Harold Shipman: The Family Doctor Who Killed His Patients, and the Forged Will That Caught Him
In the late 1990s, in a small town in the north of England, there was a doctor that elderly people adored.
He came to their homes without being called. He did not rush them. He told their families that he preferred to let old people stay at home, instead of sending them to a cold hospital.
And in that town, elderly women kept dying.
They died at home, in the afternoon, sitting in an armchair or on a sofa. They were fully dressed. Many of them had not been ill. Very often the same doctor was there, or had just been there.
His name was Harold Shipman. He was a family doctor, a general practitioner. Between 1975 and 1998 he killed his own patients with injections of diamorphine, the medical form of heroin. A British court convicted him of 15 murders. A public inquiry later concluded that the real number was at least 215, and probably about 250.
This is the story of how nobody saw it for 23 years, how a first police investigation looked straight at him and found nothing, and how a forged will finally brought it all down.
A doctor everyone trusted
Harold Shipman was born in 1946 in Nottingham, a city in the English Midlands.
When he was 17, his mother died of lung cancer. In her last months a doctor came to the house and gave her morphine for the pain. The inquiry later noted how similar that scene was to the way he would kill.
He qualified as a doctor in 1970. In 1974 he took his first job as a family doctor in a small town in Yorkshire.
A year later he was caught forging prescriptions for pethidine, a strong painkiller, for his own use. He was fined £600 and spent a short time in a drug clinic. He was not removed from the medical register.
In 1977 he joined a group practice in Hyde, a town 10 km east of Manchester, England.
In August 1992 he left that practice after a bitter dispute and opened his own surgery, alone, in the town centre. Many of his patients followed him. He was known as a doctor who listened, who visited, who cared.
From here on, almost everything in this story happens in Hyde.
How the deaths looked
Much later, investigators understood the method.
Shipman would visit an elderly patient at home, usually in the afternoon. He would give her an injection of diamorphine. She would die within minutes, often while he was still in the house.
Then he would sign the death certificate himself, giving a natural cause such as heart disease, stroke or simply "old age". He would tell the family that no post-mortem was needed. Very often he advised cremation.
In England a body cannot be cremated on one doctor's word. A second, independent doctor must sign a confirming form. That second doctor is supposed to see the body and question the first doctor about the death.
Shipman's second doctors came from a group practice directly across the street from his surgery. Its doctors signed his cremation forms, and he signed theirs.
Their own record later showed something striking. Between September 1993 and September 1998, all but 5 of the confirming forms they signed were for Shipman's patients.
Nobody counted at the time.
The first person who said it out loud
The first warning came from a funeral home.
On 23 February 1998, a doctor from the practice across the street went to the town's family funeral business to sign a form for one of Shipman's patients.
The daughter of the owner, who worked there with her father and her husband, took her aside. She said she was worried about how many of Shipman's patients were dying.
She described what she saw. Elderly women who had died at home, apparently alone. Found sitting up in a chair, fully dressed. They did not look as if they had been ill.
In her experience, people who died of illness died in bed, surrounded by medicines, often with a relative there. People who died suddenly were usually found on the floor. These women were neither.
She had also noticed that Shipman was often present at the death or soon after. Sometimes she wondered how he had got into the house.
She had chosen this doctor because she seemed the most approachable. She was afraid nobody would take her seriously.
A few days later, another doctor of the practice went to the funeral home and spoke to her father. He had known Shipman for many years. Shipman had many elderly patients, he explained, and liked to keep them at home. The father passed this on to his daughter, and she felt somewhat reassured.
A doctor across the street
Another doctor in that practice had her own doubts.
She had joined the practice in September 1996, after 19 years as a family doctor elsewhere. In her new job she was asked to sign confirming forms for Shipman far more often than she was used to.
Reading his forms, she saw that he had often been present when the patient died. In 19 years of practice, that had happened to her only 2 or 3 times.
At the end of 1997 she mentioned it to her partners. They reassured her.
Then, on 17 March 1998, another of Shipman's elderly patients died. Two days later the doctor signed the cremation form. Afterwards she was deeply worried that she should not have signed it.
Her husband later told the inquiry about a conversation they had at home. He asked her if she really thought Shipman could be killing his patients. At first she said no. Then, after a moment, she said: "No, I know he is killing his patients."
The partners met in a pub to discuss it. On 23 March, Shipman asked another of them to sign a form for a woman who had died 3 days earlier.
That evening they checked their own records. In the previous 3 months they had signed 16 cremation forms for Shipman. In the same 3 months, 14 or 15 patients of their own practice had died, in all places and all ways.
Their practice had 5 doctors and about 9,500 patients. Shipman worked alone. They guessed he had about 3,000.
On those numbers, his patients were dying at least 3 times as often as theirs. Some of the doctors thought it could be 8 or 9 times.
On 24 March 1998 the doctor took the numbers to the coroner, the official responsible for investigating unexplained deaths. The coroner asked the police to look into it, quietly.
The investigation that found nothing
The police gave the case to a detective inspector, under the supervision of a chief superintendent. Neither had experience of an investigation like this.
It had to be confidential. The detective could not interview Shipman, and he could not go to the families. Years later the daughter of one of the victims told the inquiry that she understood how hard it was, without the records and the families, to believe that a respected doctor was killing healthy patients.
But the investigation that followed went wrong at almost every step. Here is what happened, as the inquiry later reconstructed it.
The detective asked the local register office for copies of the death certificates Shipman had signed in the previous 6 months. There were 31. Because of an error in the office, he received only 19 or 20.
Even so, he did not see the problem. 19 or 20 deaths in 6 months did not match 16 cremation forms in just 3 months. He did not grasp what the comparative death rates meant, and he attached no importance to them.
He asked to see the medical records of 17 of the dead patients. Without the families' consent, the health authority would not hand them to the police. Instead, its medical adviser, a doctor, examined the records himself. 14 sets were available.
That adviser knew Shipman and respected him. On 26 and 27 March he went through the files and made a chart.
The chart itself showed the pattern. 13 of the 14 dead were women. 12 had died at home. In 10 of the 14, Shipman had been present around the time of death.
The adviser did not point any of this out. On 1 April he met the detective and told him that in 2, or "a few", cases the records did not contain enough to explain the death, and that he himself would have reported them to the coroner. But the overall message, the inquiry found, was one of reassurance.
The same day the detective visited the local crematorium. He asked nothing about how cremations were certified. He did not look at the crematorium register. If he had, he would have found 11 more deaths of Shipman's patients that he knew nothing about.
The visit to the surgery
On 2 April 1998, something happened that the police did not know about.
The owner of the funeral home, the worried woman's father, went to see Shipman in his surgery. By now he too was uneasy. But above all, he felt that things had gone too far, and that Shipman should know what people were saying.
He told Shipman that people were talking about the number of deaths among his patients.
Shipman was calm. He took out his book of death certificate stubs and showed him names and causes of death, one after another. The book, he said, was open to anyone who was concerned.
The undertaker left completely reassured.
The inquiry later found that this visit warned Shipman that he was under suspicion. It believed that he then stopped killing for a while. It also found that the undertaker had acted in good faith, and that his visit may even have saved lives.
The case is closed
Around 15 April, the detective finally met the funeral home family. He did most of the talking. He told them what he had done and gave the impression that he had found nothing.
He did not ask the daughter to explain her concerns. He did not ask about the deaths her family had dealt with. He did not ask for their records. If he had, he would have learned of 5 more recent deaths.
He never checked the national police computer for any record against Shipman. He said he forgot. If he had checked, he would have found the old convictions for drug offences.
On 16 April he went to the doctor who had raised the alarm and told her there was no evidence. He spoke about the lack of any motive. She was disappointed. What worried her was the difference in death rates, and he had no explanation for it.
On 17 April 1998 he phoned the coroner and said that nothing indicated any criminal act. The coroner accepted it. The investigation was closed. There was no written report.
**Two bodies, of the women who died on 17 and 20 March, had still been available for a post-mortem during the investigation. Nobody ordered one.**
The inquiry concluded that if the case had been given to an experienced detective, a post-mortem would very probably have been carried out, morphine would have been found, and Shipman would have stopped.
He did not stop. On 11 May 1998 he killed again. On 12 June he killed again. On 24 June he killed Kathleen Grundy.
Kathleen Grundy
Kathleen Grundy was 81. She was a widow and a wealthy woman, who had once held the ceremonial title of mayoress of Hyde. She was also very active. She worked part-time in a charity shop and volunteered at a pensioners' centre in the town, helping to serve lunches.
She lived alone in an old cottage on the edge of Hyde.
On the morning of 24 June 1998, Shipman visited her at home.
That day she did not arrive at the centre. Nobody answered her phone. Two volunteers went to her cottage. The door was unlocked. They found her on the sofa, grey-faced and dead.
Shipman came and examined her briefly. He said no post-mortem was needed. On the death certificate he wrote "old age".
Kathleen Grundy was buried, not cremated. That decision, made by her family, would later prove crucial.
A will that made no sense
On the very day she died, a firm of solicitors in Hyde received a typed will in her name, with a covering letter.
The will left her entire estate, £386,000, to Shipman. Her daughter and her grandsons were left nothing.
Her daughter was a solicitor herself, in another town. She had always handled her mother's affairs, and she knew her mother's real will, which was kept at her own firm.
The new document was wrong in every way she could see. The typing was poor, and her mother had been a secretary and an excellent typist. The wording was strange. The signature did not match the one on her mother's bank slips.
A few days later a second typed letter arrived, signed only "J. or S. Smith", claiming to have typed the will for her mother. Nobody of that name could be traced.
The daughter found the two witnesses who had signed the will. Both were patients of Shipman: a 29-year-old man who ran a pet shop on the main street, and a young mother.
Their account was simple. On 10 June, Shipman had called them into his room at the surgery to witness a signature. An elderly woman was sitting in the patient's chair. Neither of them actually saw her sign anything.
What Kathleen Grundy really signed that day has never been found. The police later believed it may have been a consent form for a study on ageing.
In July 1998 the daughter went to the police.
The first exhumation
This time the case reached a senior detective, a detective superintendent. He agreed with her: the will was a forgery.
If Shipman had forged a will to inherit from a patient, the next question was obvious. How had the patient died?
In the early hours of 1 August 1998, Kathleen Grundy's body was exhumed. It was the first exhumation ever carried out by that police force. Samples were sent to a forensic laboratory.
The same day, police searched Shipman's surgery and his home. At the house they found a portable typewriter. Shipman remarked that Mrs Grundy sometimes borrowed it.
The house was filthy. Among piles of medical records, the police found jewellery, including rings too small for his wife's fingers.
On 2 September the laboratory reported. Kathleen Grundy had died of a fatal dose of morphine. It had been given within about 3 hours of her death, exactly when Shipman had been with her.
Shipman had an answer ready. Mrs Grundy, he said, was a secret drug addict. He pointed to entries in his computer records that said so.
But his computer kept something he could not erase: a time stamp on every entry. The entries about addiction had been written after she died.
The typewriter matched the will, the covering letter and the "Smith" letter. Fingerprint experts found Shipman's fingerprint on the will. They found no trace of Kathleen Grundy.
On 7 September 1998, at 09:18, Harold Shipman was arrested at a police station near Hyde. He was charged with her murder and with forgery.
Opening the other graves
The police now had one murder. They had good reason to fear many more.
They concentrated on patients who had died suddenly after a visit from Shipman, and who had been buried rather than cremated, because only a buried body can be tested.
On 21 September a second body was exhumed. By 9 December there had been 12 exhumations, more than in any single inquiry before. Some bodies were too decayed to give results. In others, morphine was found.
In August, a local taxi driver had also come to the police. He told them he suspected Shipman of killing 21 people.
Computer experts went through Shipman's records patient by patient. The time stamps told the story. On 10 December 1997, on the very day one 49-year-old patient died in her chair, Shipman had added 10 false entries to her file, dated back over 10 months, to create a history of illness she never had. For another patient he had invented a brain tumour. Independent doctors later pointed out that she had been going shopping and out with friends.
Families told the police the same story again and again. Shipman would say he was calling an ambulance, then say it was no longer needed because she was gone. Telephone records showed that no call had been made.
He had also been collecting unused morphine from the homes of dead patients, saying he would dispose of it, and prescribing far more than his patients needed.
In the end the police chose 15 deaths, all between 1995 and 1998, for the trial. The victims were women aged 49 to 81.
The trial
The trial opened on 5 October 1999 at Preston Crown Court, about 56 km from Hyde.
Kathleen Grundy's daughter was the first witness. The prosecution case took 25 days. Relatives described the last day of each woman. A pathologist told the court that morphine poisoning had caused most of the deaths. A police computer expert showed, entry by entry, how Shipman had invented symptoms after his patients were dead.
Shipman gave evidence himself from 25 November. He denied everything. Kathleen Grundy, he said, was an addict. The others had died naturally. He admitted changing records, but said he had only been bringing them up to date. Of one patient, he suggested she must have injected herself while he was out of the room.
His defence argued that the bodies had been in the ground for too long, and that the toxicology could not be trusted.
The jury retired on 24 January 2000. On 31 January 2000, after 6 days, they returned a unanimous verdict: guilty of all 15 murders, and of forging the will.
The judge gave him 15 life sentences and recommended that he never be released. He added 4 years for the forgery. On 11 February 2000 he was struck off the medical register.
How many?
After the trial the government set up a public inquiry, led by a senior High Court judge. It examined hundreds of deaths, heard about 2,500 witness statements and reviewed some 270,000 pages of evidence.
In July 2002 its first report concluded that Shipman had killed at least 215 patients over 23 years, from 1975 to 1998. Most were elderly women in good health.
In July 2003 its second report examined the failed police investigation of March 1998, the one described above. It concluded that, had it been done properly, his last 3 victims would probably have lived.
In January 2005 the final report went further back. It found that as a young hospital doctor, before he ever became a family doctor, Shipman had probably killed 3 more patients, and it had serious suspicions about others, including a 4-year-old girl. Of the 459 people who died while in his care between 1971 and 1998, the inquiry estimated that about 250 were his victims.
Different sources give 215, 218 or about 250. The differences come from the different stages of the inquiry, not from any doubt that he was a mass killer.
Harold Shipman never confessed and never explained. On 13 January 2004, the day before his 58th birthday, he was found hanged in his cell at Wakefield prison.
What remains open
Two things will never be known.
The first is the exact number. Most of his victims were cremated, and there is nothing left to test.
The second is why. He gained money from only a few of the deaths, and the one will he forged was so crude that, as the trial judge said, it made detection inevitable. He took his reasons with him.