One of this town's best-loved doctors was almost certainly Britain's worst serial killer.
A year after Harold Shipman was convicted of injecting 15 elderly women with fatal doses of heroin, a government report released Friday suggests that the revered family doctor may have killed closer to 300 of his patients during a quarter of a century of practicing medicine.
Most of his suspected victims were elderly. Most were widows or women living alone. And most no doubt welcomed him into their homes.
Such was the high regard for Shipman that when Hilda Hibbert died unexpectedly five years ago while sitting in a living room armchair, her bereaved granddaughter made a contribution in her memory to the doctor's equipment fund. Jane Ashton-Hibbert never dreamed that Shipman might have had a hand in the death of her Gran.
When the doctor was charged with murder and forging the will of another elderly Hyde woman in 1998, Ashton-Hibbert was among the hundreds of patients who lent him their heartfelt support.
Now Ashton-Hibbert is convinced that her 81-year-old grandmother was another Shipman victim and that an inquest scheduled to begin Tuesday will prove she was murdered. Hibbert's is the first of 24 inquests into the deaths of Shipman patients set to be held this year ahead of a public inquiry into the killing spree that has left a community ravaged by grief, guilt and shame at having been duped.
"In a million years, you don't expect your doctor to be Britain's worst serial killer," Ashton-Hibbert said at her home on a wintry afternoon. "This was someone you trusted with your emotional and physical problems. I think for me personally, the sense of betrayal is sometimes worse than the actual murder."
Shipman, 54, denies that he killed anyone, and his exact murder toll might never be known. But the Health Department review of Shipman's practices revealed that between 1974 and 1998, he signed 2 1/2 times as many death certificates as did any of the six practices with which his was compared--an "excess" of 297 deaths. Of those, most suspicious are 236 that occurred in the patients' homes.
While some of the "excess of deaths" date back to his early years in Yorkshire, most of Shipman's evil appears to have been unleashed during his two decades in Hyde. Few serial killers have wrought so much devastation in such a small area.
A former mill town on the outskirts of Manchester, Hyde was a tightknit community of 30,000 people where the elderly felt safe enough to leave their doors unlocked when they were home alone and neighbors traded gossip on the doorsteps of their brick row houses.
In a place where everyone seemed to know everyone else's business, it amazes residents today that acquaintances seated together on a bus or colleagues sharing a cup of tea never stumbled across their common experiences--that one never said, "Me mum died after a visit from Dr. Shipman" and another never answered, "Hold on, that's what happened to me mum."
Perhaps it was the fact that Hyde already had suffered humiliation at the hands of the notorious Moors murderers, and residents believed lightning could not strike twice. Ian Brady and Myra Hindley, sentenced to life in prison for the 1960s torture-murders of five children, were from the area and had brought Hyde untold misery and bad publicity.
But that was history. By the 1990s, Hyde was again a typical English town of salt-of-the-earth folks who put a local doctor on a pedestal, seldom questioning his word or his authority. Especially a charismatic doctor such as Shipman, a father of four who served on the local parent-teacher association and apparently gave his all to patients.
A History of Addiction
Born to working-class parents in Nottingham, Shipman earned a degree in medicine from Leeds University before going to work in 1974 for the Todmorden Group Practice in Yorkshire. In 1976, his colleagues discovered he was addicted to the painkiller pethidine. Repentant, he admitted to forging nearly 70 drug prescriptions, was fined by a magistrates court and fired from his job, and went into rehabilitation.
Less than two years later, Shipman turned up in Hyde at the large Donneybrook House practice, whose members were unaware of his past. He worked there for 15 years before going it alone. The National Health Service doctor hung his shingle on a brick storefront with frosted glass windows on Market Street. His wife, Primrose, helped out in reception.
Soon there was a waiting list to join his roster of 3,000 patients, many of whom would put in a good word for a friend with Shipman.
Even today, former patients and relatives of his victims marvel at how Shipman was what many called "the perfect doctor," who always had time for them. Not only did he make house calls, but he would drop in unexpectedly to see how a young mother was faring with her newborn or to check on someone's grandmother with a touch of flu.
How were they to know he was preying on widows and elderly women living alone?
Actually, one man thought he did know. For years, taxi driver John Shaw chauffeured the elderly around Hyde. And for years, he knew that an awful lot of his clients were dying under virtually identical circumstances. They were healthy and active one day, dead the next. Often, they had just seen their doctor, or the doctor had just arrived to find them dead on a chair or settee.
It was happening so frequently that Shaw began to keep a list. He started to ask who the doctor was, and the answer was always the same: Shipman. He agonized about what to do and discussed his dilemma with his wife, Kath.
"I'd say, 'I've got to tell someone.' And Kath would say: 'If you do go to the police, you'll be ridiculed. If you're wrong, you'll get taken to court for libel-slander.' "
In the end, they always came to the same conclusion: "Who would have believed a taxi driver?" Shaw asked.
As it has so many Hyde residents, the Shipman case has consumed Shaw's life. An oversize scrapbook of neatly pasted newspaper clips testifies to the fact that he followed the case through charges, exhumations, further charges, trial and conviction--two years during which he blamed himself.
"I felt if I had confronted the fellow, he might have stopped. But then if he had stopped, maybe he wouldn't have been caught," Shaw said. "I get some solace from the fact that there were people in a lot better position than myself to do something."
Some of those people did eventually try to do something. About six months before Shipman's arrest, the five doctors at the Brooke Surgery across the street realized that although they had three times as many patients as Shipman, his death rate was higher.
The doctors spoke with staff at a local undertakers who, it turned out, had been concerned by the unusual number of funerals they were arranging for women who had not been seriously ill prior to death. They had checked the bodies for signs of foul play but found none.
The doctors referred the case to the coroner and police, who investigated but discovered nothing out of the ordinary.
An Incriminating Will
Shipman went on to kill three more people before tripping himself up by forging the will of his last victim, 81-year-old Kathleen Grundy, a widow whose daughter happened to be an out-of-town probate lawyer.
Grundy's body was found seated in the living room of her unlocked home on June 24, 1998, several hours after Shipman had been there to take a blood sample. Days later, daughter Angela Woodruff received a copy of a badly typed will leaving Grundy's home and estate, worth a total of more than $600,000, to Shipman "to reward him for all the care he has given to me and the people of Hyde." The signature did not appear to be her mother's.
Woodruff alerted police, and investigations revealed that the will had been written on Shipman's typewriter. It had a print from one of his little fingers on it, but none from Grundy.
Grundy's body was exhumed on Aug. 1, 1998, and morphine was found in her muscle tissue. Shipman, it turned out, was injecting his patients with diamorphine, the clinical term for heroin, which is metabolized by the body into morphine.
When news that Shipman had been charged with Grundy's murder hit the press, Shaw finally went to the police with his list of names. And so, it seems, did many families wondering about relatives whose untimely deaths seemed to mirror the Gundy case.
The stories that emerged were unbelievable in their audacity:
* Ivy Lomas, 64, died in an examining room at Shipman's office. He apparently injected her with diamorphine, left her to attend to three more patients, then returned to find her collapsed. He did not call emergency services or ask for help resuscitating her before she died.
* Marie West, 82, died in her living room in front of Shipman while her best friend waited politely in the kitchen, unbeknown to the doctor. Marion Hadfield had gone to the bathroom and was on her way back when she heard Shipman's voice and decided to give patient and doctor some privacy. When the living room grew silent, she reentered to find the doctor standing over her collapsed friend. He pronounced her dead.
* Kathleen Wagstaff, 81, was found dead at home 45 minutes after a neighbor heard her greet Shipman at the front door with a surprised "What are you doing here?"
In several cases, such as Wagstaff's, Shipman claimed to have called an ambulance, but records showed he had not. On the death certificates, he generally listed the cause of death as heart attack, stroke or some disease common among the elderly. If a distraught family member suggested an autopsy, Shipman insisted that it was not necessary, since the patient had been under his care and the cause of death was apparent.
Police have investigated 205 deaths involving Shipman dating back to 1980. Fifteen of the clearest-cut cases were taken to court, and convictions were won. Prosecutors have said they will not try Shipman again, as he is already serving life sentences--there is no death penalty in Britain--but there was sufficient evidence in 27 other cases to warrant inquests, three of which have already returned verdicts of "unlawful death."
In the scores of other cases, either the families do not want to pursue the case, the remains are no longer in the Manchester coroner's jurisdiction, or there is insufficient evidence to back up suspicions.
Health Secretary Alan Milburn had wanted to hold a low-level inquiry into the serial killings behind closed doors, but the relatives of murdered patients fought for seven months and took the case to the High Court to force a weightier public inquiry.
"We had to fight for this. My Gran would have fought for me," said Jane Ashton-Hibbert, who suffered a split with her sister over the inquest and inquiry.
"There are so many questions that all of the families have," said Carol Woodruff, whose 67-year-old mother, Irene Turner, died after a house call by Shipman. "Why wasn't he stopped, and how did he manage to get hold of the drugs? Once this was reported to the coroner--who saw that Shipman's death toll was rather high--why didn't they look into it when the next death was reported?"
Another question that the inquiry will have to answer is how Shipman was allowed to practice and to dispense drugs after his conviction for abuse. The inquiry also may determine if Britain's current practices for reporting deaths should be changed. A sudden death does not have to be reported to the coroner if the deceased was seen by a doctor for a related ailment within two weeks before passing away. In the case of Shipman's victims, he had seen all within hours, and he signed their death certificates. The cases never went to the coroner.
It turned out that Shipman did not even bother to record all of the death certificates with the registrar, which apparently is why police did not turn up anything suspicious in their initial investigation after other doctors raised a red flag. Several certificates were found in boxes at his home.
But the question the inquiry most likely will not be able to answer is the one nagging so many aching families: Why did Shipman take so many lives?
Despite the forged Grundy will, the reason apparently was not money, though police found what they believed to be "trophy" jewelry belonging to his victims at Shipman's house.
Some people have speculated that his killing might have stemmed from the fact that, at age 17, he witnessed his 43-year-old mother's death from lung cancer and saw her given doses of diamorphine to ease her agony.
Others believe that Shipman was an arrogant man who needed to be in control. Still others say he was simply sick, a man with the urge to kill. Sometimes he killed more than once a week, and sometimes he went many weeks without killing.
"He was addicted to death. He got a thrill out of seeing people die," said Father Denis Maher, a Roman Catholic priest who lost seven parishioners at St. Paul's Church.
Whatever the motivation, Shipman destroyed scores and possibly hundreds of lives and reduced Hyde to the status of home to Britain's worst serial killer. On top of the personal pain so many have suffered, Maher said, "People feel the town will never be able to live this down. For all time, Hyde will be associated with this."