The New Lucy Letby Report Misses the Point

Brearey, his colleague Ravi Jayaram, and another pediatrician brought their worries to Tony Chambers, the hospital’s chief executive. At a meeting, Jayaram acknowledged that their suspicion was “entirely subjective,” contemporaneous notes read. Nevertheless, the hospital agreed to temporarily remove Letby from the unit and place her in a clerical job while it reviewed the deaths.

The accusation against Letby was so incomprehensible to the pediatric nurses that a false rumor spread that Brearey was targeting Letby because she had rebuffed a sexual advance. “I found it very difficult to act on something I didn’t believe in—it was a witch-hunt,” the deputy manager of the neonatal unit said at the time. Eirian Powell, the neonatal manager, had analyzed Letby’s shifts, in addition to multiple factors that could have contributed to each death, including congenital abnormalities and failures with transportation between hospitals. Letby was present for so many deaths, Powell said, because she was “so amenable and flexible.” Powell added that Letby was “one of my best nurses,” who “avails herself to work overtime when the acuity or unit is over capacity.” The lead nurse for pediatrics said, “No one could give us any other reason and why—why should it just be her? You know, we had highlighted in another table that one of the Registrars”—a junior doctor—“had also been present on a number of—of occasions. But for some reason it was only the nurse that was being sort of pinned.”

The Countess’s executives decided that the hospital should no longer treat babies born before thirty-two weeks, because it was “currently understaffed and under skilled,” as one report put it. They also commissioned the Royal College of Paediatrics and Child Health to review the deaths, and, at another meeting, the executives decided that they would keep Letby away from the unit until the review had been completed.

“Frustrated + defeated,” the director of nursing, Alison Kelly, wrote afterward. In an e-mail, Rees called Letby’s prolonged removal from the ward “wrong and immoral,” saying that it was “based on a senior Clinician having a ‘gut feeling’ with no evidence.” She warned of “the message that this sends out—a Clinician is being listened to and supported, with potential devastating consequences for a nurse.”

Letby filed a grievance, saying that she had been removed from her job without justification. “It is awful and I don’t know where it has all come from and why they can’t let it go,” Letby said, at her grievance hearing. “I have gone through all of this on their word.”

The chair of the grievance hearing said, “It is clear that the 2 consultants”—the British term for senior doctors—“call the shots.”

“I was disgusted by their behavior,” the grievance investigator responded. He also said that, if the pediatricians had called the police, the unit would have become a crime scene.

“I was happy for the Police to come,” Letby replied. “I had nothing to hide.”

Powell, the neonatal manager, told the investigator, “When I started my career the hierarchy and the gap between consultants and nurses was so bad. And at the end of my career, it’s exactly the same.”

In addition to the Royal College review, the hospital asked a neonatologist from a different hospital to assess each of the deaths. Neither review identified signs of deliberate harm. The pediatrics department had seven consultants, and they all signed a letter saying that they were not satisfied with the reviews, which were not forensic. Powell told Brearey that “our only issue” is the mistreatment of Letby, who was “1srcsrc % innocent.” She thought that Brearey and Jayaram had “brainwashed other consultants” into thinking Letby was to blame.

At a meeting in January, 2src17, Chambers, the chief executive, who is also a former nurse, said that it was time for Letby, who had been off the unit for half a year, to start working again. The grievance investigator had completed his report and recommended that Letby return to the neonatal unit and consider submitting a bullying-and-harassment complaint against Jayaram and Brearey, who had never confronted Letby directly about their concerns.

“I just want him to do the right thing,” Letby messaged a union representative, about Jayaram, “and to be a man and see this through by talking to me as adults.”