Even with my eyesight at the moment forcing me to take to reading in short bursts, I decided to spend the Easter weekend reading and reviewing Paul Bamford’s book, ‘Lucy is Innocent’. Several of my readers here have recommended his book and suggested it might be worth reading. Sadly, after reading the first third of the book I am not so sure… but I will reserve judgement until the end.
Letby Books
Take your fingers for a walk to Amazon and you will find at least 17 books and three podcasts available that are each titled around Lucy Letby.
They range from those with innocuous titles like ‘The Unusual Case of Lucy Letby’…
To those that seem to claim the author somehow had access to undisclosed secrets about Letby that you, I and maybe even her own parents don’t know…
And others that clearly have only one opinion and have shaped even the title to broadcast it…
Then there was this one with a photo that several people have commented on, asking whether it is even Lucy at all…
It seems a whole raft of people have decided they have the inside track on Lucy and the Letby trial and an opinion regarding her guilt or innocence, more often guilt, that simply has to be expressed to you in print for the princley sum of anything from £8-15 plus postage. I have already received a couple of these books and over the next few months will review them here; suffice to say that on initial perusal the quality of writing in them ranges from sensationalistic journalistic prose to the clumsiest of GCSE-level high-school grammar - and almost everything inbetween. The majority appear to draw vapid conclusions from little more, and sometimes vastly less, than the Guardian and Mail Online newspaper articles that followed the trial each day, and the Mail+ podcast. Few, if any, have legal or nursing training or even a passing familiarity with either domain. Some even stray into venemous polemic attacks that, in some distant future if a Lucia De Berk -style appeal was to be successful, may come to be seen as shameless defamation of character. In some ways, the devolution that is self-publishing may not always be as beneficial as we might like to think. Some things are best left unsaid… or unwritten, as it were.
Bamford’s ‘Lucy is Innocent’ - Part One
In the early chapters of the book there are two things that Bamford presents as his strongest arguments for Letby’s innocence, and which he seems prematurely self-congratulatory about. The principal item is his presentation and discussion in Chapter 5 of the Prosecution’s Operation Hummingbird spreadsheet in which Letby is crafted as the only correlation with a range of incidents in the neonatal unit - a manipulated and misleading document which Professor Fenton, Richard Gill and I have all discussed more than once in podcast, interview and writing. The second, which I intend to mostly discuss in this part of my review, is his presentation and discussion of four venn diagrams in Chapter 4.
In Chapter 5 (page 40) we are told that the prosecution’s spreadsheet was the first item that, once addressed, provided the initial evidence of innocence for Bamford. The inference from that short paragraph is that his spreadsheet rebuttal when taken together with the venn diagrams supporting his theory of the wind-shadow killer either bookends or provides the core structure which Bamford argues conclusively proves Letby’s innocence.
In my discussion I will demonstrate why I believe Bamford has made several mistakes and at least one glaring omission in both the scope and content of these venn diagrams. I will also argue that I believe this happened because he made the same mistake as the police and prosecution, albeit in this case in Letby’s favour.
‘In doubt that Letby did it’ becomes ‘In doubt it has to be the wind-shadow killer’
Banford in several places laments the police and prosecution reasoning as a deviation from the judicial precept ‘in doubt for the defendant’, which he says they inverted into ‘in doubt it has to be Letby’ in order to lay as many allegations at Letby’s feet as possible. In essence, this requires starting with a predetermined conclusion of Letby’s guilt and, working backwards from little more than her inconvenient presence, and finds her culpable for every incident.
I want to be clear here and state my own position - which is that I too believe there have been several instances of this backwards reasoning error made by the police and prosecution. However, I also believe that in his book Bamford has made the same mistake.
All appearances to the contrary (and he does claim early on to have simply been curious and on the fence as to her guilt or innocence), Bamford’s thesis starts by concluding two things, that: (i) deaths in the neonatal unit were the result of murder; and (ii) Letby was innocent of these murders. The first conclusion is problematic given that these were poorly premature babies who already have a high statistical likelihood of dying. Consider what is more likely: that there was a serial baby killer on the ward or that a handful of babies who had anywhere from 10-85% known chance of dying succumbed to death due to their sometimes significant prematurity and other congenital and birth-related issues? In order to support the second conclusion Bamford constructs the logical fallacy that: (a) an unknown wind-shadow killer committed the murders; and (b) the wind-shadow killer selected Letby as the person to frame for these deaths. Bamford’s invention of the wind-shadow killer allows the reader to unquestioningly adopt the prosecution-tendered and incompetently Evans-led belief that these poorly babies were actually the victims of a cold-blooded killer as they lay in their incubators, and serves throughout the book to provide a convenient scaffold supporting the assertion of Letby’s innocence.
The Venn Diagrams
Bamford’s first venn consists simply of an overlapping representation of deaths and incidents at the Countess of Chester Hospital (CoCH), which I have reproduced in MS Visio here as Figure 1.
While I agree that deaths and incidents overlap, I have two criticisms even of this, his simplest of diagrams. First, the fact that it lacks the numbers of deaths and incidents Letby was found guilty of - which would give the reader a better understanding of the diagram, the Letby trial evidence, and would have highlighted to Bamford the exisence of logical errors and omissions. Second, the fact that it fails to identify any of the deaths Letby was not prosecuted for or the number of incidents she was acquitted for. these were all known values which would have given context to his reasoning for why these venn diagrams were so crucial to his judgement of her innocence.
In his second venn, Bamford simply translates Letby over the original deaths and incidents venn, with Letby incorrectly subsuming the entire population of deaths and most of the incidents. Bamford explains the latter decision as reflecting that incidents were taking place when Letby was not present.
I have reproduced Bamford’s second venn as Figure 2a, with the only changes being inclusion of the values for the fatal and non-fatal alleged incidents Letby had been found guilty of (7 deaths arising from 7 fatal incidents, and 7 non-fatal incidents).
However, during the trial: (i) evidence was introduced that Letby had been charged with an eighth death that the judge ordered the prosecution to withdraw prior the trial commencing; (ii) Letby was acquited of six incidents; and (iii) Evans testified to having investigated a total of 33 incidents. Sadly, while these values have been reflected on Figure 2b, they still do not tell the full story.
In response to a Freedom of Information (FOI) request made to CoCH in September 2018, hospital administration acknowledged that in 2015 there had actually been nine neonatal deaths on the unit and a further eight during 2016, for a total of seventeen deaths during the ‘Letby period’. This means there were nine additional deaths during the period that were not laid at Letby’s feet or mentioned during the trial, and these additional deaths surely resulted from an additional undisclosed number of incidents which I reflect as the unknown value ‘x’. When we reflect this additional information on my updated version of Bamford’s Figure 2 diagram we arrive at the values shown in Figure 2c.
In describing his Figure 3, Bamford is correct when he states that the police and prosecutors simply threw out the incidents that occured when Letby was not present (the ‘13’). However, this leads me to wonder why it is that he has done the same thing with with the deaths. His fourth and final venn simply adds a central circle representing the theoretical wind-shadow killer and encompasses the deaths and incidents Bamford imagines that unidentified person contrived to commit and frame Letby for.
The reader is left to wonder why the wind-shadow killer is not in the frame for all of the deaths or, more appropriately, why it appears from Bamford’s version of Figure 4 that Letby may still have committed some of the incidents and caused some of the murders. If nothing else, this in my opinion weakens the entire wind-shadow killer theory.
However, there is still one additional actor missing who actually encompasses every incident and death, whether it involved Letby or not.
That’s right. The one actor that should always be a part of any discussion of what happened on the neonatal unit is the neonatal unit itself - aka The Hospital. The hospital is a combination of the people, facilities, policies, operating procedures and resources that are collectively termed a hospital and in totality are responsible for delivery of patient care. For what its worth the police are looking at the hospital now, at least from the perspective of the management. However, I believe this focus is far too narrow, in that the hospital also includes the doctors (who were omitted from the (in)famous spreadsheet), the management, the building (including the impact it generally has on provision of efficient, safe and effective care and the ongoing maintenance issues), interactions between care provision and hospital guidelines or policies, resource availability (including adequate supplies of the medications, tools and other consumables needed in the provision of care and the well documented lack of appropriate numbers of staff to provide that care at CoCH) and many other elements. Any discussion, even in diagrammatic form, that omits the hospital ignores the very real impact this critical actor plays on care delivery and patient outcomes. For example, while in my own substack I have highlighted the high incidence of suspected sepsis and sepsis-like symptoms and illness in the neonatal unit and for the ‘Letby babies’ in particular, this issue was not limited solely to the neonatal unit. The entire hospital had an ongoing issue with sepsis that saw it as the main topic of more than one official report and several newspaper articles. Sepsis existed in and around the hospital and the culture at the hospital saw it publicly recognised as one of the worst in the UK in regards to their reponse to sepsis infections in patients. For all these reasons, the hospital must be a necessary and critical element of any critical evaluation of the Letby case. Yet, and just like the deaths that occured during the period and which Letby was not prosecuted, the hospital was also absent from Bamford’s diagrams.
This has only been the first part of my review of Bamford’s book. I feel that there is also much to like about the text, and I will endeavour to come to those aspects in future posts as well.
If you managed to get all the way here to the end, then I say thanks again for staying with me. I realise it has been a long post but I hope it has been informative.
You write with precision. That takes length. It does seem that the hospital was happy to let Lucy take the rap for its many problems over which Lucy had little control.
Thanks for doing this. I simply don't have the time...but this case is deeply concerning to me, because it looks like a witch-hunt and smells like a witch-hunt. This does not mean that it IS a witch-hunt - I mean for all I know she could be as devious and murderous as Myra Hindley, but I just don't think that the prosecution proved that, against all reasonable doubt.