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The BBC's Fergus Walsh
"The crimes of Harold Shipman defy description, belief or understanding"
 real 56k

Professor Richard Baker, Leicester University
"There is an excess of deaths among Shipman's patients"
 real 28k

Daughter of alleged victim, Helen Blackwell
"You cannot just get on with your life"
 real 56k

Dr Liam Donaldson, Chief Medical Officer
"It is amazing that no one spotted the wrongdoing"
 real 28k

Friday, 5 January, 2001, 13:09 GMT
Shipman 'may have killed 236'
Harold Shipman
Harold Shipman: Patient records studied
Harold Shipman probably killed 236 of his patients, a report suggests, making him one of the world's worst ever murderers.

It beggars belief that he got away with it for so long

Alan Milburn, Secretary of State for Health

At the very worst, claims statistics expert Professor Richard Baker, the GP may have had a hand in well over 300 deaths, but this is unlikely.

The independent report, described as "chilling reading" by the government's Chief Medical Officer, has reawakened concerns over the monitoring of doctors and the drugs which are available to them.

It compares the pattern of deaths at both his former practice in Hyde, Greater Manchester, and his first practice in Todmorden, Yorkshire, with other similar practices.

Shipman issued many more death certificates over the 24 years than any of the other practices used as comparators.

The raw statistics suggest that at the extreme, there were 345 extra deaths when Shipman's records were compared with normal practice at similar surgeries.

However, more detailed analysis of the circumstances surrounding each death means that the probable figure is 236 - as these were the patients who died at home.

Researchers at the University of Leicester, took into account factors such as time of death, and whether relatives or Dr Shipman himself were present.

For example, many of Shipman's patients appear to have died in the afternoon, which is also unusual.

Professor Baker told the BBC: "I am only presenting circumstantial evidence - this was not a forensic investigation.

"There were a lot of cases about which there was a reason for concern."

He said he felt "extreme anger" about the nature of the crime.

"Hyde's a good town, it's humbling to see how they have been coping with this."

Records review

Dr Shipman was jailed for life last January after being convicted of killing 15 of his patients.

But after reviewing all the evidence and his own records, the police and other investigating authorities said they suspected he had killed as many as 192.

The latest research looked at the years 1974 to 1998, to calculate the number of what the study termed "excess deaths".

Between 1985 and 1998, Professor Baker's analysis suggested that more than half of 288 documented deaths under Shipman's care were "highly suspicious". Another 14% were "moderately suspicious", he said.

To know that anyone could be killing on this scale is absolutely horrifying

Dr Simon Fradd, BMA
Health Secretary Alan Milburn said: "The truth is we will probably never know for sure just how many people were killed by Harold Shipman. Only Harold Shipman can tell us that.

"What we do know is that very many patients suffered at his hands. My heart goes out to each and every one of the families affected.

"Harold Shipman was a cold, calculating, evil killer. He abused his position of trust in the most callous way imaginable.

"It beggars belief that he got away with it for so long."

Shipman killed his victims, patients at his single-handed practice by giving them overdoses of diamorphine, the medical name for heroin.

Part of Professor Baker's report gives recommendations for tighter controls on the procedure for death certification, as well as the availability of controlled drugs such as diamorphine.

These issues will be considered by a public inquiry to be held later this year.

Dr Simon Fradd, from the British Medical Association (BMA), said it was time for much tighter checks on doctors' use of these drugs.

He said: "These drugs have to be signed for individually - Shipman was using vast quantities of them yet this was not being picked up.

"We have got computer technology now to make sure doctors aren't going around every chemist in town getting controlled drugs.

Statistics needed

"We need to collect statistics on deaths for each doctor. The average doctor has only 20 or so deaths a year.

"To know that anyone could be killing on this scale is absolutely horrifying."

Copies of Professor Baker's report will also be handed to the police and Crown Prosecution Service, but it is unlikely that any more charges will be brought.

The criminal law has done everything it can to Shipman. He is serving a life sentence.

David Calvert-Smith QC, Director of Public Prosecutions
The Director of Public Prosecutions, David Calvert-Smith QC, told the BBC that there was insufficient evidence to proceed with any more cases.

He said: "We had 24 cases in which we felt the evidence was sufficiently strong to secure a conviction.

"The criminal law has done everything it can to Shipman. He is serving a life sentence."

He said the chances of Shipman getting a fair trial were virtually none in the light of the publicity surrounding the trial and afterwards.

But he said a tightening of the law to monitor doctors was very likely in the wake of the case.

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See also:

28 Dec 00 | Health
Male Shipman 'victim' named
29 Feb 00 | UK
Shipman launches appeal
11 Feb 00 | Health
Shipman struck off
05 Jan 01 | Health
Shipman: calls for change
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