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Gold, incentives and meh

Missed chances over the rules on controlled drugs

Professor Richard Baker is quoted in your news report 'Demand for overhaul of rules on controlled drugs' as saying that confusion about these rules could be traced to the end of regular inspections in 1991 (Pulse, February 9). Actually the regional medical service of the Department of Health and Social Security was abandoned in August 1990 on the grounds of poor cost-effectiveness.

Up to then regional medical officers, with years of general practice experience, had authority to demand evidence of methods of obtaining and supplying controlled drugs and to examine stocks and controlled drug registers kept by GPs. Regular visits to all GPs every year or two enabled GPs to be reminded of the correct regulations under the 1985 Misuse of Drugs Act.

In 1990 medical advisers were appointed instead to the new family health services authorities, mainly inheriting the RMO's prescribing role. Authority in the field of controlled drugs eventually vested in them but without its previous emphasis and it is not clear whether it continued to be acted upon.

Over 60 years of information on individual GPs and their practices was presumably filed away as it was not passed on to medical advisers. This is not to mention the role of RMOs in the control of social security claims and the possibility that Harold Shipman's activities could have been spotted more readily and his medical career shortened.

Dr TM Mitchell-Fox



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