The inquiry into the murders carried out by baby killer Lucy Letby is set to be made statutory, with judges given the power to compel witnesses, following calls on the government from the lawyer of bereaved families.
Letby was convicted on Friday (18 August) of murdering seven babies and attempting to kill six other newborns at the Countess of Chester Hospital. Prosecutors said she was a “calculated opportunist” who used the vulnerabilities of premature and sick infants to camouflage her acts. Colleagues believe she may have committed the murders to get attention.
The 33-year-old was sentenced on 21 August for her heinous crimes, and is expected to be given a whole-life tariff. She refused to appear in the dock for her sentencing hearing, and the victims' families said in tearful victim impact statements that “there is no debate that, in your own words, you killed them on purpose. You are evil. You did this".
Earlier this month, the government announced an independent inquiry "into the circumstances behind the murders and attempted murders of babies at Countess of Chester Hospital to help ensure families get the answers they need". It will look at "the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with".
Now health secretary Steve Barclay confirmed the move to a statutory inquiry on Wednesday (30 August) evening. He said in a statement: "These are truly appalling crimes and my thoughts remain very much with the families. We wanted to discuss the terms of the inquiry with the families, that's what I have done, and reflected on the comments that they have made.
"There's different ways of having inquiries which bring advantages and disadvantages, so having discussed that with the families, it's clear their preference is for a statutory inquiry and that is what the government will now deliver on."
It comes after the unit's lead consultant, Dr Stephen Brearey, told the BBC that hospital bosses failed to investigate allegations against Letby for months, and refused to call the police. They brought a grievance procedure against the doctors who raised concerns, and found in Letby's favour. The hospital is now under new management.
Now it has been made a statutory judge-led inquiry, it means that the investigation will benefit from a strong set of legal powers though it does mean it will last longer. While a non-statutory inquiry means witnesses are not compelled to give evidence.
The Department for Health and Social Care said that the inquiry "will investigate the wider circumstances around what happened at the Countess of Chester Hospital, including the handling of concerns and governance". It will also look at what actions were taken by regulators and the wider NHS.
There had been many calls to make proceedings statutory, including from Dame Christine Beasley, a former chief nursing officer, who joined a growing list of figures pushing for the investigation to be strengthened. She told the BBC: "I think what a statutory inquiry will do is compel people to come and give evidence where in an independent inquiry people can opt out of it if they want to.
“Whatever the outcome of the independent inquiry is, I feel that relatives and patients will not feel that they’ve got to the bottom of it. And so I think on balance, it would be best to do a statutory inquiry.”
While Steve Brine, the Conservative chairman of the Health Select Committee, warned on Sunday (20 August) that some key witnesses may not be willing to co-operate with the independent inquiry, which he said could drag on for years and “disappear down a rabbit hole”.
Shadow Health Secretary Wes Streeting urged the government to make the inquiry statutory. He said: "These were unspeakably evil crimes and one of the worst scandals in the history of the NHS. The independent inquiry needs the full force of the law behind it to deliver the justice and accountability that the families deserve.
"We are urging the government to listen to the families and put the inquiry on a statutory footing. There must be no hiding place for the catastrophic failures that enabled children to die.”
The government said that an independent inquiry would be quicker than a judge-led investigation. When asked about this, Rishi Sunak said: "I think the important thing for the inquiry to do is make sure that families get the answers that they need, that it is possible for us to learn the lessons from what happened, everything conducted transparently and to happen as quickly as possible. Those are the objectives that we want for the inquiry and we’ll make sure that it’s set up to deliver on those aims.”
On Friday, Health and Social Care Secretary Steve Barclay said: “I would like to send my deepest sympathy to all the parents and families impacted by this horrendous case.
“This inquiry will seek to ensure the parents and families impacted get the answers they need. I am determined their voices are heard, and they are involved in shaping the scope of the inquiry should they wish to do so.
“Following on from the work already underway by NHS England, it will help us identify where and how patient safety standards failed to be met and ensure mothers and their partners rightly have faith in our healthcare system.”
The Parliamentary and Health Service Ombudsman called for “significant improvements to culture and leadership across the NHS” in the wake of the Lucy Letby trial.
Rob Behrens said: “We know that, in general, people work in the health service because they want to help and that when things go wrong it is not intentional. At the same time, and too often, we see the commitment to public safety in the NHS undone by a defensive leadership culture across the NHS.
“The Lucy Letby story is different and almost without parallel, because it reveals an intent to harm by one individual. As such, it is one of the darkest crimes ever committed in our health service. Our first thoughts are with the families of the children who died.
“However, we also heard throughout the trial evidence from clinicians that they repeatedly raised concerns and called for action. It seems that nobody listened and nothing happened.
“More babies were harmed and more babies were killed. Those who lost their children deserve to know whether Letby could have been stopped and how it was that doctors were not listened to, and their concerns not addressed, for so long.”
In 2015 and 2016, there was a significant rise in the numbers of babies who suffered serious and unexpected collapses in the neonatal unit at the Countess of Chester Hospital. Letby was the only member of the nursing and clinical staff who was on duty each time the collapses happened.
She used various ways to harm the babies including injecting air into the bloodstream, injecting air into the stomach, overfeeding with milk, physical assaults and poisoning with insulin.
Some of the children were subjected to repeated attempts to kill them by the “cold, cruel and relentless” band 5 staff nurse, the trial – which began at Manchester Crown Court last October – heard. Letby’s presence when collapses took place was first mentioned to senior management by Dr Brearey in late June 2015.
Concerns among some consultants about Letby increased and were voiced to hospital bosses when more unexplained and unusual collapses followed.
She was not removed from the unit until after the deaths of two triplet boys and the collapse of another baby boy on three successive days in June 2016, and actually brought a grievance procedure against her colleagues over their complaints. They were ordered to apologise to her.
The hospital did not call the police until May 2017, by which time she had attacked five more babies, killing two. Dr Brearey told the BBC that managers were trying to avoid going the police: "If you want to call that a cover-up then, that's a cover-up."
She was eventually arrested at her semi-detached home in Westbourne Road, Chester, at 6am on 3 July 2018, and charged with murdering five boys and two girls and attempting to murder another five boys and five girls between June 2015 and June 2016. Letby, originally from Hereford, denied all the allegations.
The jury convicted her of seven counts of murder and seven counts of attempted murder. She fought back tears in the middle of the dock after the first verdicts were returned by the jury foreman, and her mother Susan, 63, could be heard sobbing and saying “you can’t be serious” and “this can’t be right”.She was cleared of one count of attempted murder, and the jury couldn't reach verdicts on six other charges.
Dr Nigel Scawn, medical director at the Countess of Chester Hospital, said: “We would like to extend our thanks to Cheshire Police for their extensive investigation and the work they did to bring this case to trial. We would also like to thank them for the comprehensive support that they have provided to all the families involved.
“Since Lucy Letby worked at our hospital, we have made significant changes to our services and I want to provide reassurance to every patient that may access our services that they can have confidence in the care that they will receive. Finally, and most importantly, our thoughts are with all the families and loved ones at this very difficult time. Thank you.”
PA Media reported that he walked away without answering as a journalist asked “why did hospital managers try to stop Lucy Letby from being investigated?”.