Ms Ceri Fiona Floyd 17 July 2011


Ms Ceri Fiona Floyd
Investigation Officer
General Medical Council
3 Hardman Street,
Manchester
M3 3AW

Your ref: E1-6PFP1I
My ref: Dr Nicholas Charles Alexander Hunt GMC 4025151 : The unnatural death of Dr David Kelly 17/18 July 2003

Dear Ms Floyd,

Thank you for your letter of 8 July. This follows letters from myself to the GMC 16 May 2011, to Ms Patel of the GMC 14 June, Ms Durham of the GMC to myself 15 June and myself to Ms Durham 17 June.

I will deal with four of my main concerns in order, including the one I have raised already. I will append relevant references and documents separately.

Thank you for giving me the link to the 'fitness to practice' details. I see that a warning which was given to Dr Hunt five years ago expires today - 17 July 2011.

I have quoted by copying and pasting from the original documents.


ONE Failure to reveal at the Hutton inquiry that he changed his opinion as to the cause of death.

The inquest was opened by Mr Nicholas Gardiner Oxfordshire Coroner 21 July 2003. A letter (1) came to my hand six months ago that was written by the coroner to Ms Albon of the Department of Constitutional Affairs dated 6 August 2003.

“The preliminary cause of death given at the opening of the inquest no longer represents the view of the Pathologist and evidence from him would need to be given to correct and update the evidence already received.”

A full report entitled 'Final Post Mortem Report' by Dr Hunt

http://www.attorneygeneral.gov.uk/Publications/Documents/Post%20mortem%20report%20by%20Dr%20Hunt%2023%20July%202003.pdf

as well as a toxicology report made by Dr Allan,

http://www.attorneygeneral.gov.uk/Publications/Documents/Dr%20Allan%20statement%201%20%2021%20July%202003.pdf

followed by two more reports 18 August * and 17 September 2003, were made public by the Ministry of Justice 22 October 2010. ** This is dated 25 July 2003. This is the stated cause of death:-

1 (a) Haemorrhage
   (b) Inscised wounds to left wrist

11 Co-proxamol ingestion and coronary atherosclerosis

A death certificate, which it is presumed was written at the re-opened inquest 14 August 2003 records the same cause.

It is evident the opinion as to the cause of death given by Dr Nicholas Hunt, Home Office approved forensic pathologist, was changed in the four days between the opening of the inquest 21 July 2003 and 25 July 2003, the date of the 'definitive' opinion, entitled 'Final Post Mortem Report'. Why was it changed and in what way was it changed? The reasons might be entirely innocent but that original opinion, the fact that it had been changed and the rationale for that change should have been brought to the attention of the Hutton Inquiry. An Initial Post Mortem Report or a Preliminary Post Mortem Report should have been brought before the inquiry if such existed.

In Dr Hunt's evidence to the Hutton inquiry 16 September 2003

http://www.the-hutton-inquiry.org.uk/content/transcripts/hearing-trans33.htm

the same cause of death is recited:-

17 A. In the formulation, the cause of death is given as 1(a)
18 haemorrhage due to 1(b) incised wounds of the left
19 wrist. Under part 2 of the formulation of the medical
20 cause of death, Coproxamol ingestion and coronary artery
21 atherosclerosis.

No hint was given by Dr Hunt at this most public inquiry that there had been 'need …..to correct and update the evidence already received.” Mr Gardiner Oxfordshire Coroner 6 August 2011.

I have already alluded to the close parallel with the case of Dr Kenneth Shorrock and repeat the essence here:-

He was charged with serious professional misconduct by the General Medical Council of serious professional misconduct on eight countsI believe. He had produced a second post-mortem report on a hospital patient which was indicative of negligence by the surgeon without any reference to his first report which had exonerated the surgeon. After much delay he was found guilty and warned.

At the last Fitness to Practice hearing 15-16 and 18-19 January 2007, this was recorded:-

“Professor Vanezis also described the procedure a pathologist should follow when asked to produce a supplementary post-mortem report. Any additional information should be provided to the coroner in the form of a supplementary report which should be read in conjunction with the first report. It should not replace the first report. In addition, reference should be made to the first report’s existence. He further stated that if a pathologist had reason to change his conclusions or opinion, an explanation should be given as to why he has deemed this necessary.

Professor Pounder agreed with this opinion. He too stated that when supplementary reports are issued it is important to make reference to the existence of an earlier report. In Professor Pounder’s opinion Dr Shorrock had a duty to make reference to the existence of the first report. In addition, the second report should have given the reasons for his change of view.

**********

Both of the forensic pathologists who gave expert evidence before the Panel took the view that Dr Shorrock’s conduct fell below the standard to be expected of a pathologist carrying out a post-mortem examination and reporting on it to the coroner’s court and to the criminal court. The Panel has already found proved that Dr Shorrock’s actions were unprofessional, inconsistent, unreasonable, inappropriate, not based upon the medical and pathological information available to him and likely to bring the profession into disrepute.

**********

In the light of this guidance, and in all the circumstances, the Panel has determined to conclude this case with a reprimand. It considers that this is a proportionate and appropriate sanction in the light of Dr Shorrock’s serious professional misconduct.”

 



TWO Failure to take the rectal (core) temperature of the corpse early in his examination. (NB Complaint withdrawn later after the opinion of the eminent Professor Henssge was received.)

Dr Hunt arrived at the scene on Harrowdown Hill where the corpse of Dr Kelly lay at 12 noon. He did not go directly to the corpse. He was shown a video recording taken by the police. After 10 minutes he went to the corpse. He delayed in carrying out a detailed examination until after the forensic biologist etc had arrived. He went back to the corpse at 14.10 hrs. The rectal temperature was taken at 19.15 hrs 24 ° C. The ambient temperature was noted to be 20.8° C.

Dr Hunt, from his PM report of 25 July 2003:-

Time of Death Estimation

The following estimate offered of the likely post mortem interval is based upon the temperatures recorded at the scene and computed with the aid of Henssge's nomogram as described in: Henssge, Knight, Krompecher, Madea and Noakes. The Estimatation of the Time of Death in the early post mortem interval; 2nd Edition, arnold, London, 2002.

Using the standard nomogram, the estimate obtained is that death is likely to have occurred some 18-27 hours prior to taking the rectal temperature at 19:15 hours (1915 on Friday 18th July (18/07).

My view, and the view of some others, is that this 7 hour delay unnecessarily widened the window of the time of death. Although the time of death can only be an estimate in a large majority of deaths, the estimate is very important in cases of homicide where the negation or substantiation of alibis etc is a central part of the investigation.

Lecture notes from the forensic science department of Dundee University, headed by Prof Derek Pounder read thus:-

“ 1. ALGOR MORTIS (BODY COOLING)
This is the most useful single indicator of the time of death during the first 24 hours post mortem. Some writers would regard it as the only worthwhile corporal method.

**********

It may be necessary to make small slits in the clothing to gain access to the rectum, if the body is clothed and the garments cannot be pushed to one side.

**********

The body temperature should be recorded as early as conveniently possible. The environmental temperature should also be recorded and a note made of the environmental conditions (see below) at the time the body was first discovered and any subsequent variation in these conditions.

Thus the two important unknowns in assessing time of death from body temperature are (1) the actual body temperature at the time of death; and (2) the actual length of the post mortem temperature plateau. For this reason assessment of time of death from body temperature clearly cannot be accurate, (even approximately), in the first four to five hours after death when these two unknown factors have a dominant influence. Similarly, body temperature cannot be a useful guide to time of death when the cadaveric temperature approaches that of the environment. However, in the intervening period, over the linear part of the sigmoid cooling curve, any formula which involves an averaging of the temperature decline per hour may well give a reasonably reliable approximation of the time of death. It is in this limited way that the cadaveric temperature may assist in estimating the time of death in the early post mortem interval, provided the sigmoid nature of the relationship between the temperature of the cooling body and that of its environment is kept in mind.”

**********

Dr Nicholas Hunt 16 September 2003 Hutton Inquiry

8 Q. Were you able to estimate the time of death?
9 A. Yes, within certain limits, using a particular technique
10 based upon the rectal temperature.



So what was the consideration that overrode the need to measure the core temperature as soon as possible?

 



THREE Failure to report that 5 blood specimens were taken from the corpse during the post-mortem examination when he was giving evidence before Lord Hutton. Instead, he spoke only of one blood specimen and the measurement of paracetamol and dextroproxyphene/metabolites in that one specimen.

Dr Hunt records these 5 blood samples in the list of exhibits at the end of his post-mortem examination of 18 July 2003, and released by the Ministry of Justice 22 October 2010.

NCH/43 Heart blood

NCH/44 Blood fluoride oxalate

NCH/45 Blood EDTA

NCH/46 Blood EDTA

NCH/47 Plain blood

Dr Alexander Richard Allan 3 September 2003 Hutton inquiry:-

12 A. It is the same preservative, to retard decomposition of
13 the fluid. NCH43 hard blood. NCH44 preserved blood.
14 I have blood fluoride oxidate which is, again, preserved
15 blood. NCH46 blood EDTA.
16 Q. What does EDTA signify?
17 A. That is an anticoagulant in the blood to stop it
18 clotting.
19 Q. Is that something that is added to the blood?
20 A. That is something that is added to the blood.
21 Q. After the event?
22 A. Yes, it is in a preservative containing -- it is in
23 a little phial containing EDTA and the blood is added to
24 that at the post-mortem.
25 Q. What next?

3
1 A. Some more plain blood NCH47.

**********

25 Q. If I could ask you first of all about the blood and

5
1 urine samples. What were they specifically analysed
2 for?
3 A. The blood and urine samples were analysed for the
4 presence of alcohol and a wide range of commonly
5 available drugs that includes amphetamines,
6 barbiturates, benzodiazepine drugs, that is the group
7 that includes diazepam and temazepam, benzoylecgonine
8 which is the metabolite or breakdown product of cocaine;
9 cannabinoids, that is the constituents of cannabis;
10 chemically basic drugs such as anti-depressants, and
11 that includes things like dextropropoxythene
and
12 antihistamines as well, amongst a wide range of other
13 substances, methadone, methyl amphetamine,
14 3,4-methylenedioxymethylamphetamine which is known by
15 its initials MDMA and also known as ecstasy and related
16 compounds. Opiate drugs such as morphine and heroin,
17 and this is the standard sort of analysis that we do in
18 all suspicious deaths in criminal cases.
19 Q. That is specifically what you looked for in the blood
20 and urine samples?

21 A. Yes.

**********

12 Q. I want to ask you about the results, first of all the
13 results of the blood item which you have called NCH47

14 which I think is the plain blood. Could you tell us
15 what you found there, in NCH47, the blood sample?
16 A. Yes, I found paracetamol at a concentration of
17 97 microgrammes per millilitre of blood; and
18 dextropropoxyphene at a concentration of 1.0
19 microgrammes per millilitre of blood.
20 Q. Did you find anything else in the blood sample?
21 A. Yes, I did. I also found some substances related to
22 dextropropoxyphene, breakdown products, metabolites, and
23 so on, and some caffeine.

24 Q. What about the blood item, 44 and the urine item, 39?
25 A. I analysed the blood item, 44, for alcohol and I found

7
1 no alcohol in that. And I found no alcohol in the urine
2 item NCH39.
3 Q. Did you find anything at all in the blood item 44?
4 A. I found traces of acetone in the blood and also possibly
5 in the urine and none of the other volatile substances
6 were detected.

**********

Q. What would you expect to see in the usual case where
12 dextropropoxyphene has resulted in death? What types of
13 proportions or concentrations would you normally expect
14 to see?
15 A. There are two surveys reported I am aware of. One
16 reports a concentration of 2.8 microgrammes per
17 millilitre of blood of dextropropoxyphene in a series of
18 fatal overdose cases. Another one reports an average
19 concentration of 4.7 microgrammes per millilitre of
20 blood. You can say that they are several fold larger
21 than the level I found of 1.

**********

Dr Nicholas Hunt September 16 2003 Hutton Inquiry

8 Q. Were you handed a toxicology report at any time?
9 A. Yes, I was. It was the report of Dr Alexander Allen.
10 Q. Did you have this report before or after your
11 examination?
12 A. After the examination.
13 Q. In summary what did it show?
14 A. It showed the presence of two compounds in particular.
15 One of them is a drug called dextropropoxyphene. That
16 is an opiate-type drug, it is a mild painkiller, and
17 that was present at a concentration of one microgramme
18 per millilitre in the blood.
19 Q. Did it show anything, this report, in summary?
20 A. Yes, it did. It showed the presence of paracetamol.
21 Q. The concentration of that?
22 A. 97 milligrammes per millilitre.

**********

Summing up by Dr Hunt:-

'Given the finding of blister packs of Coproxamol
7 tablets within the coat pocket and the vomitus around
8 the ground, it is an entirely reasonable supposition
9 that he may have consumed a quantity of these tablets
10 either on the way to or at the scene itself.
11 Q. What did the toxicology report suggest?
12 A. That he had consumed a significant quantity of the
13 tablets.'

The first extracted image below is from the 15 page report prepared by Dr Nicholas Hunt 25 July 2003 and released by the Ministry of Justice 22October2010.

http://www.justice.gov.uk/downloads/publications/corporate-reports/MoJ/2010/pathologist-report-dpa.pdf

The second extract is from a report by Dr Alexander Richard Allan dated 21 July 2003 and released by the Ministry of Justice 22 October 2010

http://www.attorneygeneral.gov.uk/Publications/Documents/Dr%20Allan%20statement%201%20%2021%20July%202003.pdf

TOXICOLOGY

At the time of completing this report, I have been provided with the following verbal information by Dr Alexander ALLAN, a forensic toxicologist from Forensic Alliance Limited.

  • The blood sample contains the drug dextropropoxyphene at a concentration of 1.0 micrograms per millilitre.
  • The blood sample contains the drug paracetamol at a concentration of 97 micrograms per millilitre.

MG 11W (11/2010)

 

The following substances were found in the blood, item NCH/47, at the stated concentrations:

paracetamol - 97 micrograms per millilitre of blood

dextropropoxyphene - 1.0 micrograms per millilitre of blood

Signed: A R Allan

2006/07(1)

 

Continuation of Statement of: ALLAN ALEXANDER RICHARD   Form MG11(T)(CONT) Page 4 of 7

Alsopresent were dextropropoxyphen-related substances such as metabolites and breakdown products and caffeine.

No alcohol was found in the blood item NCH/44 or urine item NCH/39. A trace of acetone was found in this blood and also possibly in the urine. No other volatile substances were detected. None of the other substances listed under 'Nature of Examination' were detected.


Commentary: Questions yet to be answered

a. 5 blood samples were taken from the corpse.

b. The site of origin of only one was reported. It is widely recognised that drugs which are ingested can diffuse from the stomach into the great vessels and thus be the cause of elevated levels.

c. Dr Allan recorded receipt of 4 blood samples in his written report of 21 July 2003. He specified the measured levels of the chemicals relating to ingestion of co-proxamol (NCH/47 – origin unknown) and indicated that two studies of fatal overdose showed levels of dextropropoxyphene several fold larger than the level of 1mcg per ml of blood he measured in the blood of Dr Kelly. He was asked about NCH/44. 'Did you find anything at all in the blood item 44?' He said 'I found traces of acetone in the blood and also possibly in the urine and none of the other volatile substances were detected.'

He made NO MENTION of finding paracetamol or its metabolites, or dextroproxphene or its metabolites in this specimen of BLOOD labelled NCH/44 - origin unknown, in response to the above question. This point is reinforced by his words above 'None of the other substances listed under 'Nature of Examination' were detected.' I can conclude these drugs or their metabolites were absent in this blood sample of unknown site of origin.

He was not asked about the other 2 specimens (in fact 3) and he did not volunteer any information about them. He did not tell the inquiry that the site from where the blood was taken could be important in the interpretation of the measured levels.

d. In the above extract from page 2 of his report which was put in the public domain 22 October 2010, he writes '...were found in the blood, item NCH/47 ….' The lay person, without scientific training, would assume from this that no other blood samples had been made available. Furthermore, he would not know that Dr Allan had been asked about NCH/44 and that nothing relating to Co-proxamol had been found. This was a public inquiry.

e. Dr Hunt did not raise site of blood sampling relevant to measured levels, or distortion of opiate/opioid levels by time from death. He knew he took 5 samples seven days previously at the post-mortem examination, or at least 4 as recorded by Dr Allan, but spoke only thus 'the blood sample contains the drug paracetamol …. and the blood sample contains the drug dextropropoxyphene …...'.

f. As the sole forensic pathologist present at the Hutton inquiry, it was Dr Hunt's professional duty to be as explicit as possible and to interpret the complexities of death by overdose of drugs as well as he could. In addition, his recital of the findings of the drugs in a sole blood sample cannot be accepted as having happened by pure chance. The fact that Lord Hutton had never acted as a coroner before compounded the paucity of explanation/exposition coming from the expert witness, as well as the paucity of questioning by the appointed barristers.

 



FOUR Haemorrhage Inscised wounds – left wrist

There have been differences between the witnesses as to the amount of blood at the scene. Most prominent amongst those reporting little visible blood were the paramedics Ms Vanessa Hunt and Mr David Bartlett.

Ms Hunt
8 Q. And is there anything else that you know of about the
9 circumstances of Dr Kelly's death that you can assist
10 his Lordship with?
11 A. Only that the amount of blood that was around the scene
12 seemed relatively minimal and there was a small patch on
13 his right knee, but no obvious arterial bleeding. There
14 was no spraying of blood or huge blood loss or any
15 obvious loss on the clothing.
16 Q. On the clothing?
17 A. Yes.
18 Q. One of the police officers or someone this morning said
19 there appeared to be some blood on the ground. Did you
20 see that?
21 A. I could see some on -- there were some stinging nettles
22 to the left of the body. As to on the ground, I do not
23 remember seeing a sort of huge puddle or anything like
24 that. There was dried blood on the left wrist. His
25 jacket was pulled to sort of mid forearm area
and from
1 that area down towards the hand there was dried blood,
2 but no obvious sign of a wound or anything, it was just
3 dried blood.

 


and Mr Bartlett

22 Q. You mentioned the injury to the wrist. You saw some
23 blood, did you?
24 A. There was dried blood across the top, yes.
25 Q. Was that congealed or not?

**********

Q. Is there anything else you would like to say about the
10 circumstances leading to Dr Kelly's death?
11 A. Just the same as my colleague actually, we was surprised
12 there was not more blood on the body if it was an
13 arterial bleed.
14 MR KNOX: Thank you very much.

Statements and records made by Dr Hunt. Firstly 16 September at the Hutton inquiry:-

8 Q. What about the bloodstains on the clothes, did you
9 notice any of them?
10 A. Yes, there were a number of areas of bloodstaining on
11 the clothes, including over the front of the shirt, over
12 the Barbour jacket itself, including in the sleeve of
13 the Barbour jacket on the left.
14 Q. And what about around the trousers or the legs?
15 A. Yes, there was some bloodstaining over the trousers;
16 and, in particular, there was a patch of bloodstaining
17 over the right knee.
18 Q. What about around the arms?
19 A. There was some staining, as I have said, over the left
20 arm. That was the heaviest staining, really, including
21 within the sleeve of the jacket. And there was some
22 bloodstaining over the back of the left elbow.
23 Q. What about bloodstains on the exposed body surfaces;
24 what did you notice about that?
25 A. The most obvious area of bloodstaining was around the

12
1 left wrist, where it was relatively heavy.
2 Q. Did you notice any other bloodstaining around the hands?
3 A. Yes. Over the palm of the right hand and the fingers of
4 the right hand there was further bloodstaining.

**********

17 Q. Were any other bloodstains noted on the body?
18 A. There was a small bloodstain over the right side of his
19 neck, which we sampled at the scene. And two further
20 smaller areas of bloodstaining over the right side of
21 his face; again, they were sampled at the scene.

**********

16 Q. Was there any blood beneath the knife?
17 A. Yes, there was. There was blood around the area of the
18 knife.
19 Q. How close to the knife was the blood?
20 A. It was around the knife and underneath it.

**********

7 A. Yes, there was some smeared blood over both the bottle
8 itself and the bottle top.
9 Q. Did that indicate anything to you?
10 A. It indicated that he had been bleeding whilst at least
11 placing the bottle in its final position. He may
12 already have been bleeding whilst he was drinking from
13 it, but that is less certain.
14 Q. Was there any other bloodstaining that you noticed in
15 the area?
16 A. There was. There was an area of bloodstaining to his
17 left side running across the undergrowth and the soil,
18 and I estimated it was over an area of 2 to 3 feet in
19 maximum length.

**********

13 Q. Did you notice any signs of visible injury to the body
14 while you were there?
15 A. Yes. At the scene I could see that there were at least
16 five what I would call incised wounds or cuts to his
17 left wrist over the what is anatomically the front of
18 the wrist, but that is the creased area of the wrist.
19 Q. Were there any other visible signs of injury to the
20 body?

**********

5 Q. And in summary, what is your opinion as to the major
6 factor involved in Dr Kelly's death?
7 A. It is the haemorrhage as a result of the incised wounds
8 to his left wrist.
9 Q. If that had not occurred, would Dr Kelly have died?
10 A. He may not have done at this time, with that level of
11 dextropropoxyphene.
12 Q. What role, if any, did the coronary disease play?
13 A. As with the drug dextropropoxyphene, it would have
14 hastened death rather than caused it, as such.

(and see recorded cause of death on page 1)

“A textbook suicide: The pathologist who conducted the autopsy on David Kelly in 2003 breaks his silence to reject the conspiracy theories surrounding the scientist’s death” Steven Swinford Sunday Times Published: 22 August 2010

“Critical medics say Kelly would have had to have lost several pints of blood to threaten his life, which would have been evident.

According to Hunt, however, both Coe and the paramedics are wrong. He said: “Nobody would have seen the amount of blood at the scene. In actual fact there were big, thick clots of blood inside the sleeve, which came down over the wrist, and a lot of blood soaked into the ground. They [Coe and the paramedics] might not have seen it, but it was there and I noted it in my report.”

NB - Dr Kelly was undressed later during the in situ examination so 'big, thick clots of blood inside the sleeve' would have been seen and recorded in the Final Post Mortem Report of 25 July 2003.

Extracted image (2) from Report prepared by Dr Hunt 25 July 2003 and released by the Minister for Justice 22 October 2010 is attached as a separate sheet.

From http://www.justice.gov.uk/downloads/publications/corporate-reports/MoJ/2010/pathologist-report-dpa.pdf Page 2 Extracts:-

Bloodstaining and contamination on clothing 

  • there was heavy bloodstarning over the left arm, including that part which was within the jacket at the scene.

Bloodstaining and contamination on exposed body surfaces

  • There was heavy bloodstaining over the left arm, including that part which was inside the jacket sleeve.


Comment

Heavy blood staining of the left sleeve and left arm was observed and noted by Dr Hunt when he and others were undressing the corpse of Dr Kelly on the afternoon of 18 July 2003. This evidence is clearly stated in his “Final Post Mortem Report” of 25 July 2003. This was consonant with what he said at the Hutton inquiry:-

19 A. There was some staining, as I have said, over the left
20 arm. That was the heaviest staining, really, including
21 within the sleeve of the jacket. And there was some
22 bloodstaining over the back of the left elbow.

These verbal and written descriptions cannot be matched with “... there were big, thick clots of blood inside the sleeve, which came down over the wrist, and a lot of blood soaked into the ground.”

One has to presume that the latter statement was based on privileged records held by the coroner and that he had given permission for their public use. What record was the basis for this latter description of the blood seen in relation to the left arm and the cuts at its wrist? Which is the truthful description? Are the first two the truthful descriptions, or is it the third? What or who prompted Dr Hunt to speak to the Sunday Times and was it proper for him to do so?

 



Explanations and Summary

History of our plea


I have not become involved in the plea for a second inquest into the unnatural death of Dr David Kelly because of prurient or morbid motives. Instead I came to it for these reasons which were published in a national newspaper 16 December 2003. I had delayed in writing for several months because I did not want to cause distress in the loved ones:-

As a past trauma and orthopaedic surgeon I cannot easily accept that even the deepest cut into one wrist would cause such exsanguination that death resulted.  The two arteries are of matchstick size and would have quickly shut down and clotted.

Furthermore we have a man who was expert in lethal substances and who apparently chose a most uncertain method of suicide.


This came to the notice of a group of like minded doctors with a lay chairman. We have persisted since then with our plea and devoted a great deal of our time to it. We hold that due process of law has been subverted and that 'insufficiency of inquiry' is a central part of that. We did not believe that 'intent to commit suicide or suicide' had been proved beyond reasonable doubt. We remain determined to see the laws of our country upheld. We wrote in February 2004 asking the coroner to re-open the inquest rather than accept the conclusions of the Hutton inquiry, into which the inquest opened by Mr Gardiner had been subsumed. It is noteworthy that about half of one day's sitting was given over to the forensic evidence whereas about twenty days were spent on 'urgently inquiring into the circumstances surrounding the death of Dr David Kelly'. We have always considered that instruction to be oblique compared with the ancient duties of the coroner.

Public interest

i. You have raised the question of public interest. At its most shallow, there is wide public interest. Millions of UK citizens, and many world wide, were shocked by the morbid death of Dr Kelly. We can attest that shock persists in many even now. It was widely acknowledged in the media and in the citizenry that the Hutton inquiry was a whitewash. Not many people knew that the inquest into his death took place within the inquiry. There are several reasons therefore why people feel the death of this man is in limbo. Furthermore, they feel the state might have had something to do with it.

ii The public interest as I believe you mean it requires that the coronial system maintains the highest standards. This includes the standards of forensic pathology and forensic science in this country. It should be a matter of grave concern that two pathologists have had their licences to practise taken away in this specialism, one has been warned and one found guilty of serious professional misconduct. This is within a corpus of about forty forensic pathologists. I cannot find the references now but remember well reading a survey (I think from the GMC) which concluded that peer review and 'quality control' in forensic pathology was not optimal. Yet it is at the heart of our system of justice.

'Knowledge' in the legal sense

Finally, please note that three of the four topics expanded above, were not open to analysis and professional comment before 22 October 2010, and the first ie ONE, not until this last February.

Expertise/Qualification

Dr Hunt and some of his colleagues (see http://www.attorneygeneral.gov.uk/Publications/Documents/Hunt%20to%20AGO%2025%20May%202011.pdf) consider we are speaking and acting in an arena which is outside our areas of expertise.

The group of Doctors who appear to be driving this are offering apparently authoritative and 'expert' commentary fat outwith their own fields of practice. It has been pointed out by a number of my colleages that in doing so their actions ought to be reported to the General Medical Council and where appropriate the NPIA. To date I have not taken any action on this front though others appear inclined to do so.

Although our group has contracted due to illness and death, I can say this. Firstly we have a right as well informed citizens to speak up when we believe there is wrong. Secondly, it is disingenuous at least, to dismiss or belittle the thoughts and experiences of doctors in fields other than in forensic medicine. For instance, as a senior orthopaedic and trauma surgeon, I know very well how arteries behave in life. I know how humans come to die, and how they can often be saved from dying. Furthermore, I was trained very well in pathology at St Mary's and thereafter (3 – as relevant to this subject). I taught that deceased patients should undergo post-mortem examination whenever necessary and that a good knowledge of pathology gave the clinician 'X ray eyes'. I attended many post-mortem examinations as a student, in training and as a specialist.

We are possibly being accused of hounding Dr Nicholas Hunt. We are not. Speaking for myself, I would never have come to know of Dr Hunt unless I had doubted the causes of Dr David Kelly's death. Since I doubt those stated causes and the integrity of the inquiry I cannot avoid examination of the actions, records and opinions of the central witness in this inquiry. Far from conducting a witch hunt, I have sympathy for Dr Hunt which I have expressed previously. Nine years from qualification as a doctor, and two years from joining the Home Office list of forensic pathologists, he was thrust under the spotlight of an investigation into one of the most 'high profile' deaths for decades. I felt at the beginning, and still do, that he should have been asked to carry out the investigation with a senior pathologist. Furthermore, the investigation should have followed logic and practice. That is, the inquest should have been conducted first and separately from the non-forensic and political issues aired later in a public inquiry conducted under oath. Any chance of this measured response was swept away when Lord Falconer asked Lord Hutton to ' urgently inquire into the circumstances surrounding the death of Dr David Kelly' within 24 hours of Dr Kelly's most tragic death.

For truth, reason and justice

David Halpin MB BS FRCS

cc Leigh Day & Co.

* Dr Allen's second report 18 August recorded a trace of dextropropoxyphene in the water within the 'Evian' bottle.

** The group of doctors which has consistently pleaded for an inquest since January 2003 asked through its lawyers for the post mortem reports and for all forensic medical reports in this case. This request was made to Nicholas G Gardiner HM Coroner for Oxfordshire by Leigh&Day on 11 December 2009. A similar request for those records was made by Leigh&Day to Mr Jack Straw Minister for Justice 22 January 2010. That request remained unanswered under the succeeding minister, Mr Kenneth Clarke, who published the Final Post Mortem Report of Dr Nicholas Hunt 25/07/03 and the Toxicology Report of Dr Alexander Allan 21/07/03 on 22 October 2011. On the same date our solicitors were told by Mr Clarke that the medical and other records we had requested would remain 'closed' for 70 years as directed by Lord Hutton in 2004. I believe this was at the request of Lord Falconer.

Enclosures:
1. Letter from Mr Gardiner to Ms Albon
2. Page 2 of Dr Hunt's report of 25 July 2003
3. CV of David Halpin as relevant to this case