Lucy Letby inquiry will deal with 14 infants murdered or harmed

The 14 babies murdered or harmed by child serial killer nurse Lucy Letby are at the ‘heart’ of a public inquiry into the events surrounding her crimes, a senior Court of Appeal judge said as the hearings began today.

Lady Justice Thirlwall is chairing the investigation at Liverpool Town Hall to examine how Letby was able to attack babies on the Countess and Chester Hospital’s neo-natal unit in 2015 and 2016, and how its bosses handled concerns about her.

Letby, 34, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims.

The inquiry will cover three broad areas:

1. The experiences of the parents of the babies who featured on the criminal indictment that Letby faced.
2. The conduct of those working at the Countess of Chester and how Letby was able repeatedly to kill and harm babies. Despite mounting concerns raised to bosses by some consultants, she was not removed from the unit until after the deaths of two triplet boys and the suspected collapse of another baby boy on three successive days in June 2016 and police were not called in until the following year. 
3. A focus on the wider NHS in examining relationships between the various groups of professionals, the culture within hospitals and how these affect the safety of newborns in neonatal units.

In Lady Justice Thirlwall’s opening statement today, the senior Court of Appeal judge said: ‘At the heart of this inquiry are babies who died or were injured and their parents.

‘I do not presume to describe the feelings or emotions that those parents have already experienced but I will remind you of what happened since the birth of their children.

‘First, each parent celebrated the birth of each child, then when things seemed to be going well for those babies each one of them collapsed suddenly and unexpectedly. Some of the babies recovered, some survived but with life-long consequences, some died.

‘Death and injury occurred in 2015 and 2016, the parents were told that natural causes were the reason for their deaths and life long difficulties, and so each parent grieved the loss of a new life and all that it promised and lived with that profound sorrow.’

The judge said that it wasn’t until 2018, two to three years later, that the parents ‘learned that their babies had been deliberately harmed and a nurse looking after them had been arrested.’

The judge outlined Letby’s convictions, saying she was found guilty of seven counts of murder and seven counts of attempted murder ‘eight years after those babies had been born’ in August 2023 at Manchester Crown Court.

In May, Letby lost her Court of Appeal bid to challenge her convictions from the first trial which took place between October 2022 and August 2023. 

She was convicted at retrial earlier this year of the attempted murder of a baby girl, Baby K.

Lady Justice Thirlwall said that appeal judgment was a ‘watershed’ as the parents of the nurse’s victims could now turn their minds to the inquiry.

She said: ‘At last the parents had finality, or so it seemed. But it was not to be.

‘In the months that followed…there has been a huge outpouring of comment from a variety of quarters on the validity of the convictions.

‘As far as I am aware it has come entirely from people who were not at the trial. Parts of the evidence have been selected and there has been criticism of the defence at the trial.

‘All of this noise has caused enormous additional distress to the parents who have already suffered far too much.’

Lady Justice Thirlwall said the inquiry bears her surname so that the parents do not repeatedly see the name of the person convicted of harming their babies.

She said it was planned that the hearings in Liverpool would finish in early 2025 and she expected her findings to be published by late autumn of that year.

Lady Justice Thirlwall went on: ‘It is not for me to set about reviewing the convictions. The Court of Appeal has done that with a very clear result.’

She said the parents of those harmed had waited years for their questions to answered and it was her responsibility to focus on the inquiry’s terms of reference.

‘It is time to get on with this inquiry,’ she said.

Ms Langdale said Letby’s appeal against her convictions has been dismissed and added ‘we recommend careful reading of the Court of Appeal judgement.’

She said there is a requirement to take into account all the evidence and consider each piece of evidence in the context of all the other evidence – and it should not be compartmentalised.

She added: ‘Those who do this will be less likely to see the picture as a whole. They may reach conclusions that are not only wrong but are speculative and damaging.’

Rachel Langdale KC, counsel to the inquiry, began her opening statement by speaking about serial killer nurse Beverley Allitt, who was convicted of four counts of murder, three of attempted murder, and a further six of grievous bodily harm on children at the Grantham and Kesteven Hospital in Lincolnshire in the 1990s.

Ms Langdale said a statement had been received by the inquiry from former secretary of state for health Baroness Bottomley, who ordered an inquiry be conducted to establish the facts after Allitt’s crimes.

Ms Langdale said: ‘Nevertheless, and distressingly, 25 years later another nurse working in another hospital killed and harmed babies in her care.’

She said the inquiry would hear the crimes of Allitt formed part of the training course Letby underwent at the University of Chester.

Lady Justice Thirlwall also said: ‘I do not presume to describe the feelings or emotions that those parents have already experienced… but I will remind you of what happened since the birth of their children.

‘First, each parent celebrated the birth of each child, then when things seemed to be going well for those babies each one of them collapsed suddenly and unexpectedly. Some recovered, some survived but with life-long consequences, some died.

‘Death and injury occurred in 2015 and 2016. The parents were told that natural causes were the reason for their deaths and life-long difficulties, and so each parent grieved the loss of a new life and all that it promised and lived with that profound sorrow.

‘In 2018, two to three years later they learned that their babies may have been deliberately harmed and a nurse looking after their babies had been arrested.’

The nurse was later charged and her trial at Manchester Crown Court followed which led to her convictions, she said.

And Ms Langdale KC said: ‘At the Countess of Chester between June 2015 and June 2016 the neonatal unit was a place where babies were murdered and injured by someone trusted to care for them, a nurse on the ward.’

She said the first part of the inquiry would include ‘heartbreaking’ evidence about the experiences of the parents whose babies were attacked by Letby.

She added: ‘The provision of written or oral evidence to you is a testament to the enormous courage of the parents.

‘In the midst of their pain they have demonstrated a selfless commitment in the principle that others in the future should not suffer as they do.’

She said medical and scientific evidence in each case should be considered in the context of all other evidence and should never be compartmentalised.

She added: ‘Those who do this will be less likely to see the picture as a whole. They may reach conclusions that are not only wrong but are speculative and damaging.’

Ms Langdale KC also said the second part of the inquiry into Letby’s crimes would consider whether they could have been prevented and whether she should have been removed from the neo-natal unit earlier.

She said: ‘The inquiry’s unwavering process will not be examining the convictions but rather what the response of those at the time was and should have been to what they knew or should have known at the time.

‘Our inquiry will serve the vital purpose of keeping babies safe in the future for those rare cases when a healthcare professional intends them harm.’

She said witnesses would be expected to tell the truth ‘however difficult that may be’.

Ms Langdale said the third part of the inquiry would consider the wider NHS, including the current culture, governance and management structures.

She said: ‘History tells us that serial killers are deceptive, manipulative and skilled at hiding in plain sight.’

She said an inquiry into Harold Shipman, a GP thought to have murdered hundreds of his patients, shed little light on why he carried out his crimes and found he was able to kill undetected over many years, enjoying a high reputation.

She added: ‘For ordinary, decent right-thinking people the actions of Letby will remain unfathomable. We will not be inviting speculation from witnesses about her motive or mindset.’

She said the inquiry would examine why detailed medical analysis of the deaths and collapses of babies did not take place earlier and whether bias in favour of Letby influenced the hospital’s response.

She said: ‘It was not until April 2017, almost two years after the first murder, that the hospital made a referral to the police and detailed multi-disciplinary medical scrutiny and analysis was finally conducted.’

In Lady Justice Thirlwall’s opening statement in November, she said she would probe what recommendations had been made from previous inquiries into events in hospitals and other healthcare settings, and what difference they made.

Letby protested to the court ‘I’m innocent’ as she was led from the dock when she was sentenced in July to her 15th whole-life order after a jury convicted her at retrial of the attempted murder of a baby girl.

In May, she lost her Court of Appeal bid to challenge her convictions from the first trial which took place between October 2022 and August 2023.

Her new lawyer, Mark McDonald, has claimed that new medical evidence and expert opinion had revealed ‘flaws’ in the prosecution case and that he plans to apply to the Criminal Cases Review Commission (CCRC) to ask it to return the case to the Court of Appeal for consideration.

In recent months a number of doctors, scientists and statisticians have publicly challenged how the evidence was presented to jurors.

While a letter to Government ministers from 24 signatories including neonatal experts and professors of statistics called for a rethink over the terms of the public inquiry and warned that important lessons could be missed from a ‘failure in understanding and examining alternative, potentially complex causes for the deaths’.

Speculation about Letby’s case in the media and possible future appeals had been ‘upsetting’ for her clients, said solicitor Tamlin Bolton who is representing the families of six victims.

The first week of the inquiry will hear opening statements from the counsel to the inquiry, along with legal representatives from ‘core participants’ including the families of Letby’s victims. Evidence is scheduled to begin the following week.

A court order prohibits reporting of the identities of the surviving and dead children involved in the case.