Inquiry Report Underscores Letby's Guilt, Dismissing Defense Theories

Lady Justice Thirlwall's recent report into the failures at Countess of Chester Hospital has unequivocally stated that "dysfunctional management" and a "complete failure" to understand safeguarding meant vulnerable infants were not protected from harm by former neonatal nurse Lucy Letby. The senior Appeal Court judge asserted that up to three children murdered by Letby should not have died had hospital managers acted sooner to remove her from the ward.

While Lady Justice Thirlwall's remit was not to re-examine trial evidence or pre-empt the Criminal Cases Review Commission (CCRC), her 822-page report dismisses many arguments put forth by Letby's supporters. These arguments often claim no murders occurred and that Letby was a scapegoat for a failing hospital. The report specifically addresses several points raised by those maintaining Letby's innocence.

Regarding claims of understaffing on the ward, the report states that "none of the deaths could be attributed to staff shortages," noting that nursing staffing levels were "slightly better than in all other comparable hospital neonatal units in the region." Concerns about pseudomonas bacteria found in the neonatal unit's taps in 2012 and 2015, which some supporters cite as a cause for infant deaths, were also addressed. The judge found that these issues were dealt with and "had no consequences for babies," concluding "there was no evidence that pseudomonas played any part in any of the deaths."

The report also clarified the context of a note found on Letby's belongings that read, "I AM EVIL I DID THIS." Contrary to some reports, Lady Justice Thirlwall stated that Ms. De Berger, who supporters claimed advised Letby to write the note during counseling, "was not a counsellor and there is no evidence that counselling or any form of therapy was provided to Letby." Furthermore, the judge concluded that the downgrading of the neonatal unit to no longer admit babies under 32 weeks' gestation "was not an explanation for the absence of deaths and unexpected collapses," refuting the idea that this change, rather than Letby's removal, caused a drop in infant mortality.

Despite the inquiry's findings, a public relations campaign, reportedly undertaken pro-bono by Maltin PR, has continued to promote Letby's innocence. This campaign has coincided with the airing of documentaries questioning her convictions and newspaper articles highlighting hospital failings or calling for a retrial. These platforms have featured individuals such as a statistician, a former nurse, and a disgraced coroner's officer, all of whom have been vocal supporters of Letby.

A retired vascular surgeon, Colin Ferguson, suggested in one documentary that air embolism, a potential cause of death, would have been evidenced by gas in the infants' hearts. However, evidence presented at Letby's trial by Professor Owen Arthurs, a pediatric radiologist, and Professor Andreas Marnerides, an expert pathologist, indicated that air was visible in the major blood vessels of several victims, including Baby D, which could not be explained by infection or decomposition. Pathologist Jo McPartland also testified that air is very difficult to detect in neonates' hearts post-mortem.

Questions have also been raised regarding Letby's convictions for poisoning two baby boys with insulin, evidenced by high levels of the hormone in their systems. Critics argue that newborn babies can naturally produce high insulin levels and that control tests were flawed. However, the trial heard testimony from Dr. Anna Milan, a biochemist, who expressed confidence in the test results, and endocrinologist Professor Peter Hindmarsh, who stated the blood readings could only be explained by external insulin administration. The report also noted that a blood test result from Baby F, five hours after Letby tampered with his drip, which critics claimed was inconsistent with insulin poisoning, was entered into the medical notes by Letby herself, who was found to have deliberately altered entries in other infants' records.

Journalist Liz Hull, who attended the trial, noted that those who doubt Letby's guilt were not present for the ten-month proceedings but confidently assert the jury erred. She highlighted specific testimonies that were pivotal in convincing the jury. Nurse Ashleigh Hudson recalled an incident where Letby appeared to know a baby was struggling before alarms sounded and before she could have seen the infant's distress, a slip of the tongue where she corrected herself from saying she knew "what I was looking for" to "at," suggesting prior knowledge.

Further testimony from Baby E's mother described her son's distress and Letby's reassurances, which were later contradicted by medical notes showing Letby falsified the timings of when she called for medical assistance. The jury convicted Letby of murdering Baby E by injecting air into his bloodstream and ramming medical equipment down his throat.

In their closing remarks to the public inquiry, the parents of Letby's victims, through their barrister Richard Baker KC, expressed no doubt about her guilt. They urged those promoting conspiracy theories to be ashamed, stating that they, along with the jury, "collectively sat through ten months of evidence" and have "no doubt that she was guilty." Lady Justice Thirlwall also paid tribute to the parents, urging respect for their dignity and courage, and emphasizing that they "must not be collateral damage in the public argument about whether or not Letby is guilty."