Lucy Letby: Innocent until stitched up?

As with routine medical practice, so it is with the ‘routine’ of medical disasters and cock-ups.

The fact that so many maternity and neonatal units are currently the subject of investigation should have alerted us to the understanding that, rather than being rife with bad sole actors determined to wreak havoc and death on those who they have dedicated their lives to helping, we are facing a perfect storm of dysfunctional organisational settings.

In my extensive experience as a Director of Public Health and Regional Medical Officer in the UK’s second largest region of England’s North West, while bad actors certainly do exist, when clinical disasters occur they are usually the result of a convergence of factors amounting to a perfect storm in a dysfunctional organisation.

These factors include a lack of self awareness in hierarchical organisations combined with overweening ambition and a closing of ranks when things go wrong; none of which is helped by underinvestment and stretched resources.

Having had over the course of my career first hand experience of some of the most notorious clinical service failings of the last 40 years, including the Shipman murders, the Alder Hey Children’s Hospital organ retention scandal, and the Morecambe Bay maternal and child health hospital deaths, and having cut my disaster awareness teeth at the Hillsborough Stadium disaster in 1989, my antennae were aroused very early on during the trial of Lucy Letby.

What we now know is that among the factors in play was a hospital hell bent on playing above its competence in the race to be a Foundation Hospital Trust in 2004, leading to a collusion of management and medical staff in taking very sick babies that were outside their competence; staffing levels and clinical practices that were not fit for purpose in a worn out building that suffered from serious environmental health threats; and when things went wrong a rush to scapegoat a dedicated nurse whose only fault was her willingness to go above and beyond the call of duty in pursuing her vocation.

Once the clinicians in the hospital got the bit between their teeth alongside a dysfunctional and publicity seeking Cheshire Constabulary the script began to write itself, helped along by a long retired and unqualified ‘expert witness’ who had skin in the game.

By the time the case came to court Lucy Letby was on a hiding to nothing, what with the gross misuse of medical statistics and of conjured up ‘evidence’ since disproven, relating to the use of insulin and injections of air to kill and harm the innocents.

A scientifically illiterate judiciary and jury were the icing on the cake for the ‘journalistic bystanders’, knitting while the tumbrels approached to claim a young nurse as a victim. If the death penalty were still in place, she would by now have been hanged.

At the beginning of this sorry affair, I held the view that the evidence against Lucy Letby was wholly circumstantial and that it was not possible to say whether or not she was guilty.

Having been immersed in the detail of the evidence with dozens of international experts from a wide range of relevant disciplines for the past two years, I can now say that I have every reason to believe that Lucy Letby is innocent of the charges against her and that the true culprits lie elsewhere and with a failed system of medical care and justice.

My heart goes out to all those who are the victims of what now appears to be a gross calumny.

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Professor John Ashton served as Regional Director of Public Health for North-West England for 13 years.

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