them."

Among her recommendations is that patients should be able to check details of a doctor's disciplinary record and fitness to practice from a central database.

Her interim report also says procedures should be put in place to make it easier for staff to raise concerns.

One of the most common complaints from relatives of the victims and from Shipman's nursing staff was that they did not know who to report their suspicions to or how to report them.

Dame Janet says the "prevalent" attitude among doctors is "it was not done" to question and report a fellow doctor to the GMC, adding: "The culture of unwillingness to report doctors is still

there. It must go. There can be no room today for protection of colleagues when the safety and welfare of patients are at stake."

The report will be sent to the Department of Health for consideration and Health Secretary John Reid said he would respond in full early next year.