Harold Shipman: Can We Rule It Out?
Every six weeks, we became the on-call murder team for South London.
For seven days, twenty-four hours a day, we would respond to all murders in our area.
That didn’t mean we were sat in a car, ready to put the lights and sirens on.
We’d be getting on with our existing investigations.
Gathering evidence, preparing for court, doing whatever was needed to progress our cases.
For the duration of that week, we had a mobile phone. If we were needed, that’s where the call would come.
It was known as The Phone.
It might be that The Phone didn’t go off at all during your shift. It might go off in the first hour.
When it did, the hairs on the back of my neck would stand up.
Even after years of doing this, I still got that same reaction because I had no idea what was about to come my way.
Whenever I answered, I could feel the tension growing in my stomach.
Was it a shooting? A stabbing?
Or was it the call I dreaded the most?
“I’ve got a death…. And there’s something not quite right about it.”
Harold Shipman was born in Nottingham in 1946.
He was considered bright academically and was close to his mother.
However, when he was 17, she died of lung cancer, after receiving morphine injections for pain.
In 1970 he qualified as a doctor from the Leeds School of Medicine and initially worked in hospitals.
In 1974, he became a GP in Todmorden, West Yorkshire.
Around this time, he had developed an addiction to the powerful opioid painkiller pethidine, and between 1975 and 1976, he took to forging prescriptions to feed that addiction.
This was discovered and led to him being convicted of obtaining pethidine by deception, forging NHS prescriptions and unlawfully possessing pethidine. The General Medical Council issued a formal warning but took no further disciplinary action.
In 1977, the year after his conviction, he took up a GP position at Donneybrook Medical Centre in Hyde, Cheshire.
Shipman began to build himself a reputation as a respected doctor. He was seen as particularly good with elderly patients and would frequently visit them in their homes. He became a trusted and popular figure in the Hyde community.
To his patients he was known as Dr Shipman. To his friends and colleagues, he was simply known by his middle name, Fred. What none of them knew was that he was murdering his patients, nearly all of them elderly women.
He would inject them with diamorphine, another powerful opioid painkiller, then certify their deaths as by natural causes. He would also encourage relatives that their bodies be cremated. A practice that continued unchecked for years.
That was until 1998, when another Hyde GP, Dr Linda Reynolds, became concerned. There appeared to be an unusually high number of deaths among Shipman’s patients, along with the number of cremation forms he was asking Dr Reynolds’ practice to countersign.
Dr Reynolds raised her concerns with the local coroner, who then asked Greater Manchester Police to conduct a confidential enquiry. They in turn appointed a detective inspector to lead an investigation into the suspicions surrounding Shipman.
Detectives examined several recent deaths certified by Shipman, reviewed medical records, spoke to funeral directors and staff at the local crematorium, and interviewed Dr Linda Reynolds about the concerns she had raised. They also sought advice from a Home Office forensic pathologist, who concluded there was insufficient evidence to justify exhuming any of the bodies.
Shipman was also interviewed by detectives. He denied any wrongdoing, explaining that he cared for an older, sicker patient population than neighbouring practices. He also said he frequently treated patients at home rather than admitting them to hospital, so was more likely to be present when they died.
Detectives identified no evidence of criminality, and the investigation was closed in April 1998.
Over the following ten weeks, Shipman went on to kill three more of his patients.
The third of those was Kathleen Grundy, an 81-year-old widow, former Mayoress of Hyde and well known in the local community. Despite her age, she remained active and independent.
On 24 June 1998, she was found dead in her home after Shipman had visited earlier that day. He certified the cause of death as old age.
Several weeks later, her daughter, Angela Woodruff, a solicitor, was contacted by another solicitor acting on behalf of Shipman. He explained that a new will had been discovered.
The will, apparently prepared shortly before Kathleen’s death, left almost her entire estate, worth around £386,000, to Dr Harold Shipman. Angela was left nothing apart from a small amount of jewellery.
Angela immediately believed the will was a forgery. She knew her mother had intended her estate to pass to her family and was also suspicious that the will had been typed, even though Kathleen did not own a typewriter.
She reported her concerns to the police.
As detectives investigated the will, they also began to question the circumstances of Kathleen’s death. Her body was exhumed and a post-mortem examination found lethal levels of diamorphine.
Further enquiries revealed that Shipman had altered her medical records after her death to suggest her health had been declining.
Over the following months, detectives exhumed a total of twelve bodies as they re-examined deaths previously certified as natural.
The findings revealed a pattern consistent with murder and provided detectives with evidence that Shipman had caused the deaths of his patients.
Shipman was charged with fifteen counts of murder, plus the forgery of Kathleen Grundy’s will.
In January 2000 he was convicted of all offences and sentenced to life imprisonment.
Now the enquiry into the true extent of his murders would begin.
“I’ve got a death…. And there’s something not quite right about it.”
I lost count of the times I heard variations of that sentence. In my twelve years investigating murders, it ran into the hundreds. And every single time I knew exactly why I was being asked it.
In the UK, when someone dies unexpectedly, the police will often need to attend. Their role is to establish the circumstances of the death and determine whether there is anything to suggest that somebody else was responsible.
The officers initially tasked with making that assessment are usually local uniform, as it’s them who deal with the calls that come into the police. So, they’ll turn up to the scene of the death and, essentially, begin an investigation.
They will ask questions of whoever is present. Establish the circumstances of the death itself, the timeline and whether there may be an obvious cause. They will seek to understand their medical history, lifestyle, habits and relationships. They will assess the scene itself, to see if there’s anything out of place that may suggest a crime has occurred.
What they are looking to do is rule out third party involvement. To be able to satisfy themselves and, ultimately, the coroner, that nobody is culpable for the death.
But what if they can’t reach that point? What if there’s something that stops them being able to make that call? Well, in those circumstances, a detective would be called to the scene, so they can make their own assessment.
Detectives tend to have more experience in investigations. They are trained to ask questions, assess scenes and make decisions, often with limited information.
And they will be asking themselves the same question: can we rule out third party involvement?
The first thing they will do is to ask the previous officers what they’ve done. Who have they spoken to? What did they say? What have you found out about the deceased’s history? Then they will begin making their own assessments.
But what if they can’t be sure? What if there’s something about the circumstances of the death that just doesn’t sit right with them?
That’s the point they declare this a suspicious death and a call would come into us.
And why did I dread these calls?
Well, with a shooting or a stabbing, it’s clear a crime has been committed. At that point, my instincts kick into gear. I know exactly what needs to be done, and I get on with doing it.
But when I was called to a scene where nobody was quite sure, I knew the pressure would be on me. If I made the wrong call, it literally meant someone getting away with murder.
As an experienced homicide detective, I knew that murders aren’t always obvious.
It may be that the method used to kill didn’t leave behind obvious signs: poisoning, suffocation, internal injuries.
Alternatively, the scene could be staged to hide a murder. To make it look accidental or even suicide. Did they fall, did they jump or were they pushed?
But here’s the thing. My job wasn’t to decide whether it was a murder. It was to treat it as if it was until it can be proven one way or the other. In many ways that makes things much simpler.
The problem with deaths like these is that there may be no obvious signs of violence. No forced entry. No weapon. No witnesses. Just someone who has died unexpectedly. If you decide too quickly that nothing is wrong, you may miss a murder.
So, how would I approach a scene like this?
For me, there is no secret ingredient to being an effective murder detective. It’s about being methodical. Taking your time to think things through logically. In my mind, it would look something like this.
I’d always start with the deceased. Is there anything I can work out from physically looking at them that might give an indication of not only how they died, but the circumstances around it?
There were countless different situationa I found myself in but, in general, if a suspicious death wasn’t obviously homicide, there were four scenarios I was potentially presented with: natural causes, accident, suicide or unknown.
Whichever it was, I would be looking for signs that either supported or contradicted that conclusion.
For instance, if it was a fall where injuries had been received, were they all consistent with the circumstances? Somebody may fall from a height, but if they show signs of defensive injuries to their arms, that may tell a different story.
Likewise, if natural causes seemed the likeliest explanation, but they had injuries such as bruising or a head wound, what could that indicate?
There are far too many scenarios to list them all, but I’m sure you get the picture.
As well as what I could physically see, I’d want to know their medical history. Is there anything there that could point to a cause of death and, if so, does what I can see align with that?
Then I’d be taking in what the scene itself might tell me. Are there signs of a disturbance, forced entry, a clean-up or unnatural tidiness?
Then what do witnesses say? Are their accounts credible? Are they consistent? Can they be corroborated?
The timeline is important too. When you regularly see dead bodies, you begin to recognise signs that can indicate how long someone may have been dead.
For instance, there’s a process called lividity, which is essentially gravity acting on the blood after death. If that process is well established, it may suggest the body has been lying in that position for a number of hours. Does that fit with what I’m being told?
And probably the most important area, and one that might not be immediately obvious to others, is the history of the victim.
Are they in a relationship? If so, what do we know about it? The three biggest signs for me would be suggestions of a coercive relationship, a history of violence or a major change in circumstances, such as separation or pregnancy. If any of those existed, it would make me dig deeper.
As I go through this thought process, I’m essentially working towards one of three outcomes.
The first is that his death is non-suspicious, meaning responsibility for reporting it to the coroner, remains with local police.
The next is that I’m satisfied this is most likely a murder, in which case it would then become a homicide investigation.
The third is where I can’t be sure one way of the other. In that instance, we carry on treating it as suspicious death and arrange for a special post-mortem examination to be carried out by a forensic pathologist. In my experience, it would be at that stage that most deaths could be called one way of the other.
One thing, though. There can sometimes be a difference between what you suspect, and what you can confidently show. You’d sometimes get a gut feeling. Maybe from something you’ve seen. Maybe from something you haven’t seen. But as with many aspects of detective work, you can’t make definitive calls on hunches, mostly because they can be wrong.
I was called to a suspicious death in Woolwich, South-East London. When I arrived I was presented with a scene in an old bike shed. It was a place the homeless used for shelter when the weather wasn’t so good.
Inside was a deceased man, who was a known local drinker.
As a suspicious death, the shed was treated as a crime scene with cordon tape around it. I went inside wearing overshoes, a paper suit and gloves. The shed was absolutely littered with rubbish and empty bottles and cans of alcohol, and the man was laying on a rotten old mattress. The smell was awful, and made me slightly gag (no I never got used to it). The man looked like he could’ve been asleep. There were no obvious injuries on him.
He’d recently been arrested and the records showed he wasn’t in good health.
The person that found him was another drunk sleeping in there, and when he woke up he couldn’t rouse his mate and realised he was dead. There was nothing to contradict what he was saying.
Intelligence checks on both the deceased man and the witness raised no concerns.
All-in-all, it very much pointed to natural causes, likely linked to heavy drinking.
But as I couldn’t be sure, I wasn’t happy to call it as such. So, a special post-mortem was arranged. I went along, completely prepared for a quick confirmation of what I thought had happened.
I couldn’t have been more wrong.
The man had severe internal injuries consistent with having been stamped to death.
His mate had failed to tell us about the other drinker who’d been there that night and had killed him after an alcohol-fuelled argument.
I was very glad the evidence-based process we followed meant I didn’t declare that death non-suspicious. Had I done so, a dangerous criminal could have remained free.
Shipman’s conviction for fifteen murders made him Britain’s most prolific convicted serial killer.
But those deaths really were the tip of the iceberg.
The enquiry that investigated his working history revealed the true scale of his offending.
The number of patients he murdered was likely to be around 250.
Every one of those deaths left a family behind.
It meant hundreds lost the last years with their mum or dad.
Probably thousands of grandchildren never got to know their nan or granddad.
And many of those will ask the question, how could this be allowed to happen?
The system I worked to was one designed to identify murders that might not seem immediately obvious.
But no system is perfect.
The deaths of most of Shipman’s victims would never have been brought to the attention of the police, prior to the intervention of Dr Reynolds.
Those that were would immediately have appeared to be non-suspicious.
Whether by chance or design, his method of killing avoided the very system designed to detect murder.
But in the end, it wasn’t the murders that brought him down.
It was his greed.
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You’re the Detective
At what point would you have started to suspect these deaths weren’t natural?
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