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The matter came to a head at a staff meeting. Partner Dr Michael Grieve recalled the scene: ‘We were sat round with Fred sitting on one side and up comes John on the opposite and says, “Now young Fred, can you explain this?”’

Dacre then laid before Shipman all the evidence that he has been collecting. It clearly showed that Shipman had been prescribing pethidine to patients who never received it.

‘In fact, the pethidine had found its way into Fred’s very own veins,’ said Grieve.

Realising his career was on the line, Shipman begged for a second chance. When this was refused, Shipman hurled his medical bag to the ground. His colleagues were shocked by this petulant outburst. Soon after, Shipman’s wife Primrose stormed into the room, screaming that her husband would never resign.

‘You’ll have to force him out!’ she shrieked.

Indeed, that is what they did. Shipman left Todmorden and checked into a drug treatment centre in York. He was found guilty of forgery and prescription fraud, and was fined £600, but he was not struck off by the General Medical Council.

‘If Fred hadn’t, at that point, gone straight into hospital,’ said Grieve, ‘perhaps his sentence would have been more than just a fine. I think it’s perhaps the fact that he put his hand up and said “I need treatment” and went into hospital, and then the sick-doctor routine takes over.’

This was probably also the reason he was not struck off the medical register.

There is now some doubt that Shipman had been using all the pethidine himself and there are those who believe that Shipman had been using it to kill patients in Todmorden.

Two years later, Shipmen got a post at the Donnybrook Medical Centre in Hyde, Greater Manchester, with surprising ease.

‘His approach was “I have had this problem, this conviction for abuse of pethidine”,’ said Dr Jeffery Moysey of the Donnybrook Centre. ‘“I have undergone treatment. I am now clean. All I can ask you to do is to trust me on that issue and to watch me”.’

But they did not watch him closely enough. Again, he appeared to be a dedicated, hard-working doctor, who earned his colleagues’ respect and his patients’ trust. And, again, he was seen as bullying and abusive by those under him – though he was skilled at masking this in front of his peers. But this time there were no blackouts, and no suspicion of drug abuse. This left him free to kill.

He stayed at the Donnybrook clinic for 16 years. Then in 1993, after falling out with the partners, he set up on his own as a GP with Primrose as his part-time receptionist. Such was his reputation in Hyde that he attracted a large number of patients. It is not known how many of them he killed.

The first person to suspect that something was wrong was local undertaker Alan Massey. He noted that Shipman’s patients seemed to be dying at an unusually high rate. But there was also a curious pattern to their deaths and a strange similarity to the corpses when he called to collect them.

‘Dr Shipman’s always seem to be the same, or very similar,’ said Massey. ‘They could be sat in a chair, could be laid on the settee, but I would say ninety per cent were fully clothed. There was never anything in the house that I saw that indicated the person had been ill. It just seems the person, where they were, had died. There was something that didn’t quite fit.’

The undertaker was so troubled that he questioned Shipman about it.

‘I asked him if there was any cause for concern,’ said Massey. ‘He just said: “No, there isn’t.”’

Shipman showed Massey the book in which he recorded the details of death certificates he had issued. In it, he entered the cause of death and noted any causes for concern. He assured Massey that all the deaths were straightforward. There was nothing to worry about. Anybody who wanted to inspect the book had free access. As Shipman showed no unease when questioned, Massey was placated and took no further action. But his daughter, Debbie Brambroffe, who was also in the business, was not so easily mollified. She enlisted the support of Dr