The Shipman Inquiry - Questions & Answers

Questions and Answers

When was The Shipman Inquiry set up?
What were the Inquiry's objectives?
How did the Inquiry work?
What was the duration of the Inquiry?
When did Phase 1 finish?
When did Phase 2 begin? When did it end?
When were the Inquiry Reports published?
Where can the Inquiry Reports be purchased from?
How much evidence has the Inquiry collected?
Who was represented at the Inquiry?
How do I get in touch with the Inquiry?
What are the rules of copyright in connection with the Inquiry and its website?

When was The Shipman Inquiry set up?
The Inquiry was established by Parliament in January 2001 under the Tribunals of Inquiry (Evidence) Act 1921. Dame Janet Smith DBE, a High Court judge, took up her post as Chairman in February 2001. Public hearings into individual cases began on 20 June 2001.
Back to top

What are the Inquiry's objectives?
The Terms of Reference laid down by Parliament are:

After receiving the existing evidence and hearing such further evidence as necessary, to consider the extent of Harold Shipman's unlawful activities.
To enquire into the actions of the statutory bodies, authorities, other organisations and responsible individuals concerned in the procedures and investigations which followed the deaths of those of Harold Shipman's patients who died in unlawful or suspicious circumstances.
By reference to the case of Harold Shipman to enquire into the performance of the functions of those statutory bodies, authorities, other organisations and individuals with responsibility for monitoring primary care provision and the use of controlled drugs; and
Following those enquiries, to recommend what steps, if any, should be taken to protect patients in future, and to report its findings to the Secretary of State for the Home Department and to the Secretary of State for Health.

The work of the Inquiry was divided into two Phases, the details of which may be seen in List of Issues. In essence, Phase 1 concerns the individual deaths of former patients of Shipman, while Phase 2 concerns the systems in operation during Shipman's medical career and proposals for change.
In Phase 1, the Inquiry team prepared evidence, which was put before the Chairman either in the public hearings or in written form. When the evidence in each case was completed, Counsel to the Inquiry prepared a submission to Dame Janet. Represented Parties also made submissions. Dame Janet then made decisions on 494 cases, which were published in the First Report on 19 July 2002.
Phase 2 was divided into four stages:
- Stage 1 considered the investigation of Shipman by Greater Manchester Police in March 1998
- Stage 2 considered death certification and the investigation of deaths by coroners.
- Stage 3 considered controlled drugs.
- Stage 4 considered monitoring, single-handed practices, whistleblowing and disciplinary systems and complaints.
In Phase 2, The Inquiry team prepared evidence and submissions and placed them before Dame Janet in the same way. Represented Parties were also able to make submissions. Dame Janet then made recommendations for change in four further reports.
Public hearings of the Inquiry were held in the Council Chamber at Manchester Town Hall Extension, Mount Street, Manchester.
An additional report was produced in January 2005 which considered Shipman's time as a hospital doctor at Pontefract General Infirmary
Details of the Inquiry team may be seen under Background.

Dame Janet delivered her First Report on 19 July 2002. The Reports on Stages 1 and 2 of Phase 2 (The Second and Third Reports) were submitted to the Secretary of State for Health and the Home Secretary in June 2003 and published on 14 July 2003. The Report on Stage 3 of Phase 2 (The Fourth Report) was published on 15 July 2004. The Report on Stage 4 of Phase 2 (The Fifth Report) was published on 9 December 2004. A final report (The Sixth Report) concerning the activities of Shipman during his time as a hospital doctor at Pontefract General Infirmary was published on 27 January 2005.
Investigative work began in February 2001 and public hearings into Phase 1 commenced on 20 June 2001. Oral hearings into Phase 2 began on 7 May 2002 and concluded on 30 January 2004. Investigative work into Shipman's time at Pontefract General Infirmary began in 2001. The Inquiry concluded its activities in March 2005.

The taking of oral evidence in Phase 1 was completed on 2 May 2002.
The First Report, into Phase 1, was published on 19 July 2002.

The public hearings into Phase 2, Stage 1 - the Police Investigation of March 1998 - began on 7 May 2002 and were completed on 17 July 2002.
Public hearings into Stage 2 - Death and Cremation Certification - began on 7 October 2002 and were completed on 24 January 2003.
Hearings into Stage 3 - Controlled Drugs - began on 19 May and ended on 18 July 2003.
Hearings into Stage 4 - Monitoring and Disciplinary Systems and Complaints began on 14 July 2003 and ended on 18 December 2003.
A series of seminars relating to topics discussed in Stages 3 and 4 of Phase 2 were held in January 2004.

The First Report was published on 19 July 2002. It contains the conclusions of the Chairman, Dame Janet Smith into Phase 1 of the Inquiry, which considered how many patients Shipman killed, the means employed and the period over which the killings took place.
Reports into Stages 1 and 2 of Phase 2 were submitted to the Secretary of State for Health and the Home Secretary in June 2003 and published on 14 July 2003.
Reports on Stages 3 and 4 of Phase 2 were submitted to the Secretary of State of Health and the Home Secretary in June and November 2004 respectively and were published on 15 July 2004 and 9 December 2004.
The Final Report was published on January 2005.

The Shipman Inquiry's First Report was published in July 2002. A limited number of printed copies (consisting of six volumes) were produced. The Report can be viewed in full on this website under Reports.
The Second and Third Reports are Command Papers and were published by The Stationery Office (TSO) in July 2003. They are entitled "The Police Investigation of March 1998" (Cm5853) and "Death Certification and the Investigation of Deaths by Coroners" (Cm5854) respectively. The Fourth and Fifth Reports are also Command Papers, again published by TSO, in July 2004 and December 2004. The are entitled "The Regulation of Controlled Drugs in the Community" (Cm 6249) and "Safeguarding Patients: Lessons from the Past - Proposals for the Future" (Cm 6394). They are available to purchase from TSO at www.tso.co.uk/bookshop. Alternatively, a list of TSO agents can be found in the Yellow Pages.
The Sixth Report was published in January 2005. A limited number of printed copies were produced. The Report can be viewed in full on the website under Reports.

The Inquiry took approximately 2,500 witness statements and approximately 270,000 pages of evidence were scanned into the Inquiry database.

After publishing its final report on 27 January 2005, The Shipman Inquiry was decommissioned at Easter 2005.

If you have any queries regarding the Inquiry please direct them to:

Investigations & Inquiries Unit
Department of Health
Room 531B, Skipton House
80 London Road
London
SE1 6LH

The material on the website is protected by Crown copyright unless otherwise indicated.

Crown material may be reproduced free of charge in any format or medium subject to it being reproduced accurately and not in a misleading context. The source should be acknowledged.

Any enquiries relating to Crown copyright should be addressed to:
Licensing Division
HMSO
St Clements House
2-16 Colegate
Norwich,
NR3 1BQ
Email: licensing@hmso.gov.uk
This website has been designed and produced by "Spoken" Image Limited and Idaho Technology Consultants Limited. The intellectual property rights for database design and structure, including content management system, resides exclusively with "Spoken" Image/Idaho.

The Shipman Inquiry accepts no responsibility for the content or conduct of any website linked to this website.