Inspection Arrangements Print Version CHAPTER FOUR - The Authority of a Medical Practitioner to Prescribe, Possess, Supply and Administer Controlled Drugs  Reports > The Fourth Report > CHAPTER THREE - A Brief History of the Regulation of Controlled Drugs >  Ideas for Improvement 3.58 No further significant changes had been made to the legislative framework relating to controlled drugs by the time Shipman's crimes came to light in August 1998. Since the extent to which he used and abused diamorphine has been understood, there has been much discussion about how the systems of control should be improved. There has also been much debate about ways to modernise the present systems. I shall describe those ideas and proposals later in this Report. 3.59 For the moment, I say only that this brief summary of the historical development of the regulation of controlled drugs has revealed several matters that are of particular relevance to the issues facing the Inquiry in 2004. The danger attaching to the freedom of medical practitioners to prescribe, supply and administer controlled drugs for therapeutic purposes has been recognised for more than 80 years. If that freedom is to remain, as it must, it should be circumscribed in ways that minimise the risk of diversion without compromising patient care. Two particular ways in which the risk might be reduced were recognised in the 1920s but not implemented, namely the suggestions that doctors should not be allowed to prescribe dangerous drugs for themselves and that they should be able to prescribe only while 'in actual practice'. 3.60 Also, certain specific practical arrangements have been considered in the past, but rejected or abandoned. For the time being, I shall highlight only two. The provision in the 1921 Regulations, that all private controlled drug prescriptions should be written on special forms, was not implemented, possibly because it was thought that the advantage accruing would be slight. This proposal is worthy of reconsideration now, with the advent of the computerised analysis of prescribing data. 3.61 Second, from the very beginning of the routine police inspection of pharmacies, it was suggested by the police that it might not be a suitable body to carry out the task. As the nature of pharmacy practice has become more refined, it may be said that there is an even greater need now for some specialist expertise to be introduced into pharmacy inspection. 3.62 I shall return to all these issues in Chapter Fourteen of this Report.    Inspection Arrangements Print Version CHAPTER FOUR - The Authority of a Medical Practitioner to Prescribe, Possess, Supply and Administer Controlled Drugs    Published by The Shipman Inquiry © Crown Copyright 2001