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.