GP WHO HELPED ADDICTS TELLS OF 'SHIPMAN SYNDROME' STIGMA

29 August 2000 -- A GP credited with helping 140 heroin users in a city plagued by addiction is on the brink of becoming a victim of what his colleagues have described as "Shipman syndrome" ­ a wave of panic that followed the mass murderer's conviction.

Six months ago, in the wake of GP Harold Shipman's conviction for 15 murders, Dr John Gordon was arrested on suspicion of manslaughter by detectives examining the deaths of five young addicts who overdosed on the heroin substitute methadone. In an echo of the Shipman investigation, the body of one suspected victim was exhumed and the families of others were told to prepare for the same.

The case was dropped by Carlisle police more than two months ago but Dr Gordon has only now spoken of the consequences, stating that he considers himself the victim of a "state of paranoia" which followed Shipman's conviction and is considering quitting.

"The stigma remains," he said. "Mentally I am finding it extremely difficult and I have started to question my actions more and more. It's just gone beyond what is bearable and although I do not want to leave [Carlisle] after 21 years, I don't know what choice I have."

Dr Gordon breached government guidelines in the kind of case that can be investigated by the General Medical Council but, on this occasion, landed the GP in custody and led to what is believed to be the first exhumation in such circumstances.

Dr Gordon decided that an 18-year-old patient, Keir Hamilton, was telling the truth when he said he smoked heroin and needed the substitute. Although the GP complied with clear guidelines by taking a urine sample to test for heroin, he prescribed methadone before receiving the test results. They showed no evidence that Hamilton had taken heroin. The dose of methadone already prescribed was not necessarily fatal but Hamilton died.

Dr Peter Tiplady, director of public health for North Lakeland Health Authority, said Dr Gordon's breach was a clinical matter that did not justify arrest. "Bells were not ringing," he said about the fact that five addicts at the drugs clinic Dr Gordon established had died since January 1999 ­ the reason given for his arrest.

"His mortality rate was noticeable but [Dr Gordon] did have 140 addicts at his drugs clinic. They are a difficult sub-group of a difficult group ­ very demanding, very impatient, chaotic. They have a marked mortality rate and dealing with them carries high risks.

The investigation came to nothing. Tests on tissue samples from Hamilton's exhumed body proved inconclusive and on 27 May the inquiry was dropped.

"It has never been clear as to where the suspicions arose from, though the police [told] my wife [that] they had been investigating me for a long time" said Dr Gordon. "Of course Shipman ought to have been brought to book but things here went totally over the top."

Cumbria Police have always denied comparisons between Dr Gordon and Shipman, since Dr Gordon was not suspected of wilfully causing harm, and they say a clear pattern of deaths prompted their inquiry.

Other constabularies have been equally vigilant of late. An Essex GP was this week charged with the involuntary manslaughter of a 17-year-old for whom he was prescribing methadone and professionals now fear the potential criminal consequences of treating "high risk" patients.

Dr Paul Thomas, a GP from Ipswich, last week announced he has stopped methadone prescriptions for fear of a manslaughter charge and medical defence lawyers report a flood of calls from worried GPs.