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Wednesday, 24 July, 2002, 15:19 GMT 16:19 UK
Shipman: Could this happen again?
Harold Shipman
Former GP Harold Shipman killed 215 of his patients, an official report by Dame Janet Smith has concluded. The finding confirms 56-year-old Shipman as Britain's worst serial killer.

Shipman was convicted in January 2000 of killing 15 of his patients with lethal heroin injections and he was sentenced to life imprisonment for each of the murders.

But the first phase of an inquiry into the case has found that 215 deaths were "highly suspicious" while there was a "real suspicion" he could have claimed a further 45 victims.

Dr John Chisholm, chairman of the BMA , said "There is more that needs to be done in monitoring the use of controlled drugs, and also monitoring death and cremation information."

Tragic failures in the health service allowed Shipman to murder over a 20 year period. Do you think this could happen again? What measures need to be put in place? Or can any system of safeguards ever guarantee success in the face of evil and cunning?

This debate is now closed. Read a selection of your comments below.

Your reaction

The procedures for recording deaths in the UK are primitive. All deaths should be certified by an independent person from the one giving treatment and provisions made for far more autopsies to check the cause of death and the accuracy of the diagnosis of disease leading to death.
Jim, UK

The problem is that there are too many doctors practicing alone.

Leon, UK
The problem is that there are too many doctors practicing alone. Doctors (and dentists for that matter) should practice in groups so that they can readily assess each other and offer each other second opinions when needed. It also gives them the chance to blow the whistle early on if they believe there are sinister goings on. The reason Shipman killed for 23 years was because nobody was keeping track of him. He was left to his own devices and did exactly as he liked. There needs to be more thorough regulation - patients deserve at least that!
Leon, UK

Who is to say that this has not happened before? The medical profession?
Randy, UK

Shipman is a sick man. The GMC should take some blame for his actions; his should have been struck off years ago when he had a drug problem. Don't condemn the rest of our doctors who work damned hard with a public who aren't always grateful. Give them a break? And incidentally, I for one am not happy with the idea of more autopsies. Our doctors should be allowed to carry on as they do now.
PAS, UK/abroad

Many new regulations have subsequently been introduced following the Shipman atrocity. I think it is important to realise that Shipman did formerly have a substance abuse problem (Pethidine) and committed prescription fraud. I believe there are now far better preventative methods operant to prevent doctors practising who have fallen into this category, or more appropriately, a monitoring system that deals effectively with problem doctors.
Howard, UK

The code of silence in British medical culture always appalled me

Sean Murray, USA/UK
No surprises at all. The code of silence in British medical culture always appalled me. Brits criticise the USA for being too quick with medical litigation, but now an excellent example can be seen of what can happen when physicians have all fear of repercussions removed from their conscience.
Sean Murray, USA/UK

The medical professional is no different to people of other professions: an intellect, a high IQ, university degree, and/or any other grade, does not prevent a person to be a bully, crazy, con-man, rapist, killer, serial-killer - just name it. Many people who are certified doctors, unfortunately, may have the skills that the books demand, but don't have the skills in hands on practices and human relations. And, unfortunately, some of them misuse their power over their clients, as happens in any other profession. But the difference is of course: the doctors' businesses deal with human life. Doctors should undergo regular, and strict psychological tests to maintain their profession.
Inga, Iceland

The Shipman affair was ironic justice for a system that, for far too long, had elevated the medical profession to the rank of neo-deity. It reflects the attitude among policy-makers that patients are ultimately simply two ends of a digestive tube. Where were the checks and balances? In an activity in which death is one perfectly viable outcome, it's all too easy to sweep the truth under the rug. Sadly, unless the GMC does more than simply protect its own, this may well happen again.
Simon Cameron,UK

The medical profession is hallmarked with arrogance

David, England
I think the medical profession is one of those hallmarked with arrogance. Doctors appear to be beyond challenge either by their patients or their controlling body (the GMC). Doctors should not be regarded as a breed apart. The profession should be open to far greater independent audit.
David, England

Health records should be maintained in a central database. It would then be a simple process to search for statistical anomalies in patient death rates. It would also reveal GPs who were basically incompetent in their treatment of patients in general.
Calum Steen, UK

I was called urgently to the home of an elderly woman

Dr Stephen Hayes, England
On the day after the Shipman verdict was announced, I was called urgently to the home of an elderly woman who had collapsed due to an extreme allergic reaction to penicillin. She was dying in front of me and needed an immediate injection of adrenaline. I hesitated before giving it - there was nobody else in the house to witness what I was doing. I gave the injection, called 999, and saved her life.

Please think before demanding even tougher regulation of GPs. We are doing a difficult job and some of us have had enough of all the armchair sniping. The publicity given to this case, the fact that Shipman was nailed by his "ghost" computer records, plus the fact that everybody is more suspicious now should make the chances of this happening again extremely remote.
Dr Stephen Hayes, England

Has it already happened in the past without the culprit being found out? Because of the status we have given doctors, our trust in future will have to be hard fought for by the medical profession and the medical authorities who in my opinion are the real culprits here.
Bernard Taylor, USA

As a doctor I feel ashamed

John Frain, England
As a doctor I feel ashamed of the failure of my profession to detect the practice of Harold Shipman. On behalf of our profession, we should express apology for all those affected by this man. We should commit to raising our standards further to ensure we are above reproach and that patients can genuinely expect the best from us. All of us are patients, but some patients must also be doctors. The vast majority of doctors understand the sense of responsibility and duty expected of us and will continue to strive to meet it. We ask the continuing support of our patients in doing so.
John Frain, England

Of course it can happen again. Just because one murderer is removed from society doesn't mean all murderers have gone. Society always moans "Why wasn't something done?" or "We need regulations." Trouble is we don't like the rules when they seem to hinder us! If someone is determined and especially if they are uniquely qualified, then they can kill as Shipman did.
John, UK

The police must take a large part of the blame

Jim Abel, UK
The police must take a large part of the blame as to Shipman not being not being spotted sooner. They were alerted first by a local undertaker and then by a doctor from another local practice but never investigated until there was money involved.
Jim Abel, UK

The fault in not stopping Shipman lies with the General Medical Council, which was - and perhaps still is - a disciplinary body which appears to protect doctors and not patients. Had the clear warning signs about Shipman been seen in the 1970s, he would have been struck off then. He was allowed to continue in practice and his professional disciplinary body must take the blame for that.
Kevin, England

I applaud the findings in this report, but I ask myself how??? When I was running a medical practice, drugs were very strictly controlled, all death certificates where cremation was indicated, had to be signed by the doctor attending the death and a further doctor who did not belong to the practice. This second doctor had to visit the deceased before counter-signing. This would apply whether a single handed practice or not. Finally why were the number of deaths not spotted from the reports sent to the local health authority? Yes this could happen again if the will was there.
John S. Spray, England

There are already safeguards in place to prevent another Shipman

Elaine, France
I am a British pharmacist. There are already safeguards in place to prevent another Shipman. Supplies of all controlled drugs must be recorded. Pharmacist to doctor and doctor to patient. Only simple sums required. In addition it should be a requirement to record all drugs destroyed, not used or returned to the pharmacy. The weak link is the drugs in the patient's home.
Elaine, France

General practice relies on the confidence of patients in their doctors. It is vital that this dreadful case is not used as an excuse by those who wish to discredit medicine in general. The loss of confidence that this would cause could lead to far greater risks that the distant possibility of another Shipman.
Julian, UK

Isn't it strange how most doctors surgeries have signs about how patients can be struck off for any number of reasons (including the unpublished one about complaining) but no notice is up about how to make a complaint?
Peter Galbavy, UK

Peter Galbavy's comment that patients can be struck off is very disturbing. There is some thing seriously wrong with the balance of power when vulnerable people can have this threat looming over them. I thought that personal empowerment was put in place in the Magna Carta?
Peter, Australia

Why are we so shocked?

I. Davies, Cymru
I agree it is impossible to express the horror and the damage to the medical profession that this man has caused. I have all sympathy for the people who have lost relatives and friends in this way. Yet I have to say: Why are we so shocked? This government, the National Health Service together with its various hospital management boards treat the elderly among us with the same disregard.
I. Davies, Cymru

As a doctor, I'm angry at the actions of Shipman and the damage that he has done our profession. That said, he was a mass murderer who happened to be a doctor - the fact that he was a doctor didn't necessarily contribute to the fact the he murdered people, but certainly did make it easier for him not to be caught.
Laurence Crutchlow, UK

Until the GMC takes proper responsibility for the few bad doctors in their midst, things will go wrong where they shouldn't. The GMC has long been too keen to protect its own.
CJ, England

A regular process should be introduced to review the performances of GPs

Danny, UK
How often is a doctor's work reviewed? A qualification is granted and then the individual can prescribe medicines and make life affecting decisions until they decide to retire. I do not want to increase the workload of already overburdened GPs, but a regular process should be introduced to review the performances of GPs. The decisions they make are too great and have too huge an impact for us to simply trust that their skills and objectivity can remain at their peak for the whole of their career.
Danny, UK

I don't think it's a case of could it happen again. I think you should be saying is it happening, today. There are thousands of doctors in this country, and not all of them are checked or regulated. I think this is the tip of an extremely big iceberg.
Thomas Byrne, Cheshire

The question is not will it happen again, but really how it was allowed to happen in the first place.
Anon, UK

As a GP I have to say that it is highly unlikely that Shipman could happen again. However, evil individuals will always exist and some perhaps will become doctors. I do not think that it is possible to stop a doctor from committing a murder but certainly if procedures are in place to audit doctors' performance or to review cases then problems or even crimes could be picked up at a much earlier stage.
John, Scotland

Of course this could happen again. A doctor holds such a privileged position. He is able to enter people's homes and inject them without too many questions being asked, especially by the elderly who were brought up to respect them. They know that the doctor is coming and they trust him to give them the correct treatment. Unfortunately this proves that not too many questions are asked when an elderly person dies. Even Shipman himself said that sometimes people do die of old age. There is no true answer except more careful monitoring of deaths.
Elaine, UK

As long as we allow medical practitioners to believe, and to behave as if they are gods this will happen again.
Richard, UK

An element of doubt must still remain as to whether Shipman deliberately killed so extensively

Barry, UK
The report says that the deaths were highly suspicious, not quite the same thing as direct proof of murder. Given that it seems that many bodies were cremated, an element of doubt must still remain as to whether Shipman deliberately killed so extensively, or was not such a good doctor, or maybe there is an element of hysteria on this issue. How many other doctors have wrongly recorded the cause of death or behaved in an offhand manner? Seemingly healthy people drop dead unexpectedly quite often. Without there being a clear understanding of why Shipman killed, there has to remain open the possibility that these suspicious deaths were not killings, and that the basic problem is society's inability to cope with death.
Barry, UK

The inquiry has done a first rate job and is attracting the exposure it deserves. What about the man who still holds a ministerial post and initially sought to prevent a public enquiry, presumably because it would have shown the department he then headed in a bad light. Please can we now ask Mr Milburn how he can justify opposing this enquiry in the first place, when its findings are so conclusive?
Fred Campbell, UK

The potential knee jerk reaction and excessive controls over good doctors will prevent them from making life saving decisions

David, Denmark
Yes this could happen again. However, the worrying thing about this case is the potential knee jerk reaction and the resulting overregulation and excessive controls over good doctors that will prevent them from making quick, life saving decisions. We must be careful how this is handled. We could find ourselves in a situation where further needless fatalities result from handcuffing doctors and preventing them from making on-the-spot decisions. I fear that regulations, such as two doctors being in agreement before the administration of treatment, will simply place further burdens on an already overworked medical profession.
David, Denmark

Yes of course this could happen again but to say the authorities are responsible or anything should change is daft. This man was sick, you can't expect an authority to say after his interview 20 years ago that they think he is a potential serial killer. No, nothing can be done to stop people like Shipman but you have to assume that your average man on the street does not want to kill 215 people!
Andy, UK

Any doctor could choose to take the life of an elderly patient at any time. Old people should rely on second opinions if they want to feel safer. Shipman had a history of dodgy medical procedures. I would say the General Medical Council are as guilty as him.
NAK, Edinburgh, Scotland

We must not allow single doctor practices

Jeff, UK
It could even be happening right now. We must not allow single doctor practices. Any misdeeds regarding drug abuse, the doctor should instantly be struck off the medical register. Shipman has tarnished the reputation of all doctors in the UK by what was allowed to take place in his surgery.
Jeff, UK

This awful episode highlights how dangerous the gap in knowledge can be between specialised intellectuals and the rest of society. One can only hope that improvements in education, combined with better psychological profiling of those in positions of extreme responsibility (eg doctors, judges) can ensure this level of deceit and villainy never happens again.
Jim, UK

The frightening thing is it probably could happen again. May not be in the exact same way nor to the same extent but even with better monitoring of controlled drugs, if someone is determined enough to do something they will find a way.
Sarah, UK

Key stories

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See also:

14 Jul 02 | England
29 Feb 00 | UK
31 Jan 00 | The Shipman files
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