13 August 2016

A kindly, capable, caring GP, but deadly to elderly women

Harold Shipman (1946–2004) studied medicine at Leeds School of Medicine, graduating in 1970. Then he did his house year, junior and senior residencies at Pontefract General Hospital in West Yorkshire. He moved into General Practice in Todmorden in 1974.

Nigel Bunyan in The Telegraph (16th June 2001) was very graphic. Two former northern mill towns of Todmorden and Hyde became, for over a period of 25 years, the killing fields of Harold Shipman, Britain's serial killer. But how many patients did he really inject with fatal doses of diamorphine? The paper compiled a list of c300 of these vic­t­ims, mostly older women.

Comprehensive research gave a disturbing insight into both the geographical density of Ship­man's attacks and their frequency. It has long been recognised that to fully understand Shipman, the nation needed to identify his first victims: Shipman was suspected of killing up to five of his patients as early as 1974. In c40% of all his deaths, Shipman appeared to have been with the patient on the day he/she died. Statistically this was astounding. A clinical audit prepared by a University of Leicester professor as part of his Government-commissioned brief to examine the Shipman murders, suggested a national incidence of under 1%.

The early deaths ended in 1975 when a local chemist expressed concern about the large volume of prescriptions for pethidine signed by Shipman (for his own addiction). The GP's shocked colleagues demanded his immediate resignation. Yet they felt compassion, given that they now thought his career was over, to secure him a place as a patient at a York psychiatric hospital for six months. Shipman was fined £600 by magistrates in Halifax after admitting 75 drugs offences, including forgery and possession.

The late Dr Harold Shipman
much loved GP in Yorkshire

With the General Medical Council failing to take any disciplinary action over his conviction, the much-loved Dr Shipman managed to return to medicine, following his break from practice.

In October 1977 he moved to the Donneybrook House group practice in Hyde and worked as a partner there for the next 15 years. By the time he left, in May 1992, he had gained a reputation for medical expertise and a caring bedside manner. When his patients learnt that he was setting up a solo practice in nearby Market St, many followed him. Away from the prying eyes of his Donneybrook colleagues, Dr Shipman could enjoy a freedom he had craved since his arrest in Todmorden.

His patients did not even have to be ill to interest Shipman. He gained his thrills by exploiting those who trusted him most. Although psychiatrists diagnosed him as a classic necro­philiac during the exhaustive police investigation, there was never any suggestion that he ever molested his victims. After injecting each patient, he laid the dead body out on the bed with great care. His favourite time to watch his patients die was mid-afternoon. Sometimes, though, he would call at their homes on his way to work. He returned time and time again to particular streets, sometimes even to the same house, in search of fresh victims.

The beloved GP, who sometimes stole jewellery as trophies to remind him of a murder, was almost caught on a number of occasions before his eventual arrest. Such was his arrogance that he may actually have enjoyed such moments; and perhaps even courted them.

Undertakers and local GPs began to voice their concerns, begging the authorities to take notice. In the end it was only the sheer number of deaths that finally began to raise suspicions. Shipman's Market St surgery gained a reputation for los­ing a lot of its patients. The South Manchester coroner requested a police investigation after being approached time after time by another GP in the town, a co-signatory to a number of Shipman's death certificates.

In Jan 2000, a jury found Shipman guilty of 15 murders. But that wasn’t the end of the story. An inquiry after his conviction confirm­ed he was responsible for c218 deaths. He was sentenced to life imprisonment, never to be released.

After the GP was safely locked away, the Shipman Inquiry began in September 2000. Its most important question was how the doctor had managed to conceal his criminal past so successfully, especially in a nation with a well-regulated public health system. Lasting almost two years, it investigated all cases where the death certificate had been signed by Shipman. Too late for the victims and their families of course, but at least Britain's health care structure was reviewed and modified as a result of this doctor's crimes. In 2004, while still in his late 50s, Shipman hanged himself in his gaol cell in Wakefield Prison.

**

Dr Shipman was one of the most prolific serial killers in recorded history. Everyone learned his name and history quickly, since the details appeared on the front page of every newspaper in the UK and across the British Commonwealth. But I had a particular interest in the case. Along with many other young medical graduates from Australia, New Zealand and South Africa, my partner and his friends graduated medicine in 1970, then moved to the UK to do three years in a large British hospital. I did not ever meet Dr Shipman at hospital conferences or dinners; he spent his career in West Yorkshire and my friends spent their hospital years in London and the Home Counties. But the dates and career paths were uncannily similar.

Could a doctor ever allow elderly patients to die in misery in Australia? My late father, frail and elderly, was subjected to 15 days of starvation by a particular doctor in a private hospital. I wrote 45 long, urgent reports to the hospital, the Health Commission and the Professional Standards Office, but no-one in authority tried to stop the doctor. I don’t think the Australian doctor’s motives were remotely the same one as those that motivated Dr Shipman’s killing spree in Britain, but the public’s blind trust in doctors still allowed patients(s) to die.





11 comments:

Dina said...

Probably every profession has members who go feral. We have to hope that the authorities catch the criminals quickly and with severe consequences.

Parnassus said...

Hello Hels, We were talking about the infamous Dr. Shipman just the other day--thanks for this review of his "career." Ohio also had a surgeon run amok, the infamous Dr. James Burt from Dayton, known as the "Love Doctor." Before I left the U.S., and while the Burt lawsuits were still in process, I worked for a medical malpractice insurance company that insured most of the doctors in Ohio. Luckily we had not insured Burt--what he did was criminal, not malpractice, but often the insurer has to pay anyway in cases like that. I have no idea what English law is like, but I am assuming that most of the victims' families had no recourse.
--Jim

bazza said...

I'm feeling as shocked and horrified now, after reading this, as I did at the time. We do tend to put doctors on pedestals without question, usually with justification. Who wouldn't want a kindly looking GP such as shown in your picture. Even his name is redolent of a reliable, kindly and trustworthy Yorkshire character.
His crimes are hard to understand, even as a psychologist (not professionally but with a degree), I find it hard to come to terms with.
Incidentally, did you the get the news in Oz that they have just transferred Peter Sutcliffe, the Yorkshire Ripper, from Broadmoor to a regular prison, stating that he now has "no mental problems". Chilling.
CLICK HERE for Bazza’s fabulous Blog ‘To Discover Ice’

Hels said...

Dina

I agree. Teachers in private schools were beating or sexually abusing their own students throughout the 1960s, 70s and 80s, yet there were no royal commissions and no legal consequences until much later. Why didn't the parents report what was happening to their sons at the time? Why did the principals deny for decades that their own students were abused by the very professionals who were supposed to care for them?

Hels said...

Parnassus

I did not recognise the name Dr James Burt or the Love Doctor. But I quickly found the newspaper reports.

Apparently the surgeon women trusted this respected ob/gyn at St. Elizabeth's Hospital in Dayton, Ohio in 1966. In his later book Surgery of Love he wrote "Women are structurally inadequate for intercourse. This is a pathological condition amenable to surgery". So he designed and implemented surgical procedures to redesign women's genitalia. With, or usually without their consent.

Where Burt's story dovetails with Shipman's in two important ways.
Firstly other doctors tried FOR YEARS to alert the state medical board about Burt! But it did not take action until the Ohio Governor became aware of the mutilation and demanded answers in 1988! How many women were damaged in those 22 years?
Secondly Dr Burt voluntarily surrendered his medical license in 1989, thereby avoiding a medical board hearing and allowing him to slip away quickly and without consequence.

Hels said...

bazza

We really do tend to put doctors on pedestals without question, which is fine 95% of the time. But what are the consequences if something goes awry in hospitals and medical practices?

I suppose most people would say the punishment should depend on the doctor's motives. If he was simply medically unskilled or unread, he could be be debarred for a few years and do intensive re-training in the meantime.

But what if he was a sexual abuser, a necrophiliac or someone who selected out women, blacks or Muslims to inject with morphine? What happens if he had been selected by God to do His work, getting rid of the frail and the sick to make his society a healthier place?

I would put him in gaol for the rest of his life because doctors have a higher responsibility than ordinary citizens to take care of vulnerable citizens.

Hels said...

bazza

I listen to the BBC News each night :) Joe and I remember the 1975-77 killings by The Yorkshire Ripper very well! Women in particular were afraid.

So which reason is being given in 2016 to move him?
a] Sutcliffe was not schizophrenic in the first place
b] He was schizophrenic in the years leading up to the 1981 trial, when he was doing all the mutilations and murders of young women, but 35 years of treatment have cured the disease
c] Broadmoor Psychiatric Hospital doesn't care what his condition is now ... they just want him out of there as soon as humanly possible.

Mandy Southgate said...

If I had to judge against the impersonal, heartless lack of care my mum receives, I'd say what happened to your father happens in UK too. It is a travesty how Shipman got away with his crimes.

Hels said...

Mandy

there is a God Complex that seems to weigh heavily on some medicos' thinking (and perhaps on surgeons most heavily of all). Not only the elderly patients are terrified; the nursing staff told me what would happen to their careers if they revealed "the true situation". That sort of travesty will continue to occur, because no-one is brave enough (or stupid enough) to speak out.

Andrew said...

It is almost unbelievable that Shipman could get away with what he did without an alert on some system or a person saying something. While what you describe with your father is disturbing and puzzling, we can only hope it is unusual. Were you ever told why he was not fed?

Hels said...

Andrew

I think it was utterly shameful that Shipman was not detected and stopped, but perfectly believable. The children and grandchildren of the victims are usually too poor and too powerless to get the authorities to investigate, and the villain's professional equals would not dream of dobbing in another doctor.

In dad's case, the Health Services Commissioner read all my reports since dad was still alive and after 3 months wrote "Thank you for our discussion on the phone this morning. I regret we are unable to assist you further with your complaint. However, should you wish to send us documents to place on your late father's file, we are happy to do so". The Medical Director of the hospital met me with all his Heads of Departments and told me out loud that "they will sue me for libel if I ever mention his hospital and Mercy Killing By Starvation By Doctor again".

How many other frail elderly patients has he mercy killed by starvation?