Selection of inquiry members: passing the responsibility

Dr Lowe (Psychiatric Bulletin, March 2000, 24, 116) believes that the development of a new QUANGO, namely the Commission for Healthcare Audit and Inspection (UK) (CHAI) and the passing of responsibility for murder reviews to this body is a wonderful step forward. The reason this will make absolutely no difference is that no government sets up a body that is likely to criticise it. Those invited to sit on such bodies are invariably drawn from the list of the great and the good, which excludes anybody who is likely to be properly independent or who believes that the whole process is fundamentally misguided. As I have previously noted, the fundamental purpose of these inquiries is to pin the blame for tragedy on individuals and to protect the Government, the Department of Health and Health Service managers from criticism consequent upon their failure to deliver a properly funded, functioning, psychiatric service. Of course, something useful may occasionally emerge.

Although Dr Lowe may have no complaints about the way he was dealt with, many of us have not had such a happy experience. I was only rather peripherally involved in an inquiry, but I was very unhappy with the nonsense produced by way of a draft report and complained vociferously about it, as a result of which almost all the criticism of me was removed. In the final document I received a glowing commendation! On this occasion, it was a respected senior colleague who was up for crucifixion.

My advice to any colleague caught up in these difficulties is to stand up for yourself and to be totally honest and open, to outline all the background difficulties to practising psychiatry at the relevant time, to react strongly to any unfair criticism or mistakes in the draft report and to marshal whatever support can be obtained from any quarter.

While Dr Lowe is quite correct that the results of inquiries are unpredictable, one effect appears to be perfectly predictable, namely that one or more doctors will emerge from the process feeling that they have been treated unjustly.