On 31st January 2000 a jury found Dr Harold Frederick Shipman (A 54 year old GP practising in the north of England) guilty of the murder of 15 of his patients. He was sentenced to life imprisonment and is the only British doctor ever convicted of murdering his own patients. The subsequent Shipman Inquiry by Dame Janet Smith suggested Shipman was probably responsible for around 250 deaths between 1971 and 1998, making him one of the most notorious serial killers in recorded history. Shipman committed suicide in his prison cell by hanging himself with his bed sheets on 13th January 2004. He never said a word to explain his killings - we will never know why he did what he did.

The repercussions of the Shipman case and inquiry affected every doctor, hospital and GP surgery in the UK in an attempt to ensure this could never happen again. For a GP like me (in the middle of my career when this happened) it altered how I studied; how I practised; how I treated my patients; how I signed death and cremation certificates; how I recorded my day to day consultations; and how I was registered with the General Medical Council (GMC). The regulatory framework for doctors now assumes everyone is capable of being another Dr Shipman - until proven otherwise by annual appraisals, peer review, and “revalidation” by the GMC every 5 years to confirm the doctor is competent and safe. When revalidated successfully the doctor is granted a 5 year “licence to practise” by the GMC – all doctors have to be registered with the GMC but only those with a licence to practise can actually see and treat patients in the UK.

I doubt anyone involved in the Shipman Inquiry recommendations and the subsequent reform of the GMC ever thought there would be consequences for the health of a few people in Ethiopia.

I no longer have a licence to practise in the UK. The way the system has been set up renders it impossible for British doctors working long term overseas. I surrendered my licence last August as there was no way to keep it - I won’t bore you with the details as to why. I am however still registered with the GMC, and I am licensed to practise in Ethiopia by the Ethiopian Ministry of Health (I have a legal Ethiopian document with my photo on covered in legal stamps that legally has to be displayed on my clinic wall).

I have several patients here suffering with conditions for which treatment is not available in Ethiopia - severe depression and non-cancerous prostate disease are the main ones right now. With a licence to practise in the UK I would have been able to buy their medication from a UK pharmacy and bring it with me to keep my patients treated. Without a licence I cannot prescribe to patients in the UK so my requests to purchase medication while in the UK to bring to my patients in Addis are being declined. Before Shipman there wouldn’t have been a problem.

So unless I can find an alternative way to obtain these medicines, three men I care for here are at risk of unnecessary prostate surgery (which in the Ethiopian healthcare setting can be very dangerous) and one woman may relapse into her severe post-traumatic catatonic depression.

And all thanks to Dr Shipman.

(Footnote: This problem came to light two weekends ago when I tried to buy the medication while on a brief three day trip to the UK, ostensibly to do some postgraduate education at the BMA in London. I did the excellent 2 day intensive “GP Masterclass” of course, but the real (secret) reason was to collect my Microsoft Surface Pro 3 tablet computer which had been sent back to the UK for repairs to a cracked screen. Briefly playing with Natalia and Isaac could also have been an influence…)