Quote:LONDON, England (CNN) -- Relatives of patients killed by Dr. Harold Shipman say they have been "vindicated" in their struggle to reveal him as the UK's worst serial killer.

Families and friends have fought an "uphill" campaign to have the full extent of Shipman's killings investigated and reported.

The interim findings of the public inquiry released on Friday show he killed at least 215 people, mainly elderly women.

But families, who described the father-of-four as "one of the most evil men in history," were still left bemused by his motive for the orgy of killing over 23 years.

The report also criticises medical and legal systems that allowed Shipman to get away with it for so long.

Shipman was jailed for life in January 2000 for the murders of 15 women but hundreds of other families had been left to wonder whether their relatives had fallen victim to his lethal injections too.

The inquiry investigated 887 cases and was able to conclude, in most of them, whether Shipman was responsible or not.

Inquiry chair Dame Janet Smith found that Shipman had killed a further 200 people and there was also a "real suspicion" he could have claimed another 45 victims.

Of Shipman's 215 victims, 171 were women and 44 were men, with the oldest being a 93-year-old woman and the youngest a 41-year-old man.

Dame Janet said the cause of death could not be determined in 38 cases because the evidence was too weak to form any view at all, while 210 patients had died of natural causes.

The 2,000-page report delivered a decision on 494 of the 887 cases.

Dame Janet said there was "compelling evidence" in 394 of these cases that Shipman was not responsible for the death.

Her first report into Shipman's killings said he began murdering patients in 1975, just a year after entering practice in Todmorden, West Yorkshire, but the bulk happened after he moved to Hyde, Greater Manchester, northwest England

The report said systems that should have safeguarded patients against misconduct failed to operate satisfactorily and that it was "deeply disturbing" that his killings did not arouse suspicion for so many years.

CNN's Diana Muriel said the report made "shocking reading."

She added that Shipman's reasons for the killings were unclear. His first victims tended to be terminally ill, but then he moved on to murder patients that simply irritated him. He himself has never admitted guilt or his thinking behind the deaths.

Dame Janet said she had examined Shipman's possible motivation for the killings. But she said: "I regret that I have reached no clear conclusion."

The trail to Shipman's conviction began when he was found to have changed the will of his last victim Kathleen Grundy, 81, in his favour. But that was the only evidence that Shipman had acted for monetary gain, the report found.

Quote:I wouldn't even have enough hours in a fuckin day to ace all the people that irritate me

Quote:Obviously he's mentally ill

Quote:Doc made me chuckle...but the doc has an early bed time.