HL Deb 15 July 2004 vol 663 cc64-5WS
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner):

The fourth report of the Shipman inquiry, The regulation of controlled drugs in the community, Cm 6249, was published today, and copies have been place in the Library. This follows the publication of reports on the extent of Harold Shipman's activities, on the 1998 investigation by the Greater Manchester Police, and on death certification and the coroner system. The inquiry's final report on monitoring of medical practitioners, disciplinary systems, whistleblowing and complaints is now expected to be published later this year.

The Government would again like to thank Dame Janet Smith for the meticulous care which has gone into the preparation of this report; for the sensitivity with which she has listened to the views of healthcare and law enforcement professionals at the inquiry's seminars; and for the skilful balance she has struck between the need to safeguard the legitimate use of controlled drugs for patient care and the need to protect the public from their misuse. We would also like to reiterate our sympathy to the relatives and friends of Shipman's victims.

Dame Janet's report makes three major groups of recommendations. First, she advocates setting up an integrated and multidisciplinary inspectorate to monitor and audit the prescription, storage, distribution and disposal of controlled drugs. Secondly, the report recommends a number of restrictions on the prescribing of controlled drugs which would discourage or prevent health professionals prescribing in circumstances in which it could be considered to be unsafe or unwise for them to do so—prescribing for their own use or for that of their immediate families, prescribing outside the requirements of their normal clinical practice, or prescribing by professionals convicted of controlled drugs offences. Thirdly, the report proposes a series of measures to tighten up the handling and safekeeping of controlled drugs along each part of the supply chain from the supplier to the patient's home, and to provide a complete audit trail to account for the movement of controlled drugs at each stage, both in the National Health Service and in the private sector.

These are very significant recommendations with fundamental implications for the use of controlled drugs in the NHS and elsewhere. We will need to study them carefully and in consultation with existing inspectorates, patients, NHS and police organisations, and the healthcare professions. In particular, we will be seeking the views of the Advisory Council on the Misuse of Drugs (ACMD) which has already begun some valuable preparatory work on possible improvements to the present system and on the legislative changes that would be required. And we will need to wait for the recommendations in the inquiry's fifth report, on the general monitoring of general medical practitioners (GPs) and other health professionals, before we can reach final decisions on those issues on which there is a potential overlap between the two reports.

In the mean while there is much valuable and important work already in hand. In addition to the work of the ACMD, the national prescribing centre has published preview guidance for NHS organisations and professionals summarising the legal requirements and best professional practice in the handling of controlled drugs. This work will be updated to take account of the inquiry's recommendations and issued as soon as possible. Finally, the NHS national programme for information technology will make a valuable contribution towards some of the additional safeguards proposed in the report, and we will need to consider carefully what can be delivered within the timescales of the programme.

In welcoming the inquiry's second and third reports, my right honourable friends the Home Secretary and the Secretary of State for Health emphasised the need to learn lessons from the mistakes of the past. Dame Janet's report acknowledges that no system for the regulation of controlled drugs can offer complete security against abuse from minds as devious as Shipman's, while allowing for their legitimate use by health professionals to ease suffering. But her report also makes clear that much more could be done to deter and detect improper use. We accept this conclusion. In acting on her report we are determined to ensure that all reasonable measures are taken to provide the robust safeguards which are needed and which the public can rightly expect.