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Lucy Letby doctor’s damning verdict: NHS bosses who ignored warnings must account for nurse’s crimes

Regulate managers like doctors and nurses, says paediatrician, as families denied justice launch fresh legal action

Rebecca Thomas
Health correspondent
Tuesday 22 August 2023 13:21 EDT
Lucy Letby handed whole life sentence after being found guilty of murdering seven babies

The doctor who first raised the alarm over Lucy Letby has called for NHS managers to be held accountable for ignoring concerns.

Lead paediatric consultant Dr Stephen Brearey wants hospital managers to be regulated in the same way as doctors and nurses, after Britain’s most prolific child killer was allowed to continue in her role until June 2016 despite concerns being raised by clinicians months before.

The call came as Letby, 33, began her whole-life sentence in prison for the murder of seven babies and the attempted murders of six more.

It came as:

  • A lawyer representing seven families involved in the Letby case said civil action would provide answers about what happened at the hospital where the nurse worked
  • A second doctor said the NHS had “no robust system of accountability” among senior NHS management positions
  • A doctors’ union called for the law to change to better protect NHS whistleblowers
  • A minister said a statutory inquiry is “on the table” amid calls for powers to summon NHS chiefs
  • The Nursing and Midwifery Council says it is looking in claims against Letby’s former boss Alison Kelly

Dr Brearey raised concerns in July 2015 with senior management at the Countess of Chester Hospital, but it took a year until Letby was removed from frontline duties.

The first five murders happened between June and October 2015 and the final two were in June 2016.

It was several months before police were called. Some doctors have claimed that babies’ lives could have been saved if managers had responded to concerns.

Asked if he would like to see regulation of hospital administrators, Dr Brearey told BBC Radio 4’s Today programme: “Absolutely. Because doctors and nurses all have their regulatory bodies that we have to answer to.

“And quite often, we’ll see senior managers who have no apparent accountability for what they do in our trusts, and they move to other trusts, and you worry about their future actions.

Dr Stephen Brearey wants accountability for senior NHS managers
Dr Stephen Brearey wants accountability for senior NHS managers (BBC Panorama)

“There doesn’t seem to be any system to make them accountable and for them to justify their actions in a systematic way.”

His colleague, Dr Ravi Jayaram, who also raised concerns about Letby, told ITV: “As far as I can tell the people in senior NHS management positions, there is no robust system of accountability. This is the culture in the NHS and it has to change.”

Dr Brearey added that doctors around the country had contacted him to say they had suffered similar “attacks” from management when they tried to raise concerns.

He added: “I think our experiences aren’t uncommon in the NHS, that you go to senior colleagues with a problem and you come away confused and anxious because that problem is being turned in a way in which you start to realise that they’re seeing you as a problem rather than the concern that you have.”

Doctor who helped catch Lucy Letby describes seeing her stood over sick baby

A doctors’ union has also called for the law to change to better protect NHS whistleblowers.

The Hospital Consultants and Specialists Association (HCSA) said there should be an independent organisation where whistleblowers should be registered and that it should become a criminal offence if those who speak out face recrimination.

Dr Naru Narayanan, HCSA president, told Sky News: “There has to be better protection for people who raise concerns, but we see time and again that people who do so face retribution, revenge and retaliation, and they fear for their careers.

Rishi Sunak calls Lucy Letby 'cowardly' for refusing to attend sentencing

“There has to be a significant rehaul which has to be protected by law, where whistleblowers are afforded the protection they deserve.”

The calls came as a lawyer representing seven babies involved in the Letby case said they would seek civil claims against the Countess of Chester NHS hospital trust.

Tamlin Bolton, a solicitor for law firm Switalskis, is representing three families of children who Letby was accused of trying to murder but who were involved in charges which the jury did not reach a verdict on.

She said: “The goal [of the civil suit] is to establish what the NHS trust knew and what they could have done to prevent further harm to these children, when they could have done it, and what difference it could have made.”

Lucy Letby was handed a whole-life sentence for her crimes
Lucy Letby was handed a whole-life sentence for her crimes (PA Media)

She said justice will only be done when the families affected by Letby’s actions get the full picture of what happened at the hospital during her reign of terror.

“These verdicts don’t deliver answers to the further questions people have about what happened at the Countess of Chester NHS Hospital Trust,” she said.

“Justice is going to look like a complete picture. This doesn’t end with the verdicts... [the families] want to know what happened at the trust, who knew what and when they knew it. It’s only then that the families will have closure.”

She said the scale of the claim was unclear but that it would be “significant”.

A chair should be appointed to consult with the interested parties, to consult with the tragic families that have been involved in this, to find out what they want, and you may find there’s not one united voice about this

Sir Robert Francis KC

Meanwhile, the government made its strongest indication yet that a statutory inquiry into Letby’s crimes is “on the table”.

Quizzed on the prospect of a statutory inquiry, education secretary Gillian Keegan said: “That is something that is on the table, that is something that can be discussed.

“But there are pros and cons to the two types of inquiry, so when the chair works with them on the terms of reference that will be something that they can input to them.”

Dr Brearey has called for a statutory inquiry to grapple with the “magnitude of the events that occurred”, adding: “It is clearly what the parents deserve.

“And you know, the problems that we encountered weren’t confined to the problems in the trust – this is a multi-organisational learning opportunity involving other organisations... that can only be achieved with a statutory inquiry.”

He was backed by Sir Robert Francis KC, who chaired the inquiry into serious care failings at Mid Staffordshire NHS Foundation Trust. He said that the families of Letby’s victims should decide on whether the inquiry into her crimes should be statutory.

He told Times Radio: “A chair should be appointed to consult with the interested parties, to consult with the tragic families that have been involved in this, to find out what they want, and you may find there’s not one united voice about this.

“So I would ask them what they feel they want and why they want it and indeed other people.”

Ms Bolton, who is representing the families of seven of Letby’s victims, said a statutory inquiry is “exactly” what the families want.

She said: “It would be hugely significant for them. They’ve had some answers and closure from the verdicts, but not fully. For some of our families, the jury were unable to reach a decision. They really need more answers and more investigation.”

Labour leader Sir Keir Starmer also said a statutory inquiry could consider whether NHS managers should face stricter regulation, as called for by Dr Brearey.

Asked if the inquiry should consider the regulation of NHS managers, he told broadcasters: “I think a statutory inquiry should look at all relevant issues. It would have the power to do so.

“Then strong conclusions can be drawn.”

Meanwhile, the nursing regulator on Tuesday confirmed it is looking into claims against Letby’s former boss, Alison Kelly. Ms Kelly, who was director of nursing at the Countess of Chester Hospital before leaving in 2021, has been suspended from her current role, nursing director at the Northern Care Alliance NHS Foundation Trust in Salford, after she was accused of ignoring concerns about Letby.

The Nursing and Midwifery Council said she has now been referred to the fitness to practise process. Ms Kelly’s referral had been paused pending the outcome of the trial at the request of the police. The regulator will now investigate and take action if necessary.

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