Feature Professional Regulation

Have we heeded the lessons from Shipman?

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c5711 (Published 18 October 2010) Cite this as: BMJ 2010;341:c5711
  1. Clare Dyer, legal correspondent
  1. 1 BMJ, London, UK
  1. ClareDyer{at}aol.com

The £21m Shipman inquiry recommended fundamental changes to the system that allowed a family doctor to kill undetected for more than 20 years. Ten years on, Clare Dyer investigates what progress has been made

Harold “Fred” Shipman was a popular general practitioner (GP) who practised for more than 20 years in Hyde, Greater Manchester. To his patients, there seemed nothing to mark him out from other family doctors in the town. People trust doctors and they trusted him. It took more than two decades to unmask him as the United Kingdom’s most prolific serial killer.

In January 2000 he was convicted of murdering 15 of his patients. A four year inquiry chaired by the appeal court judge Dame Janet Smith concluded that the death toll was probably more than 200 between 1971 and 1998. Mostly elderly women but nowhere near death, they were killed in their homes or in his surgery with a large shot of diamorphine. “None of your victims,” Mr Justice Forbes told him when he sentenced him to life imprisonment, “realised that yours was not a healing touch. None of them knew that in truth you had brought her death, death which was disguised as the caring attention of a good doctor.”

Like his patients, the system trusted Dr Shipman. He signed the death certificates himself so there was no need to refer the case to the coroner. Fellow GPs to whom he gave a plausible account of the death countersigned the cremation certificates without making their own inquiries. The medical referee who was supposed to scrutinise the forms simply checked that they were filled in properly. The coroner was finally alerted by another GP after an undertaker commented that Dr Shipman’s death rates seemed abnormally high, but a botched and unnecessarily protracted police investigation allowed three …

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