Shipman Inquiry » GP may never reveal how much he knows about 450 deaths

Shipman. Until 1998 it was merely a name. There were seven of them in the south Manchester telephone book which covers the town of Hyde, including one, Dr HF, of The Surgery in Market Street. Now Shipman is a disembodied noun, signifying syringes, old ladies, mass murder and an administrative failure to detect it.

The green livery of the two-year Shipman Inquiry, which began in a Manchester council chamber last week, bore his name in bold capitals. But it did not invite or compel him to take part. Instead, officialdom bowed before his decision to remain brooding in his cell at Frankland Prison, Co Durham. Inquests last year into the deaths of 25 Shipman patients had started the surgical removal of Britain's worst serial killer from the process of examining his actions.

In three days, the inquiry has demonstrated that it does not need a defendant to be adversarial and rigorous. It struggles against the simple solution; demonising Shipman either because his actions were so horrific or because his living victims, the relatives, are in the chamber. He was convicted on 15 counts of murder and was the probable perpetrator of 25 unlawful killings examined at inquest, but this, said Caroline Swift QC, counsel to the inquiry, did not lead to "the inescapable conclusion that Shipman was responsible for all the deaths it is considering". The balance of probabilities, the benchmark for proof in civil courts, will allow Dame Janet Smith, the chairwoman, to conclude a patient was murdered.

So far, the inquiry has "cleared" Shipman of seven killings, reducing the maximum toll of Shipman deaths it might establish from 466 to 459. He has also been absolved of suspicion surrounding another peculiar practice, that of stowing certain patients' medical records in tissue boxes and carrier bags in his garage. Shipman's decision on which records to keep and which to destroy was apparently random.

The files of all deaths reported to the south Manchester coroner during Shipman's 21 years as a doctor in Hyde have to be sifted. This involves 2,500 files for each year. In five years of files already examined, a "small number" of cases was possibly suspicious. The grisly pattern, an unpalatable picture of street-by-street, house-by-house killing, is emerging. The story of Elsie Cheetham was presented: her neighbour Sidney died while his brother left the room to give him privacy with the doctor. While Elsie took Sidney's grieving brother a meal, her husband, Thomas, died after an unexpected call from Shipman. Then she felt ill and died, after an unsolicited visit from the doctor. Shipman's surgery record reads: "Elsie Cheetham – funny do."

Most of the people of Hyde, where the proceedings are shown in the library on a live video link, want only confirmation that a relative did or did not die unnaturally. Eight people turned up last week. They are being subjected to a welter of unsparing new detail, such as Thursday's assertion that Shipman's victims perished from lethal diamorphine (heroin) injections before the GP's syringe left their arm.

One woman, who fears her grandmother may have been a victim, said: "I want to know but cannot bear to watch. I know he came to our house and said he would look after her. He was murdering her and we thanked him for his care."