The former GP, Harold Shipman, Britain's most prolific serial killer, used massive doses of diamorphine to kill his victims, the public inquiry into his patients' deaths was told as it got under way last week.
The inquiry, at Manchester town hall, chaired by High Court judge Dame Janet Smith, is expected to take two years to unravel how the GP was able to evade the authorities for 24 years while killing hundreds of his patients.
Shipman, serving life in Frankland prison, Durham, after being found guilty last year of murdering 15 women patients, has refused to cooperate with the inquiry. It will try to establish how 459 patients died, although this may not be the full toll.
Richard Lissack QC, representing victims' families, said that the GP had “moved unchecked through families, streets, and bit by bit murdered the heart of a community.”
Shipman, practising in Hyde, Greater Manchester, was unmasked after he was named as the sole beneficiary of the will of Kathleen Grundy, an elderly patient who was fit and healthy but had died suddenly during a visit to her home by Shipman.
Warning bells had been sounded at various stages of his career, but he had managed to escape detection. In 1975, in his first year in general practice in Todmorden, West Yorkshire, police and Home Office inspectors first became suspicious about the amounts of pethidine that he was obtaining. After several denials, he eventually admitted taking it intravenously for depression.
He was convicted on drugs charges in 1976 and entered a clinic to overcome his addiction. He had given a written undertaking in 1975 that he had no intention to return to general practice. But two years later he was back in practice.
The General Medical Council decided not to take action against him after receiving a psychiatrist's report that said it would be “catastrophic” if he were not allowed to return to practice.