Jekyll and Hype

Murder used to be just murder. You read about it in the Sunday papers, "the sofa cushions soft underneath you" in the words of Orwell's famous essay, savouring the details, marvelling at the villain's cold-blooded nerve. Now, murder is high politics; to adapt Aneurin Bevan, the sound of a body falling to earth must echo through Westminster and Whitehall. Blame must be apportioned, action taken, controls imposed. Leader-writers and commentators must deplore and denounce. No serial killer can take his place in Madame Tussaud's without first being sucked dry for lessons of wider significance.

Thus it is with Harold Shipman, the Manchester doctor convicted of killing 15 elderly women patients. A Times writer informs us, in all seriousness, that Downing Street expected to be blamed for 1,500 deaths (this figure being reached on the assumption that serial murderers kill at a constant rate, getting through a steady 50-odd victims a year rather as other people get through a steady number of cigarettes or cups of tea) and "steeled itself" for a crisis that would dwarf Northern Ireland. Alan Milburn, the Secretary of State for Health, tells MPs that the "overwhelming majority" of family doctors will be as appalled as they are (well, that's a relief) and announces an inquiry, "comprehensive and inclusive" but also speedy. He huffs and puffs because a man convicted barely 24 hours earlier (and until then, therefore, presumed innocent) is still registered with the General Medical Council and still in receipt of a salary. MPs hop up and down with calls for further monitoring and regulation. Political panic is accompanied by desperate punditry. The Times's Thomas Stuttaford - the model for Private Eye's "A Doctor" and a man now beyond parody - assures us that "doctors have faults, but few are likely to be serial killers". Tom Utley in the Daily Telegraph suggests that Dr Shipman wouldn't have got away with it in the South-east, where people are too smart to allow themselves or their relatives to be killed.

All manner of things are wrong with the medical profession, and with its procedures for regulation. But a single, extraordinary case is not a good basis for making policy or law or even opinion. A lone gunman who commits multiple murder on school premises does not establish an argument for turning all schools into fortresses. He is not even an argument for banning guns, though there are ample reasons for doing so. All manner of proposals have been put forward in the wake of the Shipman case: annual appraisals for all doctors; close monitoring of pharmacists' registers; records of doctors' drug convictions; the phasing out of single-handed GP practices; more checks on death certificates. Some of these proposals are sensible ones, others not.

But the arguments for and against them are not altered one whit by the Shipman case. The entire NHS cannot be organised as though a Bodkin Adams or a Shipman lurked inside every white coat. Public sector professionals - teachers and police officers as well as doctors and nurses - already believe themselves to be over-monitored and over-regulated. They complain that an excess of paperwork prevents them getting on with their jobs. They want to restore the trust that once underlay all professional relationships with the public. Critics are at least partially justified in dismissing all this as special pleading for people who want to safeguard their jobs and, when necessary, cover up for each other. But that is the ground on which the argument should be engaged: the public's right to protection against incompetence (which is far more widespread than wickedness) versus the waste of resources and loss of professional morale entailed by excessive bureaucratic supervision. To bring into the equation a Shipman - a case likely to occur no more than once in a generation - is simply to distort the issue.

In a media-dominated society, the dramatic cases will always command attention: the few dozen who die in a railway accident, not the hundreds who die on the roads every year; the occasional child strangled by a stranger, not the dozens beaten to death in their own homes; the evil deeds of a killer doctor, not the hundreds of isolated blunders made annually by his incompetent (or, more likely, marginally competent) colleagues. Sometimes, such cases create the climate of public concern and official urgency to bring about much-needed change. But more often, all we get is hysteria and the kind of desire for action that was once, one suspects, satisfied by the gallows. At such times, politicians should keep cool heads.

This article first appeared in The Prime Minister loses control

2000-02-07