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Ten years after the Shipman Inquiry the senior judge who investigated gives her first TV interview in Shipman – When Doctors Kill, an Inside Out North West special investigation on ´óÏó´«Ã½ One, which gives a first glimpse of letters written by Shipman from prison.

Harold Shipman was Britain's most prolific serial killer. The Hyde doctor murdered 215 of his patients. Now, 10 years after the families won the right to a public inquiry, the senior judge in charge says enough still hasn't been done to stop doctors from killing their patients.

In an interview for the ´óÏó´«Ã½, Dame Janet Smith talks openly about the biggest mass murderer the country has ever seen and says she is "disappointed" that key recommendations to come out of the lengthy inquiry haven't yet been achieved.

For more than 20 years Shipman used the drug Diamorphine to kill patients both in their homes and at his surgery.

On Shipman, Dame Janet tells Inside Out North West: "I still do feel it was unspeakably dreadful, just unspeakable and unthinkable and unimaginable that he should be going about day after day pretending to be this wonderfully caring doctor and having with him in his bag his lethal weapon – his phials of diamorphine and syringe – which he would just take out in the most matter-of-fact way."

Yet, despite her recommendations to tighten access to controlled drugs, some in the medical profession fear that a doctor could still get his hands on dangerous drugs and kill undetected.

Professor Robert Forrest, one of the country's leading consultant medical and forensic toxicologists, tells the programme: "I think a doctor can still get away with murder, a nurse can still get away with murder, there are other health care professionals who can still get away with murder."

The Shipman inquiry ended in 2005. It lasted four years, took 2,500 witness statements and considered 270,000 pages of evidence. In 2003 it recommended wholesale reform of death certification that would make it less open to abuse and less dependent on the honesty of a single doctor. But seven years on Dame Janet still has concerns.

She says: "We haven't moved at all on the basic death certification. It's exactly the same. There hasn't been any further work done since I moved off it in 2003."

Inside Out North West discovers that while there have been delays nationally by the Government, the doctor who countersigned many of Shipman's cremation forms tightened procedures almost overnight.

Dr Raj Patel said: "We decided that we did not have to wait for the authorities to write legislation. We determined, as a group of doctors, if we decided we would behave differently around particularly cremation then we could affect that change very quickly."

While there are now more stringent cremation forms – introduced in January last year – there is still no unified system covering all deaths, as Dame Janet recommended. There may be tighter checks before a body is cremated – but they don't apply to burials.

Dr Patel added: "The fact that the body is retrievable is an important factor for the process for burial to be more simple. However, I certainly note that there could be potential for some wrongdoing by a healthcare professional or even a carer."

The programme also reveals that Revalidation, an 'MOT' of a doctor's fitness to practice, still hasn't been introduced.

Chief executive of the GMC, Niall Dickson, defends why these vital changes still haven't been made. "Part of the reason is convincing the profession that it is a good idea – and I think that we have begun to do that. But I think it has been a slow process. And I certainly think some older doctors found it a threatening process."

Families of Shipman's victims also voice their concerns and tell of the lasting effects on them.

Barry Swan, whose aunt and mother were both killed by Shipman, says: "It would be a travesty after all that we have been through if there were still loopholes."

The programme also analyses letters written by Shipman from prison that have never been seen in public. In one he says: "No-one saw me do anything. As for stealing morphine off the terminally ill again no-one saw me do it." In another he says: "The police complain I'm boring. No mistresses, home abroad, money in Swiss banks, I'm normal. If that is boring, I am."

Psychologist Dr David Holmes says Shipman's letters show he relished the attention: "He saw no one as being superior to him. In his own mind, in his own eyes, he was some sort of medical god."

The Ministry of Justice and the Department of Health were both asked to take part in the programme but declined. However, in a statement to the programme, the Department of Health, said: "The majority of recommendations from the Shipman Inquiry have now been implemented, improving both the quality and safety of patient care. This, crucially, included much better safeguarding of controlled drugs. Reforming the process of death certification requires changes to primary and secondary legislation – this takes time. We've already made changes to primary legislation and decisions on priorities for this area will be made in the coming weeks."

Shipman – When Doctors Kill is an Inside Out North West special investigation which can be seen on ´óÏó´«Ã½ One, Monday 19 July at 7.30pm. Viewers outside the region can watch on digital channel 978 or on ´óÏó´«Ã½ iPlayer.

Notes to Editors

Information contained in this press release, including quotes, which are used in publications, online or for broadcast, require a credit for ´óÏó´«Ã½ Inside Out North West: Shipman – When Doctors Kill on ´óÏó´«Ã½ One, Monday 19 July at 7.30pm.

A video trail for Shipman – When Doctors Kill is available to view on bbc.co.uk/insideout.

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