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"How should we characterise junior and trainee doctors with no training in the neonatal specialty using these premature and poorly neonates as little more than training appliances to perform repeated invasive and risky procedures, sometimes up to seven in one go?" That's what I found most painful reading in your previous trial details. Did the jury realise that these babies are not just small versions of normal term babies? I tell as many people as I can that the Letby trial was unfair to prime them to take an interest when some bigger media outlet suggests doubt.

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That amazed me too. How the prosecution managed to turn these premies into "stable babies".

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Coverups, conspiracies, the whole thing stinks.

I'm noticing a lot more coverage in the MSM now, though. So maybe that may make a difference. It struck me yesterday that the only thing that might get Lucy's conviction overturned is sufficient public pressure. Because the law is clearly an ass, to put it politely. That's to say the appeals process is doomed if it is simply unwilling to accept what to us is blindingly obvious evidence - the kind of evidence and inconsistencies and psychological motivations amongst her accusers and NHS underfunding and infections and all the rest of it - all of which - at the very least - points to the most blatant example of 'reasonable doubt' imaginable.

If I were the main players in this, what appears greatly like a malicious prosecution from start to finish, I would seriously start thinking about some kind of face-saving cover story.

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I think she is convicted because of public pressure. The UK media painted her as an evil serial baby killer. None of the UK media dared ask critical questions. The worked hand-in-glove with the PD. That is why the whole of the UK saw "evil Lucy Letby" being arrested and put in a police vehicle.

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In short there were people determined to protect themselves.

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Another excellent article Scott, thank you. Without the skills and knowledge required to provide safe, competent care, things are not going to end well. If high grade nurses were lost, in rounds of effeciency savings or austerity, the 'Baby was thrown out with the bathwater' yet again. The 'baby' being the expertise that holds healthcare together. I was blessed to work with some excellent consultants during my nursing career, who took their responsibilities to their patients and their units very seriously. If we were ever genuinely worried about a patient or what a junior doctor was doing, we were instructed to phone them at home, if they weren't on site, even if it was the middle of the night. What we got told off for, was apologising for doing that, when a patients life was at risk.

What on earth were the consultants at COCH being paid for? Leaving junior, inexperienced doctors to get on with it, accepting patients into their unit when there wasn't the staff to care for them safely and effectively? Their heads should be firmly on the chopping block, they did not take care of the staff or the patients properly at all. How much experience and supervision monitoring and managing early neonates did did they actually have themselves as Paediatricians not neonatologists? Maybe because they lacked competence as neonatal medicine evolved, they didn't know what they didn't know, which is where the investigation should also include.

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I think you and Rober Dyson in his comment above yours are collectively correct. At CoCH what you had was paediatricians, trainee and junior paediatricians and some trainee GPs. I am yet to see one of these doctors described 'at the time' as being a consultant neonatologist - yet, for all intents and purposes that was what should have been present. The idea that treating 27, 30 or even 32 week premature neonates as "little humans" or "little children" was okay was , on the face of it, wrong. Neonatal care is an entirely different beast and requires different training and skillsets. the fact that these people were all making it up as the went along is nothing less than disgusting.

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If those trainee doctors are now consultants, either in paediatrics or neonatology, then the outlook for babies in their care both currently, and into the future, is grim!!!

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Making it up as they went along, if and when they were there! It's truly beyond belief!

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Absolutely agree that the Consultant Paediatricians too lacked the skills of Specialist Neonatologists therefore their training of newly qualified doctors in itself would be inadequate. In addition Consultants rounds were inadequate having responsibilities elsewhere in the hospital whereas neonatologists spends most of the time with Special Care Babies often based wholly in the unit or at least undertaking a couple of rounds daily. Lucy was very experienced often undertaking extra shifts she could plainly see the failings and this I think marked her downfall.

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Text re. the refusal of the appeal.

https://assets.caselaw.nationalarchives.gov.uk/ewca/crim/2024/748/ewca_crim_2024_748.pdf?fbclid=IwY2xjawESvu1leHRuA2FlbQIxMQABHVBAuGifbmRhCKfm3vT9vLI2WI7kaZG5PTIgxzSXMIYqBdSJBpUz7er1YA_aem_h6qN3I2LbWb4icS8OJBJjg

As said, it is not going well for Lucy Letby 1 I do not see someone with deep pockets getting involved. I see none of the experts - who blogged, substacked, etc. - coming forward and speaking/writing on her behalf.

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This case is an extraordinary case, leading to an extraordinary conviction. I suspect that what will follow will not be ordinary, the CCRC will be involved a lot sooner than is usual/normal. There have been numerous uncoordinated challenges to the conviction on the basis that Lucy Letby's conviction is unsafe, that the prosecution case was not proven beyond reasonable doubt - absolute innocence is not the issue though it is (in my mind) overwhelmingly likely that Lucy Letby is indeed entirely innocent. Coordinated action is now required, I am hopeful that this will happen. Egos need to be put to one side - I saved Lucy Letby kind of thing - and the conviction overturned.

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I would have no problem with a big ego if this person also had a big amount of money to spend and was willing to spend it on this case ! To get justice you need money, lots of it.

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Given the seriousness of the questions you raise, and the gravity of Ms Letby’s current situation, it would seem an independent official Enquiry might be the only way to clarify the facts.

Unfortunately, I doubt there is the political appetite for an Enquiry as, if your concerns are proved correct, too many people might have to say they got it wrong.

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Jul 25·edited Jul 25

CoCH Neonatal Unit seen as inadequate as early as 2013 - charity appeal launched for £3million to double the size. https://www.coch.nhs.uk/media/70513/press_release_hospital_launches_biggest_ever_fundraising_project__28.02.2 013_.pdf

Took until 2021 to remedy - ' A neonatal unit with up to 16 cots will also be created on the ground floor, ( of the new 110 million Womens and Children's Unit )relocating the current unit that opened in 2021 after generous contributions from donors to the Countess Charity’s Babygrow Appeal made it

possible. ' https://www.coch.nhs.uk/corporate-information/news/plans-submitted-for-new-women-and-childrens-building.aspx

We have experienced nurses being replaced by grads, and a Charity Fund raising is needed to expand the neonatal unit . All points to an underfunding situation. Perhaps the Thirlwall Inquiry will expand.

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The Telegraph is now publishing story after story - and interviewing David Davis on Lucy Letby, on LL's conviction. Why am I cynical about this, why do I doubt their sincerity?

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For anybody who might be interested: Private Eye. No. 1629 2 August- 15 Aug. 2024. Page 38- The Lucy Letby Case: Part 2, MD on why the Nurse should be allow to appeal.

This :' MD argued in the last issue that a better way to present the science and statistics in cases of this magnitude and complexity would be to have an independent expert of current experts- not those long since retired- employed by the court rather than one side or other. The forensic pathologist agrees ' Paediatric evidence can be near impossible for a jury to understand when you have say, two professors of equal expertise with widely conflicting opinions based on the same evidence. How is a lay person expected to pick through that?'

A better approach in my view is called 'hot-tubbing' . Experts from both sides take the oath and the stand together, the evidence is more discussive and generally the experts from both sides have met each other beforehand and agree on what they agree and disagree on'

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prompted by Lucy's acceptance of the wrong information about insulin needing to have been inserted into neonate fatalities, an error by her barrister, we wondered if she was in any position to make such a judgement. Did her training cover the intricacies of insulin? We doubt it, judging by the documents found on neonate nurse training. See links below 1 and 2.

Lucy was tried for her practice in 2018 and there are deep problems with neonate 'training' identified by a government review as late as 2021, notably the lack of standardisation and the meagre anatomy and physiology training on p 15 of the same document (1)

In other words the hospital unit was appalling, AND the specialist nurse neonate training was also very inadequate, and lacking in scientific depth to say the least, document (2)

file:///C:/Users/HP/Desktop/RSM%20Neonatal%20QIS%20Review.pdf (1)

Neonatal Qualified in Specialty (QIS) Education and Training Review

HEE (Health Education England) NHS 2021

file:///C:/Users/HP/Desktop/PUB-004641%20neonatal%20nurse%20curriculum%20RCN.pdf (2)

Career, education and competence framework for neonatal nursing in the UK

RCN guidance (2014)

prompted by Lucy's acceptance of the wrong information about insulin needing to have been inserted into neonate fatalities, an error by her barrister, we wondered if she was in any position to make such a judgement. Did her training cover the intricacies of insulin? We doubt it, judging by the documents found on neonate nurse training. See links below 1 and 2.

Lucy was tried for her practice in 2018 and there are deep problems with neonate 'training' identified by a government review as late as 2021, notably the lack of standardisation and the meagre anatomy and physiology training on p 15 of the same document (1)

In other words the hospital unit was appalling, AND the specialist nurse neonate training was also very inadequate, and lacking in scientific depth to say the least, document (2

file:///C:/Users/HP/Desktop/RSM%20Neonatal%20QIS%20Review.pdf (1)

Neonatal Qualified in Specialty (QIS) Education and Training Review

HEE (Health Education England) NHS 2021

file:///C:/Users/HP/Desktop/PUB-004641%20neonatal%20nurse%20curriculum%20RCN.pdf (2)

Career, education and competence framework for neonatal nursing in the UK

RCN guidance (2014)

See right hand column of the RCN document.

See also: https://www.sciencedirect.com/science/article/abs/pii/S1471595323003323

Introduction

Since the 1980 s, changes in nursing education have inadvertently led to diminishing anatomy and physiology content in curricula (Taylor et al., 2015). The need for nurses to have a thorough grounding in these subjects is undisputed; however, the pedagogical principles for anatomy and physiology education have been under scrutiny (Perkins, 2019). Anatomy and physiology are typically incorporated as part of bioscience, which also encompasses genetics, microbiology, pharmacology, and pathophysiology (Horiuchi-Hirose et al., 2023). Registered nurses and nursing students often express anxiety about studying bioscience and its perceived difficulty, largely due to difficulties in applying theory to practice (Craft et al., 2013, Craft et al., 2017, Meedya et al., 2019). Despite this, there remains a recognition that bioscience knowledge is important for effective nursing practice (Danielson and Berntsson, 2007, Horiuchi-Hirose et al., 2023).

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I too cannot believe her lawyer allowed or told her to agree

The correct answer should always have been that she couldn't know if they were poisoned (she is not a pathologist) nor could she know if they were poisoned by insulin (again, not a pathologist, not a lab chemist) nor could she know if the test was valid or correct (not a lab chemist - and remember that all tests have false positive and false negatives). She should have been told not to answer any question dispositively that was not within her nursing training remit. We definitely don't teach nurses of the current generation anything close to approaching whether or how to identify insulin poisoning.

Her testimony on something that was so obviously not in her knowledge should have been struck out.

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I wonder whether she could fully remember all the details after such a long period? She would not have access to past medical records and unfortunately it was possible that changes can be made to medical records by those that had access. Prior to computerised records.

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I think Lucy was broken by the things that happened to her in the past few years. Being betrayed people she trusted, disappointment that no-one from CoCH NICU came forward to defend her. The press painted her as an evil serial baby killer, everything she ever had done was now used against her. Additionally there were meds prescribed to her while in prison, etc.

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Maybe they hoped that with the insulin poisoning they could cast doubt, because if Lucy did not do it, who did ? That would mean there would be a second (or another first) killer loose on the ward.

Regarding the issue of experts who could have spoken during the trial on Lucy's behalf. Maybe her lawyers looked at the Lucia de Berk case. This pediatric nurse was convicted for a large part based on the testimony of an expert requested by the defense.

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I have on several occassions raised the absence of proper Anatomy & Physiology, physics, chemistry, microbiology and infectious diseases and other similar scientific training that was part of the first two years of the nursing education curriculum when I was doing my training.

These days nursing schools are lowering the entry requirements. Year on year the entrance requirements insofar as academic achievement have been gradually watered down to the point that for some elite schools it is more important that a candidate picked THAT school as her first choice, and less important as to whether she has all the right classes and exam marks to demonstrate ability to undertake the course of study. The way they deal with this reduced academic ability is to then dilute the academic requirements of the course itself, making increasing numbers of clinical hours in what are often little more than geriatric care wards a substitute for rigorous academic inculcation.

And it isn't just nursing schools doing this. Some lawyers and barristers are graduating with marks barely over 40% - because many law schools now consider 40% (not the time honoured 50%) as the "pass mark". They go on to undertake rote learning classes in order to pass the SRA or Bar exams and come out with their shiny new practicing certificate with little or no critical thinking or legal research abilities. Those, like myself, who worked hard and read wide to ensure every mark was somewhere above 80%, and mostly above 85%, are a dying breed as the old mantra "even C's get degrees" gradually becomes "we barely have to do jack and they give us a pass mark"

I have linked people before to the articles showing that it is academics and not the failing students who are called to answer when a student receives a fail grade. Many universities make it extremely difficult to nigh on impossible for academics to fail a student, even one who consistently doesn't turn up, doesn't turn in work, and regularly fails tests.

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Amazed me too. The insulin issue was - as far as I thought - debunked. The blood was not guarded before it was sent to the laboratory - no guarantee it was kept in proper conditions and/or transported timely. The lab warned the results "could not be used for forensic purposes". And yet that happened ? How was that possible ?

I think Lucy brought the paperwork home because she wanted to figure out what was happening. In the end it was one of the things that did her in.

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On a more general point - a barristers view of the trial https://unherd.com/2024/07/the-questions-haunting-the-lucy-letby-trial/

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Jul 26·edited Jul 27

"Extraordinary claims require extraordinary evidence", from the piece you referenced. There can be no more extraordinary a claim than the claim (accusation) that a well thought of nurse - up to that point - is committing the murder of babies in her care. And harming others in failed attempts at murder. Where is the extraordinary evidence for these murders? There is none. What manner of people are these, in H. M. Constabulary, in Crown Prosecution Services, in our judiciary, who can prosecute and convict (and demonise) somebody of the most horrendous crimes on such thin evidence? They are extraordinary people, are they not? There is extraordinary evidence for that.

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Fully agree with what type of people are these? I see the problem as no party in that hierarchal structure has the gonads to say stop and suffer the media/peoples' reaction and/or even political reaction, to protect the NHS. Far easier to pass it on with the jury having to make the decision.

Of course, the jury of lay people are not competent with such an emotional and lengthy case - and as they live in the locality ( Chester is 20 miles from the Manchester Court) the thought of abuse must be present, even subconsciously, in the Jury's mind, if a not guilty decision is forthcoming.

Certainly, Cheshire Police, CPS and the Judiciary need further training in their various roles because they have all failed IMO. A typical case of the system screwing the individual because the system cannot possibly be seen to wrong.

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mbrace uses a different year. as Brearey will tell u.

High forceps?

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