The Shipman Inquiry
Encyclopedia
The Shipman Inquiry was the report produced by a British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 governmental investigation into the activities of general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...

 and serial killer
Serial killer
A serial killer, as typically defined, is an individual who has murdered three or more people over a period of more than a month, with down time between the murders, and whose motivation for killing is usually based on psychological gratification...

 Harold Shipman
Harold Shipman
Harold Fredrick Shipman was an English doctor and one of the most prolific serial killers in recorded history with 218 murders being positively ascribed to him....

. Shipman was caught in 1998 and the inquiry commenced after his trial in 2000. It released its findings in various stages, with its sixth and final report being released on 27 January 2005. It was chaired by Dame Janet Smith DBE.

While Shipman was convicted of 15 murders, the inquiry established that he probably committed 250 in total, though the true number could be more. The Inquiry took approximately 2,500 witness statements and analysed approximately 270,000 pages of evidence. In total the six reports ran to 5,000 pages and the investigation cost £21 million.

Remit and make up of inquiry

On 1 February 2000, the Secretary of State for Health
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...

, Alan Milburn
Alan Milburn
Alan Milburn is a British Labour Party politician, who was the Member of Parliament for Darlington from 1992 until 2010...

, announced that an independent private inquiry would take place into Shipman's activities. It would decide what "changes to current systems should be made in order to safeguard patients in the future". Its findings would be made public, though it would be held in private. It was to be chaired by Lord Laming of Tewin
Herbert Laming, Baron Laming
William Herbert Laming, Baron Laming, CBE isa British social worker and Crossbench Peer in the House of Lords. On 29 June 2011, it was announced that he had been elected to succeed Baroness D'Souza as Convenor of the Crossbench Peers; he will take up the post in September 2011 when the House...

.

It began work on 10 March and was to produce a report by September 2000. Many families of the victims along with certain sections of the British media called for a Judicial Review in the High Court
High Court of Justice
The High Court of Justice is, together with the Court of Appeal and the Crown Court, one of the Senior Courts of England and Wales...

. It found in their favour and recommended that the Inquiry be held in public. The Secretary of State for Health agreed and in September 2000, announced that the Inquiry would be held under the terms of the Tribunals of Inquiry (Evidence) Act 1921. This was then ratified by both Houses of Parliament in January 2001. Lord Laming was replaced by Dame Janet. Dame Janet initially hoped to finish her inquiries by "Spring of 2003". The Inquiry was held in the Town Hall in Manchester
Manchester
Manchester is a city and metropolitan borough in Greater Manchester, England. According to the Office for National Statistics, the 2010 mid-year population estimate for Manchester was 498,800. Manchester lies within one of the UK's largest metropolitan areas, the metropolitan county of Greater...

 with proceedings relayed by closed circuit television to the public library in Hyde
Hyde, Greater Manchester
Hyde is a town in the Metropolitan Borough of Tameside, Greater Manchester, England. As of the 2001 census, the town had a population of 31,253. Historically part of Cheshire, it is northeast of Stockport, west of Glossop and east of Manchester....

, where Shipman had lived, in order for the town's inhabitants to follow it more easily.

There were four main areas investigated:
  1. the extent of Shipman's unlawful activities
  2. the actions of the statutory bodies and other organisations concerned in the procedures and investigations which followed the deaths of Shipman's patients
  3. the performance of the statutory bodies and other organisations with responsibility for monitoring primary care provision and the use of controlled drugs
  4. what steps should be taken to protect patients in the future

Findings

The Inquiry found "major flaws in the systems that govern death registration, the prescription of drugs and the monitoring of doctors." In all, including the 15 deaths Shipman was convicted of, it concluded that Shipman had killed 250 patients, starting in 1971 while he was working in Pontefract
Pontefract
Pontefract is an historic market town in West Yorkshire, England. Traditionally in the West Riding, near the A1 , the M62 motorway and Castleford. It is one of the five towns in the metropolitan borough of the City of Wakefield and has a population of 28,250...

 General Infirmary. Though the majority of his victims were elderly, there was a "quite serious suspicion" that he had killed one patient aged four.

The report rejected claims by a prisoner, John Harkin, who knew Shipman while he was in Preston prison, that Shipman had confessed to 508 deaths. In Dame Janet's view, no "reliance [could] be placed on Mr Harkin's account."

Recommendations

The Inquiry made a number of recommendations for the reform of various British systems. It called for coroner
Coroner
A coroner is a government official who* Investigates human deaths* Determines cause of death* Issues death certificates* Maintains death records* Responds to deaths in mass disasters* Identifies unknown dead* Other functions depending on local laws...

s to be better trained and underlined that better controls on the use of schedule 2, 3 and 4 drugs by doctors and pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

s were needed.

It also recommended that fundamental changes be implemented in the way that doctors are overseen. Specifically, it said, the General Medical Council
General Medical Council
The General Medical Council registers and regulates doctors practising in the United Kingdom. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise...

 "was an organisation designed to look after the interests of doctors, not patients".

Post-inquiry situation

In 2008, a University of Dundee
University of Dundee
The University of Dundee is a university based in the city and Royal burgh of Dundee on eastern coast of the central Lowlands of Scotland and with a small number of institutions elsewhere....

 investigation found that even if the monitoring of patients' deaths was introduced as the Inquiry suggested, it would provide "such poor evidence that it would take 30 deaths to detect a murderous trend" because since 2004 in Britain, "patients have been registered with practices, not individual doctors, so the data on each GP is lacking".

See also

  • John Bodkin Adams
    John Bodkin Adams
    John Bodkin Adams was an Irish-born British general practitioner, convicted fraudster and suspected serial killer. Between the years 1946 and 1956, more than 160 of his patients died in suspicious circumstances. Of these, 132 left him money or items in their will. He was tried and acquitted for...

    — British doctor and suspected serial killer who "possibly provided the role model for Shipman".

External links

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