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Shipman Inquiry

Yes. I am not a lawyer, so such a subject trespasses slightly outside my expertise. The hon. Gentleman is not a lawyer, either, but he clearly has great expertise, not least because of his participation in discussions on the subject at the BMA. As I understand it, it is impossible not to have in mind the nature of the penalty that might ensue from the accusation. It does not mean that the person has to have the penalty in mind. There is an interplay between the nature of the charges and the nature of the penalty. My point, however, is that one should start from an understanding of the extent of the penalty that might ensue from an accusation. The hon. Gentleman makes a fair point, given the nature of an appeal process that might change the penalty. One has to think about that, too. However, unless I am much mistaken, in considering on appeal what should be the penalty, any responsible tribunal would bear in mind the standard of proof that had been achieved. I said that I was going to conclude, so I should. I wanted to make one point about what lies at the heart of the matter—happily, I know that such subjects are at the forefront of thinking among doctors. I was with the Association of Surgeons in Training in Belfast back in late March, and listened to a number of presentations. There was a fascinating presentation by someone whose name I forget, who had suffered the loss of his wife. Clinical negligence had not taken place, but mistakes had been made during the course of her operation. He had devoted an enormous amount of effort to communicating with doctors about how to achieve quality and safety. He was qualified to do so because he was an airline pilot. One can stretch the analogy only so far, but it is an important one. In the airline industry, it is well understood that people make mistakes. If someone makes a mistake in the airline industry, they are held to blame or penalised not for making the mistake, but for not reporting the mistake, since reporting the mistake allows the problems to be eradicated. If we are confident that we do not have a culture in which we try to escape blame, pass blame or cover things up, and that we have one in which all adverse events are brought out, not only will we disclose mistakes and deal with them but we will make it harder for all those who are guilty of wrongdoing or behaving with malice to carry on and to hope that the things that they do will be dealt with on the inside rather than exposed and dealt with through the system of regulation that we all hope to achieve. I hope that we can be confident that we will achieve that culture.