An inquiry into the murders committed by family doctor Harold Shipman found he’d Shipman killed up to 15 patients in his early career,

The report into Shipman’s crimes found he’d murdered three patients while working as a junior hospital doctor in the 1970s, and was probably responsible for many more including that of a four-year-old girl.

These came before his killing spree as a family practitioner when Britain’s most prolific mass murderer killed 215 mostly elderly patients and may have murdered another 45.

“I estimate in all Shipman probably killed about 250 patients of whom I have been able to positively identify 218,” Dame Janet Smith, the inquiry head, told reporters.

Dame Janet said she didn’t agree with the view of the medical profession that Shipman was a one-off and that his profession was not linked to his killing spree.

“It was the very fact that Shipman was a doctor that enabled him to kill,” she said.

“His profession not only enabled him to kill, but it allowed his killing to remain undetected.”

The report also dismissed claims by a former inmate that Shipman had confessed to him in prison that he had killed more than 508 patients.

Shipman, nicknamed “Dr Death” for the cold and systematic way he murdered his victims with heroin injections, was jailed for life in January 2000.

Last year he hung himself in prison on the eve of his 58th birthday.

The total of 250 murders makes him the second worst serial killer of recent times behind Colombian Pedro Lopez.

Lopez, dubbed the “Monster of the Andes”, was convicted of 57 murders in 1980 but is suspected of killing 300 young girls.

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