Letby trust director regrets not telling police sooner

A medical director at the trust where Lucy Letby worked has admitted “we got things wrong” and regrets not informing the police sooner, an inquiry has been told.

However, Ian Harvey, who has since retired from The Countess of Chester Hospital Foundation Trust, said he is unconvinced police would have acted at a significantly earlier stage.

Neonatal nurse Letby was convicted last year of murdering seven babies, and attempting to murder seven more, in 2015 and 2016 while working at the hospital.

The Thirlwall Inquiry into the events began in September and was this week hearing from several trust executives at the time.

At the start of his evidence, Mr Harvey said: “I am sorry for the hurt that has been caused to the parents and the families of the babies.

“I extend that to the parents and the families of the babies that were the subject of the reviews [of babies’ care, which were ordered by the trust], but didn’t feature in the trial, and aren’t part of this inquiry.

“It was only ever my desire to have a safe hospital and to be able to tell the parents what had happened on the neonatal unit. If I failed in those aims, I’m truly sorry.”

He added: “I think the simple fact that there was an increase in mortality is an indication that we got things wrong. I think I’ve made clear in my statement that I failed in my communication to the families, in the nature and the quality of the information that they were given.”

The trust did not report concerns to the police that Letby might have been harming babies until May 2017.

But, asked if he failed to have Letby investigated sooner, Mr Harvey said: “I am aware, from all the documentation, that in June [and] July 2016, I had expressed an opinion that we should approach the police and I sincerely regret that we didn’t at that time.

“I think looking at the processes that we went through, I can understand why we did what we did… [but] I’m not convinced, based on the communications and the conversations we had with the police a year later, that they would have necessarily acted at that point.

“But I have to accept that there would have been the potential for oversight or advice with regard to the processes and the reviews we undertook, and the possibility that they could have stepped in sooner should something have been found.”

The inquiry heard Mr Harvey was sent an email about a “cluster” of three deaths in June 2015, but he was on annual leave at the time and “didn’t receive the email in a timely fashion”.

He was then invited to a serious incident review meeting a month later, relating to a fourth baby’s death, but did not recall anyone referring to the previous three deaths in it.

Inquiry counsel Rachel Langdale KC asked Mr Harvey if he ever doubted medical consultants’ “genuine misgivings” about Letby.

Following a long pause, he replied that he never doubted Stephen Brearey, who was a lead neonatal doctor in the hospital at the time, had concerns. However, he argued they were “not fully voiced and were difficult to follow on occasion”.

‘Missed opportunity’

The inquiry previously heard the death of three babies in June 2015 was not reported to via NHS England’s serious incident framework, which Ruth Millward, who was then head of risk and patient safety, described as a “missed opportunity” during her evidence.

When asked, Mr Harvey said it was “potentially a missed opportunity”, adding it was not viewed as a “cluster that would have set off an alert that there was something linking them together”.

The inquiry was later shown emails in which consultants say they were trying to discuss further investigating the deaths of two babies on consecutive days in June 2016, to which Mr Harvey replied to all doctors saying “all emails cease forthwith”.

Mr Harvey said emails on sensitive topics can become extreme, so he was trying to “dampen that down”. But he added: “But I fully accept that I got that completely wrong. The email doesn’t read as it should have.”

The inquiry heard Mr Harvey advised Letby, who was removed from the unit due to doctors’ ongoing concerns in 2016, should be supported to return to the unit following a board meeting in January 2017.

Peter Skelton KC, a lawyer representing a group of families, asked if it was “irresponsible and dangerous”, to which Mr Harvey replied: “I accept in retrospect it was a risk.”

Asked again if this should have been allowed, he added: “Looking at this, no.”

During his evidence on Friday morning, the former medical director was asked if he and the other executives had created an “atmosphere of fear” that had discouraged consultants from speaking up.

He was asked about a later conversation reported by his successor as medical director, Susan Gilby, in which Dr Gilby told her in 2018: “You need to refer those paediatricians to the [General Medical Council]”.

When asked why he had not done so himself, he jokingly said he wanted to “keep a clean sheet”.

Mr Harvey denied making either comment.

‘Outrageous statement’

The inquiry also heard further evidence on Thursday from the trust’s then CEO, Tony Chambers, who maintained information available in spring 2016 appeared to suggest the cause of babies’ deaths were “multifactorial”, adding: “What we had were gut feelings and nothing was presented in a very explicit way.”

Richard Baker KC, who is representing some of the families, accused Mr Chambers of misleading police and ruining doctors’ careers by referring to them to the General Medical Council if they did not agree with him.

He replied: “Had that been what I had done, then it would be [wrong]. But I think it’s an outrageous statement and I do not believe that represents my actions.”

Mr Chambers was then asked about his order for doctors to apologise to Letby, after they had pressed for her to be removed from the neonatal unit, and if the executive team pushed for it. He said: “It was something that was clearly as a result of the outcome of the grievance process.”

However, he reiterated the trust “could have done better, should have done better” in fulfilling its duty of candour by informing families of the babies who were involved in the cases, about the doctors’ concerns.