A fascinating and gob-smacking interview of Dr Scott McLachlan by Norman Fenton that raises much doubt about Lucy Letby’s guilt is part of a report that takes the lid off the most sensational multiple death case in the UK. NIALL McCRAE writes in unitynewsnetwork.co.uk
After her conviction for killing seven babies and attempted murder of ten others, nurse Lucy Letby, 33, is expected to spend the rest of her life in prison. The media whipped up such a public frenzy, that she would be safer inside. But as some legal commentators argue, her trial was a farce. Is Letby the fall girl for a corrupt system, in which doctors made serious errors and found a convenient scapegoat?
The crimes were committed from June 2015 to June 2016, at the neonatal unit at Countess of Chester Hospital. The impression given is that an exceptional number of babies died during this period, but there were contributory factors unrelated to nursing care, and the peak of infant mortality at the unit occurred in 2019, long after Letby had gone.
Almost everyone who knows of Letby’s case has only heard the official story of a prolific serial killer punished for unconscionable evil. But in an interview with Norman Fenton (statistician at Queen Mary University of London), Scott McLachan doubted that any justice was served. A lecturer in applied health technology at King’s College London, MvLachan has both nursing and legal qualifications. He has meticulously studied the evidence presented in court, revealing misleading use of data and omission of crucial information.
Of critical import to the guilty verdict was a chart showing which nurses were on duty at the time of baby collapses and deaths. It looks damning: in every case, Letby was there. But this was horridly misleading: other casualties occurred when Letby was off duty, but these were not considered in court. Data from a freedom of information request to the hospital showed that 31 infants died in the 12-month period of Letby’s adjudged crimes, yet 23 of these were excluded from the trial (of the eight deaths for which Letby was believed culpable, one case was dropped). In other words, Letby was implicated by circular logic: deaths happened when she was on the unit, so she must have caused them.
According to McLachan various other factors could have caused an elevation in mortality. The neonatal unit had been upgraded, enabling it to provide for premature babies who previously would have gone to a specialist unit. There was a problem with the plumbing: sewage pipes leaked, risking contamination of the water supply. McLachan suggested that bacterial infection could have been the cause of air in the bloodstream and organs of babies, rather than injection by Letby (which nobody witnessed).
The role and responsibility of doctors was strangely marginalised in the proceedings. Why weren’t they crosstabulated by infant injury? Dr Gibbs, the unit consultant, had one foot in the door of retirement at the time of the incidents, and clinical decision were increasingly taken by the registrar and junior doctors. As McLachan described, inexperienced trainees were performing skilled procedures such as umbilical venous catherisation, which should be supervised on the first three or more occasions. Sometimes a junior doctor made multiple unsuccessful insertions, raising the risk of infection.
Letby was reported to police by consultants, after a critical report about the unit by the Royal College of Paediatrics & Child Health, despite no concerns being raised by Letby’s nursing colleagues at the time. Perhaps she was a convenient target, after disagreeing with a doctor’s decision? In my mental health nursing experience many years ago, I was the subject of a witch hunt after a patient alleged that a nurse had doubted the drug regime prescribed by a consultant psychiatrist. I had merely informed the patient that antidepressants don’t work for everyone (an evidence-based statement), but that was enough to incur the wrath of the medical gods.
NHS management always blames nurses if something goes wrong. Doctors exert power without responsibility, while nurses are given responsibility without power. In the 1990s I was manager of an innovative mental health crisis service. Months were spent working on the operational policy, partly to ensure that the service (which had six beds) was used for genuine crises and not as an annex to the psychiatric ward. When I objected to consultant psychiatrists transferring patients from the acute wards as overspill, senior management sided with the doctors rather than the manager running the service to the operational policy!
Instrumental to Letby’s conviction was Dr Dewi Evans, a retired paediatrician, who approached the National Crime Agency to contribute to the investigation. McLachan suggests that Evans touted for business and oversold his credentials. He was not a current expert in neonatal care, but his assessment of the cause of deaths and injuries was prominent in the prosecution, and clearly influenced the jury.
Forensic analysis of the court case on the Science on Trial website rexvlucyletby2023.com infers that all of the seven babies died of natural causes. There may have been clinical negligence – by doctors and nurses (including Letby). Instead, one nurse was accused of the following malice: –
- Injecting air into veins (cases A, B, D, E, M)
- Insulin poisoning (F, L)
- Force-fed milk (G)
- Injecting air into the stomach (C, I, O, P, Q)
- Attacking organs with a sharp implement (E, N, O)
- Unspecified (possible tampering or smothering) (H, J, K)
Each of these allegations is undermined by the Science in Trial analysis. As well as the selective shift data, Letby was incriminated by her possession of handover sheets. Nurses and midwives often keep such records after their shift finishes, because sometimes they may need to refer to such information; for example, if an emergency arises on the next shift or next day. But these folded notes were suggested as a trophy for Letby’s dastardly deeds. Also, Letby had written in her reflective journal (a record of clinical experience kept by practitioners and used for three-yearly revalidation) that she felt somehow responsible for babies dying. Was this an admission of guilt, or simply showing humane concern?
Letby was fed to the wolves, with politicians, media pundits and NHS worshippers calling for drastic action to prevent anything like this recurring. Meanwhile, there is no outcry from the same pontificators about the persistent weekly excess of two hundred deaths in Britain, since the mass administration of Covid-19 vaccines. Earlier this year, when Andrew Bridgen was granted a debate in the House of Commons on the harm of these injections, almost every MP left the chamber.
Lucy Letby’s trial and imprisonment will not repair a broken public health service. Instead, it will put more power in the hands of those who abuse it: overpaid senior managers and doctors, and a medical industrial complex that offends the very concept of patient-centred care.
Dr Niall McCrae is an officer of the Workers of England Union and until recently a senior lecturer in mental health nursing at King’s College London.
He has written several books, including The Moon and Madness (2011), Echoes from the Corridors (with Peter Nolan, 2016) and Moralitis: a Cultural Virus (with Robert Oulds, 2020).
Norman Fenton is Professor Emeritus of Risk at Queen Mary University of London (retired as Full Professor Dec 2022) and a Director of Agena, a company that specialises in artificial intelligence and Bayesian probabilistic reasoning.
Dr Scott McLachlan is Chief Executive at Central Coast Local Health District (NSW).