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, i
