Innocent people being convicted is far too common in today’s justice system

Why I became involved in the Letby case

While you can subscribe and follow the entire series of investigative articles I have published on the Letby case (starting here), during this week and with the assistance of my collaborators I managed to finalise and submit to an academic law journal the manuscript for the first in what I intend to be a short series of papers. Each paper will use Bayesian network (BN) AI models to reason concrete matters and evidence arising from the investigation, trial and appeal processes that led to British Nurse Lucy Letby being jailed for 15 whole-of-life terms. Under the author terms of the particular journal the paper was submitted to, and while we await the sometimes lengthy editorial and peer review processes, I am able to make a preprint version available to you here¹.

This first paper presents two perspectives on the Letby case that allow us to consider Letby’s culpability, which means the degree to which she was responsible for the harms and deaths she stands convicted of, in light of and contrast to the actual judgement. The core hypothesis that this first paper and the models it presents seeks to evaluate is the probability for an innocent person to receive a guilty verdict for multiple murder. It asks: can the innocent really be found guilty of serial murder?

Given recent revelations regarding emails and the further glaring inconsistencies they highlight in Dr Ravi Jayaram’s testimony during both trials, the second paper which I am in the process of writing at the moment drills down specifically to his evidence regarding Baby K, seeking to understand whether, on the basis of that evidence, Letby had the motive and opportunity necessary to support her conviction for murder in that instance.

However, I want to pause here for a moment to discuss why people like myself have become involved in questioning the evidence and verdict in cases like that of Lucy Letby.

Why do we do it?

Many of my readers will be aware that there have been multiple academics working sometimes in the limelight, but more often in the shadows, to expose issues with the Letby prosecution. We each tend to have particular and interesting past experiences or a reason for becoming involved. A small group of academics have been invited to present and discuss our work on the different aspects of the Letby case, with a focus on the use of statistical evidence in legal proceedings, at the International Statistics Institute’s conference at The Hague later this year. This empanelment, established and promoted by Professor Emeritus Richard Gill from the Mathematical Institute at Universiteit Leiden, includes myself, Professor Jane Hutton from the Department of Statistics at the University of Warwick, and Dr Amy Wilson from the School of Mathematics at the University of Edinburgh. The more astute amongst you might wonder if I am the only member of the group who is not expressly a mathematician of some sort - and you would be right. In fact, I struggled with calculus and functional math in High School with the ultimate cause being that I was found to have dyscalculia to some degree - the letters and numbers would sometimes blur together and I would struggle to write equations. That said, my expertise comes in that I both trained in health sciences (nursing) and law on my way to my PhD, so I offer a critical and relevant counterpoint in both domains to my more math-enabled colleagues. Further, with the advent of ever-faster computer processors and visual math tools like AgenaRisk (https://www.agena.ai) I am able to usefully participate in the development of mathematical models and math-based AI in a way that was not available to my much younger self.

Professor Emeritus Richard Gill’s introduction to the inappropriate application of statistical evidence to convict nurses was his wife pressing him to become involved in the Lucia de Berk case. de Berk, a Dutch registered nurse, had been convicted in The Netherlands of four murders and three attempted murders of patients in her care. The prosecution case was founded entirely on circumstantial evidence and statistical misrepresentation that was challenged on appeal and, as we have been seeing with the Lucy Letby case, new evidence had continued to surface that undermined the verdicts. A prosecution witness had asserted as much as a 1-in-342 million chance that a nurse at the hospital could be involved in the series of events (patient deaths and crashes/resuscitations) that de Berk had been involved in, absent any representation for the likelihood for a similar series of events to occur absent de Berk. In contrast, Professor Gill and colleagues were able to demonstrate that the true probability was 1-in-25, which was a significant difference that, given the number of nurses in an average large hospital, means a not insignificant number of nurses will experience a similar series of events in a similar time period. Professor Gill Initiated the 2007 petition that is credited as instrumental in the reopening of de Berk’s case.

While it remained unknown to many until 2024, Professor Jane Hutton, a medical statistician, had been approached by investigating officers from Cheshire police in April 2018. They asked her to provide a prediction for the likelihood that a nurse like Lucy Letby would be on duty “during all the deaths/collapses” in the unit. As Sir David Davis pointed out in his address to the House of Commons on the 8^th of January this year, what Cheshire police sought was for Professor Hutton to put a number on a false proposition. First, because Letby did not even stand accused of all of the deaths on the unit at the time, her charges concerning only seven out of seventeen deaths that occurred on the unit. Second, because to this day and absent an extensive health records audit, no one has any clue as to the exact number of collapses that occurred for all of the neonates that were in-patient during the relevant time period. While Professor Hutton was seen to correctly rebuff the police’s initial approach, it was later reported in the media that she had gone on to sign a consultancy agreement with police, presumably with the intention of aiding them to right their statistical ship. However, this was an agreement the police dropped in 2021 once the case moved from investigation to prosecution and potential for the flaws in their own initial framing of statistical evidence to undermine that prosecution became clear. If nothing else, Professor Hutton’s integrity under sound cross-examination would have led the judge and jury to more questions about the evidence police intended to present, than answers. While uncredited on the report itself, Professor Hutton went on to commission the Royal Statistical Society (RSS) report on healthcare serial killers.

Dr Amy Wilson is chair of the RSS section on Statistics and the Law and has nearly fifteen years research experience in the domain of forensic statistics. She regularly gives talks at the RSS on relevant topics, such as the use of chain event graphs for reasoning in criminal cases.

I became acutely aware of the exposure of nurses to baseless prosecutions resulting from flawed police investigations, and how life-changing even the mere implication of an accusation could be, during my own nursing training. I undertook a module during my second year of training that few nursing schools still offer - a course specifically in law for nurses that looked at the legislation and regulation you might expect nurses should know about, such as patient privacy, medications and poisons law, mental health law and the investigatory powers and disciplinary role of regulators like the Nursing and Midwifery Council. We were also required to study a few subject areas you might not expect, such as the intersection between Samaritan law and being a member of a regulated health profession that in some jurisdictions explicitly protects you and mandates that you stop and help while in other jurisdictions you are left so exposed that without explicit indemnity coverage most shy away from helping, and the common mistakes observed in criminal prosecutions of nurses and midwives.

While the particular case I observed occurred almost three decades ago I still regularly use it in lectures as an example of what can go wrong across both the nursing and legal professions when discussing not just the Letby case specifically, but even when discussing potential legal issues with nursing and law students today. It directly led me to switch from the health sciences (nursing) to engineering sciences (computing and information science) the following year and, until I became a lecturer in a nursing school and it seemed like it might be useful, I never once in the intervening years considered completing and becoming registered.

I am going to give you the cliff notes on the case as I observed them. However, please understand that, as is common with legal cases involving people who lack capacity (children, the elderly, mental health patients and so on), and in order not to add to the ongoing anguish for the now-cleared defendant, I must be careful in my description not to directly or indirectly name the people or any healthcare provider or agency who were involved. The following is based on my memory, contemporaneous notes, and the two law school assignments I wrote based on the case, and I believe is a fair reflection of the events, evidence and testimony I observed during the two-day criminal and later four-day civil trials. Case material will be presented in italics, while additional supporting information for the reader is provided in normal text.

Background:

As was common at the time, a young person - the defendant - who was in their final year of training at university to be a registered nurse was also working evenings, nights and weekends variously as a nursing assistant (NA), healthcare assistant (HCA) or ward orderly. At the time, none of these designations required formal training or a qualification beyond some number of hours of hands-on experience, and it was common to accept successful completion of one or more semesters of nursing school as initially meeting this experiential requirement. Prior to the situation that ultimately led to the defendant being prosecuted, they had accumulated more than six or seven hundred hours of this paid experience working both on what is called bank staff at some of the facilities they were training at, and as on-call agency staff via a nursing agency.

However, and it should be remembered as you read this, nursing agencies in some jurisdictions exist in a bit of a wild west environment. They position directly between the individual seeking paid work and the healthcare facility needing temporary staff. The individual in most cases never sees the classification² or rate under which they are invoiced out at the end of the month to the facility, and the healthcare facility in most cases relies on the nursing agency to ensure they provide suitably trained and vetted, experienced and, where necessary, qualified and currently registered individuals. The nursing agencies are themselves usually required to employ registered nurses to undertake the process of matching suitably qualified individuals with facilities needing that type of individual. Where this arrangement most often breaks down is, as you might already have guessed, with the middle-man... The nursing agency. In my own experience at the same time with some of the same agencies it was not uncommon to turn up to a facility and find that the charge nurse at the facility thought they would be receiving a particular type of individual that you were not and that, after terse phone calls, they would end up accepting the limitations you might bring to the staff mix simply because there was no time before handover to get the type of individual they thought they were getting. In the current case one of the items of evidence was a time sheet signed by the charge nurse of a healthcare facility where the healthcare facility record that the defendant was an NA, but at some point after the charge nurse had signed the timesheet NA was replaced with SEN. The prosecution alleged the defendant did this but, as you will see, the defendant had been candid with the agency regarding their student status. Further, the rate claimed by the defendant on the timesheet was consistent with all of their other timesheets shown in evidence that said NA. Based on the evidence, the only party that had claimed the higher SEN rate of payment was the agency themselves when they invoiced the healthcare facility - making it more likely that the nursing agency had changed the classification on the timesheet.

The defendant had been interviewed by an agency employee who was a registered nurse (RN) and accepted on the roster of a large and well known nursing agency. That agency engaged the defendant for predominately night shifts at several of their aged care facility clients, but at the time the defendant was introduced to the client involved in this case, they had only performed around fifteen shifts and no more than one hundred and twenty billable hours of service in the employ of this particular agency. One day, an RN who worked directly for the agency called the defendant and suggested they were suitable to meet with a particular client who was establishing a private care facility for their elderly parent who had advanced Alzheimer’s. The way this was described during the criminal trial was that the daughter of the elderly patient had established a Trust Company, placed the assets of the patently incompetent parent into that Trust and used them to develop two flats on a vacant block of land walking distance from their own home. Rather than putting the parent into a nursing home as one might expect, the daughter was employing carers (be they NA or HCA designation) to provide around-the-clock care for the parent. The defendant’s details were provided directly by the agency to this client and in time the agency arranged for the defendant to interview with her. The client would become the complainant who initiated the police investigation.

The Criminal Trial:

Police had raised more than twenty charges against the defendant. Small clusters of charges related to a single alleged offence that was being prosecuted using different statutes such that there were really only a small number of offences that the defendant was alleged to have committed. The police prosecutor may have known she was going to have difficulty achieving the charges, and was using this common deceptive and unfair police tactic in hopes that while most would versions of a charge would fail, one might succeed. Among other things, the prosecution primarily alleged that the defendant had: (i) presented themselves as an RN when they knew they were not (charged both under a State criminal statute for fraud or misrepresentation, as well as under the national Act that governed health practitioner regulation); (ii) through an act, omission of an act, or negligence, caused physical harm to the elderly patient (charged separately as assault and criminal negligence under the State criminal statute and as criminal neglect and malpractice under the National legislation); and (iii) possession of a controlled substance (charged under the blanket State criminal statute for criminal possession, as well as possession of a controlled substance under the far more serious national Drugs, Poisons and Controlled Substances Act). As mentioned, there were several versions of each charge with sometimes only very slight variation in the text of the police complaint.

The first group of charges related to the allegation made solely by the complainant/client that she had requested from the agency and defended had represented themselves as an RN. The second group of charges related to allegations also made solely by the complainant/client that the defendant had variously either not cared for, or had assaulted, her elderly parent. The third group of charges related to a sheet of a prescription medication which the lead detective claimed to have located in the defendants car during what was described in court as a warrantless, unconsented and against protocol (he had conducted the search alone without another officer present) forced entry search that should have been automatically excluded, yet the defence barrister was entirely ineffective and seemed to all observers in the courtroom to be out of his depth when attempting to make that submission.

Very early in the trial we observed the accounts of the complainant/client and the defendant begin to diverge. The complainant/client testified that she had already employed three NA/HCA staff and, due to one leaving her employment, she had been seeking a replacement to cover three-to-four twelve-hour night shifts per week. She described that the agency-supplied individual would be required to arrive at 6pm and:

• supervise and assist the severely Alzheimer’s-impaired parent to eat an evening meal

• prepare the parent for bed and,

• while cleaning up from the evening meal, monitor the parent as they either sat in front of the television or wandered aimlessly around the unit.

• put the parent to bed at 9pm.

• remain present in the unit in case the parent awoke during the night, and,

• to check and change the parent and their bedsheets if and when they soiled themselves.

• shower, dress and prepare the parent for the day and,

• prepare and assist the parent with eating breakfast.

The agency-supplied individual would be relieved at 7am by the day carer.

The defendant testified to attending an interview with the complainant/client and described discussion regarding the particular classes they had just completed at university and the fact that when the new academic semester started in around six weeks there would be particular days of the week that they had to be either on-campus or on-placement at a hospital, and hence unavailable to work those days. The defendant testified that the nursing agency knew and had verified they were a student nurse and was therefore not registered at the time. They also testified that the agency staff member had described the position as an HCA role.

During their time working for the complainant/client the defendant described having been requested by her to collect together all of the old medications her elderly parent was no longer taking and deliver them to the local pharmacy for destruction. When asked what had been done with these medications, the defendant described placing them in a plastic shopping bag and taking them to the local pharmacy. He testified that the pharmacist had accepted them and in his presence recorded a list of the medications in a register. The prosecutor further enquired why the defendant had not produced this register in his defence, which received the response that both the detective and the defendant’s solicitor had been told, and the solicitor’s response had been to say that it was for the police to secure the evidence. When the police detective was cross examined his response was that the story had seemed ‘fanciful’, that even though there was no evidence the defendant used drugs it was more likely that the defendant had stolen the medication for personal use and, as such, he had not felt it necessary to even approach the pharmacist or take the matter any further. The defendant plausibly proposed that if indeed the single sheet of tablets had been found where the detective claimed between the back seat bolsters, it may have fallen there during transport of the open bag to the pharmacy.

In stark contrast to the defendant’s evidence, the complainant/client further alleged she had actually requested the agency to specifically provide an RN. She also testified that the defendant at interview had presented themselves as a qualified and registered RN with significant experience in geriatric care. She denied ever telling the defendant to clean out her elderly parent’s old medications, and expanded on this by claiming that her elderly parent had never been prescribed or taken the particular medication the detective had allegedly found. She made a series of stark allegations about the defendant’s conduct, many of which were directly contradicted by the evidence of the other NA/HCA carers who also testified. The prosecution through the complainant/client also sought to introduce into evidence a reproduction of a certificate of nursing that she claimed the defendant displayed and that she had taken from the defendant that neither the defendant nor nursing agency, nor either of her other NA/HCA staff, was able to corroborate. The only person who directly claimed to have ever seen it was the complainant/client who produced it.

The complainant/client testified that the defendant was required to cook or prepare her elderly parent’s evening meal and stated it was her belief that the defendant either never prepared such a meal, or failed to prepare suitable nutritious kosher meals and that the defendant’s neglect in this and other regards had exacerbated her elderly parent’s Alzheimer’s. While initially shocking to the entire courtroom, this claim fell apart when both of the other NA/HCA with little or no prompting described their own roles during the day shift as including preparation of all meals, denying that the defendant was ever required to be or was involved in this task. Notably, during the testimony of the complainant/client and her NA/HCA staff, the judge was observed to successively order the prosecutor to withdraw each and every charge of malpractice, negligence and criminal neglect. It was clear from the glaring contradictions between her and her staff’s testimony that the complainant/client had embellished, exaggerated, or perhaps even entirely falsified these claims. The dawning knowledge that her testimony was not going to result in a conviction on these charges led to a loud outburst from her from her seat in the gallery during which she generated a previously unreported claim that she believed the defendant had sexually assaulted her elderly parent. The court declined to test this claim. Given there was also no corroboration of the certificate, charges related to it were also dismissed by the court. By the end of the first day of the criminal trial more than half of the charges had been summarily dismissed and no item of evidence or testimony had been heard that directly supported conviction for any single remaining charge.

However, it was on the morning of the second day of the criminal trial that the situation markedly changed. Almost as soon as the judge opened the hearing the police prosecutor, an attractive mid-twenties woman, stood and advised the court that a plea agreement had been reached between the parties. Under the terms of that plea agreement, the defendant’s barrister who was a well-dressed late-thirties gentleman, on behalf of his client (yes, that is exactly how she phrased it) had agreed that the defendant would plead guilty to the representative charge of criminal possession in relation to the strip of tablets, and misrepresentation in relation to the allegation that they had represented themselves as being registered, and in return the prosecution would drop all other charges. Anyone familiar with how the vast majority of police prosecutions operate should have some sense of what had actually happened - that the prosecution had used these lesser summary charges as a way to ensure they came away with some success. But, we would all find out it was somewhat worse than even the worst thing we could have thought.

The Outcome:

The judge elected to proceed directly to sentencing but prior to sentencing agreed to hear the defendant or anyone on behalf of the defendant. A middle-aged woman in a vicar’s collar who had been sitting with the defendant during the entire proceedings stood and requested to be heard. She told the judge that while she understood it was not her place to comment on matters such as the verdict that were the responsibility of the court, she could not remain silent with respect of what she knew and had observed. She described that, much like the judge, she often sees people at their worst - when they have received a terminal diagnosis or loved ones are sick or have died. That, like the judge, she often presided over events of an unfortunate and distressing nature, such as funerals. But, unlike most judges, she also got to see people at their happiest - such as at births, christenings and weddings. She said her role was one that required a great deal of empathy and psychology. It allowed her to observe people in each of these states and that, on her observation of the complainant/client, she was surprised to see a woman who, incongruently, seemed entirely pleased when describing the alleged unfortunate events that she claimed the defendant had wrought upon her elderly parent. She described the complainant/client’s demeanour as projecting pleasure at possibility of ruining the defendant’s life, rather than projecting the more expected sadness, regret or discomfort when discussing the state of her elderly parent. She said that the things that had been alleged about the defendant were entirely inconsistent with the young person she had come to know over the last several years, but that the most surprising thing was what had occurred in her presence that morning. She described that the defence barrister had approached the defendant and her in the courthouse, telling them that he had ‘just had breakfast with the prosecutor’ and ‘had agreed a deal with the prosecutor that would see most of the remaining charges withdrawn and they would all ‘be home for lunch’. He had said that the absence of evidence from the pharmacist register that there had ever been drugs taken to be destroyed meant there was no defence to this charge, and that the charge for possession of a controlled substance would in all likelihood prevent the defendant from ever working in a regulated profession or even going overseas to many countries including the United States. To prevent this he had agreed with the prosecutor that this charge was one that would be removed, and that the remaining charges carried only minimal penalties such that with a small fine, the matter would be resolved with no permanent effects. She went on to describe that on the basis of the significant number of wins the day before, the defendant had wanted to continue in the defence, but that the barrister had been unwilling. She closed by telling the judge that in her observation of the entirety of events, the defendant was being <quote> ‘railroaded’ </quote>.

The judge was entirely unmoved by the vicar’s statement and proceeded not to apply ‘small fines’ that the vicar reported the defence barrister had told her and the defendant would be forthcoming, but among other punishments levied significant fines that the vicar outside the court told me totalled more than 1.5 times the defendant’s highest ever annual wage at the time. The vicar told me that even she struggled to see the defendant ever moving beyond the events of that morning, and she wasn’t wrong.

In totality, the sentence was severe enough that when I reviewed the case and contacted the defendant two decades later, I found it had taken from them all hope of a career and made it difficult to almost impossible for the defendant to be gainfully employed in anything more than minimum wage work, had seen the defendant frequently denied credit and insurance, and had left them with a significant student loan for their nursing education with little hope of ever being able to use the training or repay the debt.

The Civil Trial:

The complainant/client immediately filed a significant six-figure civil suit naming both the defendant and the nursing agency as respondents. I also followed the civil case and it became clear during those proceedings that the solicitor and barrister funded by the Nursing Council but acting for the defendant had failed to ensure adequate or even minimum standards for discovery. Submissions, transcripts and even the judgement from the civil trial highlighted that key evidence, including exculpatory evidence, from the nursing agency was conspicuously absent both during discovery in the criminal case and during the criminal trial itself, even though that evidence had been collected by detectives and was clearly listed on an evidence receipt that had been provided to the nursing agency. The nursing agency evidence and testimony in the civil trial were seen to corroborate the defendant’s version of events from the criminal trial, and proved almost entirely to be exculpatory. First, the member of staff that had interviewed the defendant testified before the civil court that the defendant had been candid regarding their ongoing studies, that they had discussed lecturers and courses at the university that the staff member was familiar with, that the defendant had written “2^nd Year Nursing Student” in the qualification box on the rear of their employment application, and that she had verified the defendant’s status with the university. This clearly refuted any claim that the defendant had held themselves out to be an RN when seeking employment. Second, police were required by the civil court to produce the seized and previously undisclosed employment application card (the detective sought to claim the card had been lost, but when pressed with the threat of contempt of court, located it rather rapidly). On presentation, that item of physical evidence was seen to corroborate both the defendant’s statements and testimony during the criminal trial, and the testimony of the nursing agency staff member described in the first point. Third, medical records were produced that, among other things, showed doctors for the elderly parent had, just prior to the defendant’s employment, ceased a long-standing prescription for the medication that had allegedly been found in the defendant’s motor vehicle. This evidence refuted the complainant/client’s testimony at the criminal trial that her parent had never even been prescribed that drug. Fourth, two staff from the agency had recorded contemporaneous with their discussions with the complainant/client, and further testified in person, that the client at no point mentioned that she was seeking or required an RN. A fifth and final element to note was that the complainant/client had not complained to the nursing agency at any time during the four months the defendant had worked for her. In fact, when called on two occasions by the agency to follow up on the placement she had denied the existence of any problems or concerns. Evidence was led that showed the defendant had actually contacted the agency in the fortnight prior to the complainant/client initiating the police investigation to advise them that university classes would be recommencing at the start of the next month and to provide notice that they needed to start looking for someone else to take over the role. The defendant had also advised the agency that the complainant/client had been underpaying them - paying only for the originally agreed 3-4 nights per week but requiring 5 nights during most weeks.

In the end, and given the expensive and protracted nature of civil proceedings and the fact that it had become a he-said she-said battle over whether or not the complainant/client had requested an RN or not, the insurer for the nursing agency made a one-time offer to the complainant/client of a mid-range five-figure sum to withdraw the case on the basis of no admission of fault on the part of the nursing agency. The complainant/client accepted the cheque and while the civil judge still recorded a judgement, that judgement was given over mostly to his description of the salient facts and key discrepancies in the evidence. Both the complainant/client and nursing agency denied any responsibility and, where they could, they laid any remaining blame at the fault of the defendant. They did this in spite of the fact that they had both been responsible for surfacing evidence that demonstrated the truth in everything the defendant had testified to.

The implication I took from the combination of evidence and testimony witnessed during the criminal and civil trials was that the defendant was primarily quitting the role in order to return to and complete the final modules for their nursing degree, and secondarily because they were expected to work more than was originally agreed and the complainant/client had refused to negotiate or uplift the pay accordingly. Returning to school offered them an easy and less confrontational ‘out’. I reasoned that the complainant/client was, to use a colloquialism, ‘put out’ - and sought to vexatiously punish the defendant both for leaving and for telling the nursing agency what had transpired with relation to the pay situation. Given how quickly the complainant/client accepted the five-figure cheque from the nursing agency’s insurer to make the case ‘go away’, and that she was later found to have accepted payments to tell her story on current affairs news shows and in magazines, there may have been some financial motive for her at play as well.

I followed up on the case during my studies and research for my LLM, finding that the defendant’s criminal record had been expunged as a result of the evidence exposed during the civil trial. On reaching out to the defendant it became clear to me that they had been unaware that their convictions had been expunged. Their life had taken a series of unfortunate turns and they had been living a lamentable life more or less directly under the shadow of that conviction that no longer existed. The mere implication of what was a more than two-decades old conviction had restrained their life in ways that most of us would be unable to appreciate, and while they had briefly had a relationship that led to children, it had even been used against them in a family law proceeding, resulting in the entire loss of their relationship with their own children.

You might be forgiven for thinking that a situation like the one I describe above could only come about because it was a private client. However, I have seen cases with similar situations come up involving large hospitals as well. In fact, I am currently providing assistance to a registered midwife (RM) who is fully qualified, currently on the register of the NMC and who has over two decades of what I found to be easily verifiable experience, who has been stood down from her clinical role in an NHS Trust by an officious Band 8 Midwifery Manager who simply decided one day last week to make the incredible claim to HR that she believed this RM had ‘bought her registration’ from the NMC and was therefore unqualified. This same Band 8 manager has a history demonstrative of her poor critical thinking and lack of management ability, and has been instrumental in the resignations of most of the staff in a two-hospital PDT team that currently has roles open for almost all of its Band 6 and Band 7 seats. It is therefore disturbing that even a seasoned HR manager failed to critically consider the Band 8’s latest attention-seeking claim before jumping into action against the RM in question. Worse, that they didn’t question why, since the Band 8 was employed, other staff in the team have recently been off on stress leave or have simply resigned from the team altogether. Within hours the RM had been stood down from clinical duties, reported to the NMC, and had become the subject of an investigation that was going to look into every aspect of her training and prior employment. Yesterday afternoon the RM was required to present her entire academic and working history to the same Band 8 manager who, on reflection to the more than three-inch stack of certified and verifiable documentation, couldn’t even bring herself to admit she might have been wrong. Selfish, deceptive and deceitful people exist everywhere.

So... why exactly did I become involved?

Most young people, but especially those whose upbringing was in a two-parent Christian home and who otherwise could be characterised as naïve of the law, courts and legal process, find themselves in a frightening situation where they are entirely reliant on legal professionals who may: (i) also be involved in other matters and therefore not totally able to invest in or fully explore matters; (ii) have their own issues or potential for conflicts of interest that can sometimes take precedence; (iii) unlike the defendant, have no skin in the game and largely bear no risk in the outcome; (iv) may be unfamiliar with elements germane to the case (such as highly technical computer or medical evidence) and thus ill-equipped to present the defence; and (iv) have history or ongoing relationships with the judge, court staff and/or prosecutors.

More concerning is that all of these potential issues are complicated where the instructing solicitor and barrister are funded by either legal aid or a third party like the nurses’ union. First, the legal aid rules only compensate for a fraction of the preparation time that might be necessary for a complex trial, often deny applications for additional funds to cover experts or defence investigations, and create a potentially compromising situation where a barrister may receive higher compensation for undertaking an appeal than they received for the original trial - all of which could make getting the matter to the appellate stage more attractive than seeking immediate success at trial. Counsel on retainer from a nursing union often receive similarly restricted funding from that body’s insurer but have the additional implication of a potential conflict - wherein some small number have seemed more concerned with protecting the broader interests of their overarching payer, the nursing union or federation, than conducting a thorough defence on behalf of the defendant.

So, while Professor Hutton came to be involved in the Letby case initially by invitation of the police, Professor Gill had come to be involved originally at the behest of his wife but because he has developed a long-standing history of involvement in correcting miscarriages of justice involving the misapplication of statistical evidence against nurses, and Dr Wilson came to be involved due to her role with the RSS in Statistics and the Law, I left my nursing studies, eventually studied the law (DipLaw, GDL and LLM), and became involved in the Letby case because I had seen and come to understand the harm such cases can bring upon a young nurse.

I look at every one of the nurses, midwives and nursing students I interact with as part of my academic role and reflect on overturned criminal cases like those of nurses Lucia de Berk (NL) and Susan Nelles (CA), and other people such as Sally Clark (UK), Katherine Follbig (AUS), Peter Sullivan (UK) and the case I observed above, and I ask myself…

Will she be the next to be falsely convicted for doing her job?

1. At the time of publication, more than 50 people had already downloaded the preprint!

2. The classification could be as an NA or HCA, or under one of a number of regulated registration scopes - which at that time included: State Enrolled Nurse (SEN), Registered Nurse (RN), Registered Midwife (RM), and Registered Psychiatric Nurse (RPN).