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At the heart of general practice since 1960

Dame Janet may fear another Shipman but it is not GPs she should blame

Speaking to BBC Radio 4 earlier this month, Dame Janet Smith said: 'I really was shocked to find how totally our system of death certification is dependent upon the honesty and integrity of a single doctor.'

Well, Dame Janet, if you could spare a moment from criticising the whole of general practice, my chosen career and the honesty and integrity of myself and my colleagues, prepare to be shocked again.

We have a statutory duty to supply a death certificate when a precise series of criteria are met under the Births and Deaths Registration Act 1953. However, in future, I propose that instead of two doctors signing the form, how about no GPs signing them? From now on let's refer all deaths to the coroner. Confidence restored. Problem sorted.

I am still unable to work out why the penny did not drop with the one person whose job it actually was to bean-count the death certificates and cremation forms as they were coming in thick and fast from a certain practice in Hyde, Greater Manchester. Why did that person not check that they were completed duly and accurately, interview relatives, look out for any suspicious circumstances surrounding a death and, if the criteria had not been met, refer the death to the coroner and supply the raw data from which all mortality statistics are derived for vital public health surveillance?

I don't think it was Dr Shipman's colleagues who took their eye off the ball.

From Dr Steve Hirst, Preston, Lancashire

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