Politicians and doctors have warned that the lessons of the Harold Shipman case must be learnt.

But they have also united to urge patients not to lose trust in their GP.

The interim report from Dame Janet Smith's inquiry concluded the former GP murdered at least 215 of his patients.

Everyone accepts that family doctors, with very, very few exceptions, do a very good job

Prime Minister's Official Spokesman

The prime minister's official spokesman said the horror of the Harold Shipman affair should not "erode the bond of trust" between doctors and patients.

Horror

"The fact that this report today essentially confirms what everybody suspected in terms of the extent of his crimes in no way diminishes their horror and our thoughts are obviously with the families of his victims at what must be a very difficult time.

"It is important, however, to not go from the specific to the general and allow this to erode the bond of trust that exists between doctors and patients.

"I think everyone accepts that family doctors, with very, very few exceptions, do a very good job."

Dr Ian Bolge, chairman of the British Medical Association, described the case as "horrific" and "unbelievable".

But he said changes to way doctors are regulated meant "this sort of thing could not happen now".

He added that doctors are now required to "blow the whistle" on colleagues if they believe patients are at risk.

"They must blow the whistle where they suspect anything is happening that is to the detriment of patients so it can be investigated. It is a whole different culture."

Dr John Chisholm, chairman of the British Medical Association's GPs committee, said the case had not affected patients' trust in doctors.

The public have realised that this is a quite exceptional case

Dr John Chisholm, BMA

"The public have realised that this is a quite exceptional case, that Shipman was a uniquely evil individual, and, perhaps surprisingly, this has not lessened individual patient's trust in their doctor.

"But we do have to do much more in the future to prevent any possibility of recurrence."

Professor David Haslam, chairman of the Royal College of General Practitioners, said: "For a GP to betray this hard-earned trust in such a chilling way is horrific."

Vanessa Bourne of the Patients' Association said: "It is important patients can have their trust restored."

She added: "There are systems at the moment that should be protecting patients, should be talking to each other.

"If they have failed it is important they should be put right as soon as possible."

More checks

Shadow Health Secretary Dr Liam Fox said: "It is essential to learn all the lessons from Shipman's evil deeds to do everything possible to ensure that there can be no repetition.

"It is also important to remember that Harold Shipman is an isolated case, and that the public should retain confidence and trust in GPs."

The Liberal Democrats said the case highlighted the need for more checks on doctors.

Doctors must be removed from their pedestal and their actions must be questioned

Dr Evan Harris, Lib Dem health spokesman

Its health spokesman Dr Evan Harris said: "This report makes it tragically clear that there were at least 215 missed opportunities to identify and stop a murderer.

"It is sadly not surprising that it is a medical practitioner who was able to get away for so long with these crimes," he said.

"Doctors must be removed from their pedestal and their actions must be questioned and audited more often."

Labour MP for Stalybridge and Hyde James Purnell said he hoped publication of the interim report of the inquiry into the killer would begin "healing some of the scars".

He urged the media to respect the privacy of those directly affected by the case.

"I am sure the rest of the country will want to join me in offering our deepest condolences to all relatives and friends of the people who died at the hands of Harold Shipman."

He added: "I know how angry and upset they are, and hopefully this interim report will go some way to healing some of the scars."