A review of the way Ian Huntley is looked after in jail was launched today after the child murderer was found unconscious in his cell following a suspected overdose.
Sources said Huntley was in intensive care and having his stomach pumped after being discovered at 1.19am at Wakefield high security prison in West Yorkshire.
Today's incident raised yet more questions about the Prison Service's supervision of one of Britain's highest-profile killers.
A community leader in Soham - where Huntley killed 10-year-old Holly Wells and Jessica Chapman four years ago - immediately criticised the prison authorities for being "lax" and said Huntley must serve his sentence.
Questions may also be raised about procedures at Wakefield Prison, where serial killer Harold Shipman committed suicide in January 2004.
The Prison Service said staff attempted to resuscitate the Soham killer, who has taken an overdose before, and he was taken by ambulance to hospital, believed to be Pinderfields in Wakefield.
Ex-school caretaker Huntley, 32, is now under heavy sedation.
Police sources said Holly and Jessica's parents were being kept informed of developments.
John Powley, Soham's county councillor and a governor at Huntley's former workplace, Soham Village College, said: "I am very concerned that this is the second time he has managed to attempt suicide while in prison. It may be third time lucky next time.
"The prison authorities need to keep a much closer watch than they have previously been doing. The prison authorities appear to be lax."
He added: "I am sure that there are some people in Soham who would wish him to die and say good riddance to bad rubbish.
"But I am not one of those. I would not wish to see anyone commit suicide.
"My view is that he committed a heinous crime. He was properly convicted and now he should serve his sentence. If that means he spends the rest of his life in prison so be it."
In June 2003 there were calls for the man responsible for English high-security prisons to resign over a bungle which allowed Huntley to carry out his earlier suicide attempt.
While awaiting trial for the schoolgirls' murders he saved up 29 anti-depressant pills in a box of teabags and was found suffering a fit on the floor of his cell at Woodhill Prison, near Milton Keynes.
An official report into the previous suicide attempt uncovered a number of "serious systems failures".
The report criticised management and staff briefings as "not robust enough" but it did not recommend disciplining individual officers.
Then-Home Office minister Paul Goggins said the internal report revealed a "completely unacceptable situation".
The minister said at the time: "Procedures for dispensing medication to Mr Huntley fell well short of acceptable standards."
The document made 15 recommendations, including a review of the jail's cell search strategy and an independent review of security intelligence in the prison, including CCTV.
Sources said Huntley had apparently indicated again in recent weeks that he wanted to die.
A Prison Service spokeswoman said a review of the "management strategy" for Huntley had been launched.
The review, commissioned by Prison Service chiefs, will be carried out by the head of the service's Standards Audit Unit, Rob Kellett.
Mark Leech, editor of the Prisons Handbook, said it was difficult to stop inmates who were determined to kill themselves from making suicide attempts.
He said: "If he continues to make these attempts on his life, then one day he will be successful.
"The Prison Service's anti-suicide procedures are not infallible and they will inevitably fail.
"The prison officers have to be lucky every time and one day he will succeed, no matter how good their measures are."
Mr Leech suggested there may now be a case for offering voluntary euthanasia to prisoners who are facing the rest of their lives behind bars.
"It raises the question of whether people in his position facing the rest of his life in jail ought to be given the opportunity of a way out," he said.
"I think it is a position that needs to be explored rather than simply pooh-poohed.
"It's something I would support being investigated.
"It raises the question of euthanasia across the whole spectrum - should people be given the opportunity to check out with dignity?"
Mr Leech added that if Huntley survives the latest attempt, he will most likely be on close suicide watch when returned to jail and placed in a cell with CCTV coverage.
Children at both the junior school where Holly and Jessica were pupils and the senior school where Huntley worked were returning to their classrooms this week.
In Soham today, father of two Edward Sampson, 35, an electrical worker who has lived in the town for six years, said: "I think it would be better if Huntley died, although I think a lot of people would rather someone else killed him than he committed suicide."
Mr Sampson, who was speaking as he played with his 19-month-old son Luke in a park in Soham, added: "We were here when Holly and Jessica were killed. I didn't know the families.
"It is something that you want to put behind you and I don't think about it now. I think it would be better if Huntley were dead and a line could be drawn under it."
Director of the Howard League for Penal Reform Frances Crook said: "Prisons are awash with drugs and they are so hopelessly overcrowded that we cannot expect prison staff to cope, either by keeping people alive or delivering a sensible regime."
She added: "The politicians have to get a grip - the prison system is in meltdown.
"But that doesn't mean that we can build our way out of a crisis, it means we have to reduce the flow.
"The message to the Home Secretary is that he has got to stop being populist and start being a statesman."
Director of the Prison Reform Trust Juliet Lyon said: "Prisons are very hard-pressed.
"They are overcrowded, short-staffed and staff do not get adequate training.
"Prison officers are required to look after people with humanity and respect regardless of what they have done, but they are under extreme pressure at the moment."
Wakefield Prison was condemned after serial killer Harold Shipman committed suicide there in January 2004.
Although an official report said the killer GP's death could not have been prevented, Prisons and Probation Ombudsman Steven Shaw made a series of criticisms of prison authorities.
He went on to make 17 recommendations to prevent further deaths.
Mr Shaw specifically attacked decisions made in relation to Shipman under the prison privileges scheme, which meant the former Greater Manchester GP was not able to ring his wife, Primrose.
And he also expressed concern that details of Shipman having been on suicide watch before were not passed from Frankland Prison, near Durham, to Wakefield.
Shipman - Britain's worst serial killer, who murdered at least 250 patients - used a ligature of torn bedsheets to hang himself in his cell a day before his 58th birthday.