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Doctors who raised concerns over Lucy Letby were ordered to apologise – as probe launched into handling of the case
18 August 2023, 19:10 | Updated: 18 August 2023, 23:07
Nurse branded the ‘Angel of Death’ found guilty of murdering seven babies and attempting to kill six more
Doctors who raised concerns about Lucy Letby were told by hospital bosses to apologise to her.
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Dr Ravi Jayaram, who is a senior paediatrician at the Countess of Chester Hospital, said he warned hospital managers of concerns about Letby months before police were called.
He said he was told to "draw a line" under his concerns and apologise to the 33-year-old in a meeting, according to ITV.
It comes as the government has ordered an independent inquiry into the case to ensure "vital lessons are learned".
Police were only contacted by the hospital trust nearly two years after the first of the baby deaths.
Dr Jayaram said: "It's a horrible thing to say but I do genuinely believe that there are four or five babies who could be going to school now who aren't."
He said he was warned that there would be blue and white tape everywhere if he called the police and "it would be really bad for the reputation of the trust" - calling it a "Kafkaesque situation".
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Dr Jayaram said he had to have a mediation session with the killer nurse, adding: "It was bizarre.
"To listen to her saying, 'I'm coming back next week, will you work with me?' And of course I was having to say, 'Well, if the trust have deemed that you are coming back to work, I will work with you, yes' - because I wasn't happy."
He said police realised they had to be involved after listening to him for "less than 10 minutes" in 2017.
Detective Superintendent Paul Hughes at Cheshire Constabulary told the broadcaster that Dr Jayaram and his colleague, Dr Stephen Brearey, were instrumental in catching Letby.
"I think the doctors have been incredibly brave in coming forward when they have and certainly their actions have prevented more deaths.
"I went to have a meeting with Dr Brearey and Ravi Jayaram at Countess of Chester Hospital and asked them to tell me why it should be investigated. It was their explanation on a very simple level that meant I was actually able to get some criteria to look at it."
Countess of Chester Hospital gives statement after Lucy Letby convicted of the murder of seven babies
Letby was moved to clerical duties after two triplet boys died under her care and another baby boy collapsed on three successive days in June 2016.
It came after a meeting of the whole neonatal consultant body was held on June 29, the court was told, and on June 30 Letby worked her last shift on the unit.
Three months later she learned of the allegations against her in a letter from the Royal College of Nursing union and registered a grievance against her employers.
It emerged during legal argument at Manchester Crown Court, in the absence of the jury, that the grievance procedure was resolved in Letby's favour in December 2016.
A number of consultants were required to formally apologise to Letby in writing, the court heard.
Families of Lucy Letby's victims express their 'extreme hurt, anger and distress'
Giving evidence, Dr Jayaram previously told the court: "We had significant concerns from the autumn of 2015. They were on the radar of someone as senior as the executive director of nursing as far back as October 2015.
"As clinicians we put our faith in the system, in senior management to escalate concerns and investigate them. The initial response was 'It's unlikely that anything is going on. We'll see what happens'.
"We said 'OK' - against our better judgment in retrospect."
Dr Brearey went on to commission an independent neonatologist from Liverpool Women's Hospital to analyse the increased mortality rate.
The review, which concluded in February 2016, did not identify a reason for the rise in deaths.
However, concerns remained about Letby as a "common link" during all the collapses and deaths, as Dr Brearey sent copies of the report to nursing director Alison Kelly and medical director Ian Harvey.
Dr Jayaram told the court there was no response from bosses for another three months.
He said: "We were stuck because we had concerns and didn't know what to do. In retrospect, I wished we had bypassed them and gone straight to the police."
"We were also beginning to get a reasonable amount of pressure from senior management at the hospital not to make a fuss," he added.
The moment Lucy Letby was arrested over baby deaths
The government has now said it will investigate the circumstances behind the crimes to ensure "vital lessons are learned".
It will also look at the handling of concerns raised by staff at the hospital and what action was taken by regulators and the wider health service.
Health Secretary Steve Barclay said: "I would like to send my deepest sympathy to all the parents and families impacted by this horrendous case.
"This inquiry will seek to ensure the parents and families impacted get the answers they need. I am determined their voices are heard, and they are involved in shaping the scope of the inquiry should they wish to do so.
"Following on from the work already underway by NHS England, it will help us identify where and how patient safety standards failed to be met and ensure mothers and their partners rightly have faith in our healthcare system."
An inquiry chairman will be appointed in due course.
The Parliamentary and Health Service Ombudsman called for "significant improvements to culture and leadership across the NHS" in the wake of Letby's trial.
Rob Behrens said: "We also heard throughout the trial evidence from clinicians that they repeatedly raised concerns and called for action. It seems that nobody listened and nothing happened.
"More babies were harmed and more babies were killed. Those who lost their children deserve to know whether Letby could have been stopped and how it was that doctors were not listened to, and their concerns not addressed, for so long."
Tim Annett, a lawyer representing parents of Lucy Letby's victims, said "lessons need to be learned about the early recognition of serious and avoidable harm".