Shipman: Britain's biggest serial killer

And the official inquiry into his crimes -- led by Bolton judge Dame Janet Smith -- has concluded that there is a "real suspicion" he could also be responsible for a further 45 deaths. Dame Janet examined a total of 888 deaths of Shipman's patients between 1975 and 1998.

Of Shipman's 215 victims, 171 were women and 44 were men. The oldest was a 93-year-old woman and the youngest a 41-year-old man. He began murdering patients in 1975, just a year after entering practice in Todmorden, West Yorkshire, and claimed all his other victims in Hyde.

Bolton doctor, Dr David Bunn, who worked with Shipman for 18 months said: "I cannot comprehend how another doctor can have done such a thing."

In heading the official inquiry into his crimes Dame Janet, a Bolton School educated High Court judge, -- who has been hearing evidence since June last year at Manchester Town Hall -- delivered decisions in 494 deaths.

She decided that the first of Shipman's victims was Mrs Eva Lyons, who he murdered in March 1975 while at the Abraham Ormerod Medical Practice in Todmorden.

Another 71 patients were killed during Shipman's time at the Donneybrook House group practice in Hyde, and the remaining 143 were murdered at Shipman's single-handed practice that he set up in Market Street, Hyde, in 1992.

The oldest of his victims was 93-year-old Ann Cooper and the youngest 41-year-old Peter Lewis.

The judge said in her six-volume, 2,000 page report: "There are 45 deaths for which I have found that a real suspicion arises that Shipman may have been responsible, although the evidence is not sufficiently clear for me to reach a positive conclusion that he was.

"In addition, there are a further 38 deaths in respect of which there was so little evidence, or evidence of such poor quality, that I was unable to form any view at all."

Dame Janet said there was "compelling evidence" in 394 of them that Shipman was not responsible for the death.

"His activities have brought tragedy upon them and also upon the communities in which he practised and which gave him their trust." She said the inquiry would now go on to direct its efforts to devising improved systems "so as to ensure such a terrible betrayal of trust by a family doctor can never happen again".

Shipman is to be sent a copy of the report in Frankland jail, County Durham, where he is serving life for the murders of 15 patients.

Dame Janet's analysis of Shipman's killings revealed that in his single-handed practice he claimed one victim in 1992, 16 in 1993 and 11 in 1994.

In 1995 and 1996 he killed 30 patients in each year, and 37 in 1997. During the first three months of 1998 he killed 15 patients, after which there was an interval of seven weeks, before he went on to murder three more patients before his arrest in September.

Dame Janet's list of 215 patients who were unlawfully killed include the 15 women he was convicted of murdering at Preston Crown Court in January, 2000, and a further 27 on whom inquests were later held.

Dame Janet said that the majority of deaths were followed by cremation. Procedures that required a second doctor to sign the certificate and a third doctor employed by the crematorium to check were intended to safeguard the public.

But even with those in place Shipman was able to kill 215 people without detection.

"In reality, the procedures provided no safeguard at all," said the report.

Shipman had also managed to avoid referring cases to the Coroner that should have been referred, in all but very few cases.

Today reflecting on the crimes Dr Bunn, who has a surgery in Blackburn Road, said: "Nobody suspected anything at the time.

"This has been a terrible time for everyone concerned, especially for the relatives of the victims."

Dr Bunn shared a practice with Shipman in Todmorden for 18 months in the 1970s but forced Shipman to quit after discovering he had a drug addiction.

He said: "I do not know if we could have done anything different to prevent what happened."