David Boyle

The truth about Harold Shipman?

Liberator, September 2002

"The King's life is drawing peacefully to its close," said a bulletin put out by King George V's doctor, in a different and possibly more brutal age. That was what Lord Dawson, the royal physician believed, and people accepted his word. Those were the days before Dr Harold Shipman, after all.

But in the hours that followed, a series of events took place - revealed only in the past few years - which ought perhaps to shed some light on the mysterious motivations of Shipman, who is now officially Britain's most prolific serial killer.

Lord Dawson was concerned that the King should die in time to meet the morning editions of The Times, rather than hanging on long enough for the afternoon papers, those undignified tabloids in the days before tabloids. Like, heaven forfend, the Evening News.

He therefore ordered the nurse at the King's bedside to administer a lethal injection of cocaine and morphine. She refused so Dawson did it himself, and George V dutifully died at 2355 on Monday, 20 January 1936 - just in time for propriety.

"The King, who had renamed the royal family, now lost his life to meet a newspaper deadline," wrote Kitty Kelley, the notorious American biographer six decades later. "Such was the legacy of the House of Windsor, which would eventually rise and fall as a puppet show for the media."

I make the connection now between Dawson and Shipman, not because I believe that Shipman was somehow acting as any doctor should - he clearly wasn't. But because he clearly isn't mad. And for any Liberal who is suspicious of the legal system, Shipman's continued protestations of innocence are disturbing.

So is his complete lack of motive. What possessed him to hasten the deaths, Dawson-fashion - and far worse than that - of 215 patients? We haven't really got a clue.

The first thing to say is that our whole view of the Shipman case has been coloured by our double-standards about doctoring. On the one hand, we as a society these days seem to believe they should be omniscient and all-powerful. Their failures require legal inquiries.

On the other hand, we trust them less, complain about them more, try to break down their jobs into easily measurable components and measure them - as if we could somehow all be doctors ourselves. Neither of these stand up to examination. But you can't help wondering, if Dame Janet Smith was set lose on the unexplained deaths in most doctor's practices, chosen at random, whether society might suddenly discover that Shipman killed them too. He's a convenient explanation for the unexplained, the random and the senseless, just as we try to rid ourselves of all three.

But don't let's pretend that Shipman is just the victim of a statistical blip. The unexpected visits, the syringe, the injections and the faked medical certificates were all too real. You can't explain them away.

What Lord Dawson's behaviour with the Queen's grandfather does tell us, though, is not so much the way that courtiers can compromise their principles, but that professionals - when they are given unquestioned power - will abuse it. That's the lesson for Liberal Democrats in the whole affair. It's the reason it might be of interest to policy-makers, because there are all too many instances of the same thing. When one class, one professional, one sex or one race is given a privileged and unquestioned position - then history shows that it will be abused. And the abuse will be carried out by ordinary people.

The lynchings, Jim Crow separate railway carriages, separate drinking fountains for blacks in the American South until the 1960s, are proof enough of this. The whites were given a privileged position - that was all. Yet, it was enough in 1918 to lynch black American officers off the street, just for wearing a uniform.

When the Children of God cult - at its height in the 1970s - gave men the privilege of being allowed to ask for sex from any female cult-member any time, they tended to become tyrants.

When scientists were given the privilege to experiment sometimes painfully on animals at the laboratories of Huntingdon Life Science more recently, hidden Channel 4 cameras were able to catch lab assistants actually torturing them too.

In the same way, reports from the Netherlands suggest that doctors given new privileges of death under the euthanasia laws, sometimes have a new arrogance about them that wasn't there before.

It's a peculiar phenomenon, and should warn any society against giving unquestioned privileges to any group. And the past two decades has been a continual story where every profession has been forced to accept that ordinary people have a right to involvement in what they do.

That's true of doctors, social workers, planners, psychiatrists and many others - all professions that believed they had special knowledge that gave the special privileges and unquestioned power. Architects alone still seem to believe themselves beyond question, but who knows - maybe the controversy about Mayor Livingstone's skyscrapers will change that too.

Let's be honest about this. Some of that questioning has been disastrous. Sometimes we have tried to audit the work of professionals by reproducing what they do, as if they were some kind of expert system that could be broken down and analysed like software. We should never forget that doctors, for example, actually have an intuition born of experience that can never be reproduced by technology - and we should respect it.

We also have to defend that professionalism against the bureaucracies that try to reduce it, the giant hospitals that believe any doctor is inter-changeable with any other - and let the poor patients see a different one every morning. But we also have to be vigilant against the old professional arrogance, that always knew best, that could humiliate patients behind a professional smile, and that could hasten death just because they felt it was proper or more 'dignified' then than later.

Or the new professional arrogance which society seems intent on vesting on a new generation of bureaucrats. Like those we have tasked with checking the backgrounds of every teacher in the country - even school bus drivers, for goodness sake - and who will make mistakes because people dare not challenge them, and will ruin lives because we let them.

It's still there, if you look. In the notices at the end of the hospital bed saying 'do not resuscitate' of anyone over 70 - regardless of faculties. Or in the sedatives doled out to old people because it's more convenient.

And maybe - in a perverted and exaggerated way - it was there in the practice of Harold Shipman. He was a sole practitioner, after all. He was trained at a time when doctors were unquestioned. He had the 'right' - maybe it seemed - to know when it was 'best' to hasten a death he 'knew' was coming.

These are awkward areas. They can be tragic, but - as anyone who has sat through the old English comedy Arsenic and Old Lace will know - they are also sometimes comic.

The lesson for Liberals is in our attitude to professionals. The answer isn't so much in control which undermines professional knowledge. It is in a rigorous insistence on partnership. Because, we know now that doctors who are not equal partners with patients will be less effective making people well.

The same is true of the police, teachers, social workers and all the rest. It's a key Liberal insight: the vital importance of equal partnership, and pushing forward the boundaries of what those partnerships can achieve.

One thing we know of Dr Shipman: he wasn't exactly a partner of his patients.

 

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title: books by David Boyle
Broke Voyages of Discovery Money Matters Blondel's Song Leaves World to Darkness The Little Money Book Funny Money The Tyranny of Numbers