In defence of inquiry panels

As a colleague who has also protested about the iniquities of inquiries (Lowe, 1996), I am heartened by Mark Salter's latest contribution to the debate (Salter, Psychiatric Bulletin, July 2003, 27, 245-247). A patient of mine was convicted of manslaughter and, although the internal inquiry exonerated the clinical team, an external inquiry serves other purposes very well rehearsed by Salter. It is desirable, however, to expect inquiry panel members (including non-psychiatrists) to accept clear boundaries, realistic terms of reference, to be inducted for the purpose, and to function as openly as possible. Panel members are learning progressively from their predecessors and do not have to accept a process that is irrational. Reports, unique in their individuality, include detailed psychiatric case histories from which clinical lessons can be drawn - though not necessarily fulfilling public expectations. More could be done to disseminate this knowledge officially (King, 2000).

The effects of inquiries are unpredictable but may lead to significant changes. The Clunis Inquiry heralded the introduction of supervised discharge orders (1996). Consultants invited to sit as inquiry panel members should be drawn from the likes of Dr Salter and not held in contempt by their colleagues (Veasey & Cox, 2000) for participating.

From April 2004, responsibility for independent reviews passes to the new Commission for Healthcare, Audit and Inspection (CHAI) and the Government would like to see a national specification for training in complaints investigation (Department of Health, 2003). The College should lobby to ensure that homicide inquiries are included in CHAI's remit. Contributions from past panel members and critics would help in formulating an appropriate training programme for psychiatrists and lay colleagues.