What next for Lucy Letby?
Don't hold your breath for an appeal
In my last post about Lucy Letby, I said I wouldn’t write about her again unless there were further developments of any significance. The American-style press conference in which her new lawyer, Mark McDonald, said that he would be appealing the convictions, both directly and via the CCRC, counts as a significant development. It was most notable for the contribution of Dr Richard Taylor, a British neonatologist living in Canada, who asserted that one of the doctors who blew the whistle on Letby had accidentally killed one of the children Letby was convicted of murdering (Baby O). Although he did not mention him by name, it fed into the conspiracy theory that Letby was a scapegoat for failings in the Countess of Chester hospital (CoCH).
Since the summer, there has been an endless series of articles in the media raising doubts about Letby’s conviction. Sarah Knapton at the Telegraph and Phil Hammond at Private Eye have been particularly prolific and Peter Hitchens has been tweeting incessantly about the case. A lot of the ‘new’ information has been sourced from a Twitter account called @lucyletbytrials run by the freelance journalist Cleuci de Oliveira who helped out on the infamous New Yorker article that brought Letbyism to the mainstream. It is remarkable how much noise a few people can make. One of the original Letby truthers, Sarrita Adams AKA Science on Trial, deleted her website and social media accounts in October, but is no doubt still beavering away behind the scenes.
The barrage of pro-Letby news stories has acted as a distraction from the Thirlwall Inquiry1 and has given some people the impression that there is growing evidence of her innocence. In fact, nearly everything that has come out about the case this year was either brought up in court when she was being tried or is inconsequential. A lot of it is noise and ill informed rubbish about ‘statistics’, but there are a few claims that are worth addressing.
The door swipe data. In April 2024, the CPS admitted that the entry data for one door in the hospital was mislabelled in the original trial. When staff entered the room they were recorded as leaving it and when they left it they were recorded as entering it. This sounds like the kind of thing that would get someone off a murder charge immediately in the right circumstances. If the door swipe data that convinced a jury that Letby was in a particular nursery at a particular time actually proves that she was not there, the whole case would fall apart. Alas, it is not that simple. The door swipe data doesn’t prove where anyone was except at the moment when they swiped their card. Staff needed to swipe to get in the room but they didn’t have to swipe out. Moreover, Letby’s presence at the crime scene did not depend on swipe data, but on staff rotas and the testimony of other staff (and parents). As far as I know, Letby did not deny being where the prosecution said she was for any of the incidents. She said she didn’t remember the Baby K incident, but she didn’t deny being in that nursery and she wasn’t convicted of attacking Baby K in the original trial anyway. It was only at the retrial, after the CPS had admitted the mistake and the door swipe data had been corrected, that she was convicted of Baby K’s attempted murder.
The sewage theory. According to the Telegraph, ‘Pseudomonas aeruginosa colonised taps in nurseries’ at the CoCH. The Guardian has claimed that ‘the unit had struggled to eradicate the contamination of its taps with a potentially lethal, antibiotic-resistant bug’. John Sweeney has built a risible podcast around the idea that the CoCH was a ‘hospital full of shit’. The theory is that the plumbing at the hospital was appalling and raw sewage was regularly pushing up through the sinks, thereby spreading disease and killing the babies (when doctors weren’t killing them themselves). This was essentially Letby’s defence and it is why the only witness the defence called was the hospital plumber. The argument falls down on two fronts. Firstly, the plumber said in court that there was sewage on neonatal unit room 1 on one occasion but that this was a “one-off” and work was carried out “so it couldn’t happen again”. Secondly, none of the babies died of pseudomonas or any other bacterial infection and none of the sudden collapses were consistent with such a disease. The symptoms of bacterial infection would have been easily identified by doctors and nurses.
Related to the sewage theory is the idea that the CoCH was very badly run and desperately under-staffed. Sceptics frequently cite a report from the Royal College of Paediatrics and Child Health, published in November 2016, which was supposedly “damning” (Private Eye). The RCPCH was invited to carry out a review into the spike in neonatal deaths and failed to identify the cause (partly because they were not given enough information). The RCPCH report is still available online. It found that there was a 21% shortfall in nursing staff compared to the target, but since there was a 27% shortfall across the NHS as a whole, there was nothing exceptional about that. It also said that the hospital would need two more consultants before it could become a Level 2 unit again (it had been downgraded after the spike in deaths). It was not a glowing report by any means, but nor was it “damning”. Overall, it said that “circumstances on the unit were not materially different from those which might be found in many other neonatal units within the UK”.
According to the Guardian, ‘Lucy Letby’s so-called confessions were written on advice of counsellors’. This is a reference to Letby’s notorious scribblings, in which she wrote things like “I killed them on purpose” and “I am a horrible and evil person”. According to “sources close to the case”, these were written “after counselling sessions as part of a therapeutic process in which she was advised to write down her troubling thoughts and feelings.” The person who claimed this is anonymous (but easy to guess) and Letby has never said this herself (despite having every opportunity to do so), but let’s go with it. It is the kind of thing a counsellor would advise. The question is so what? It’s perfectly obvious that Letby was writing down her thoughts and feelings. Does it really make any difference if she wrote “I AM EVIL I DID THIS” because she was told to go home and write down what she was thinking? I cannot understand how anybody thinks this helps her cause.
In September, the Telegraph reported that a ‘Critical baby monitor at Lucy Letby hospital was broken during infant death spike’. This referred to a blood gas analyser on the ward that was “used to monitor the amount of oxygen and carbon dioxide in the blood and was ‘the first port of call’ for measuring blood glucose levels, according to the hospital risk register.” This machine was sometimes broken and would give inaccurate readings. Although Knapton said that this information came from ‘a leaked document’, it was not only mentioned in the original trial but was mentioned by Letby herself. Letby only mentioned it in passing, however, and did not suggest that it had any bearing on the case because nurses would simply use a different machine. Knapton’s article was later amended to acknowledge this:
CORRECTION: In an earlier version of this article it was incorrectly stated that the jury at Letby’s trial was not told about faulty equipment. In fact, in her evidence on 2 May 2023 Letby told the court that occasionally if the blood gas machine in the neonatal unit was broken, an alternative machine on the labour ward would be used. We are happy to correct the record
Dewi Evans changed his mind about the cause of death of Baby C. On the face of it, this is the only ‘revelation’ of recent months that could form the basis of an appeal. The case of Baby C was the weakest of the seven murder charges and, frankly, it is difficult to imagine the CPS prosecuting it in isolation. He was one of the few victims to live up to the sceptics’ caricature of the babies in the ward insofar as he was very small and born very premature. Back in 2017, Evans had said: “One may never know the cause of (his) collapse. He was at great risk of unexpected collapse.” Dr Bohin concluded that he had died from having air pumped into his stomach which splinted the diaphragm. Evans did not initially agree with this, but by the time of the trial, he concurred with Bohin. Then, in the witness box, he suddenly introduced air embolism as a possible cause of death.2 In interviews this year, he has said that air embolism is a far more likely cause of death for Baby C than air in the stomach (and, it seems, for Baby I and Baby P too).
Does Evans’ change of mind undermine confidence in the convictions? To some extent, it is bound to. If the evidence is consistent with air embolism but also consistent with splinting of the diaphragm due to air pumped into the stomach, people are entitled to ask how solid the evidence is and whether it is consistent with anything else, including natural causes. A further element of doubt is introduced by the suggestion that Bohin’s original diagnosis may have been influenced by an X-ray showing air in the stomach that was taken when Letby was not on duty.
It is, however, important to note that all of this information was available to the court at the time. As far as I can tell, the X-ray was not used as evidence against Letby and insofar as Evans changed his mind, he did so in court - not after the trial - and was pulled up on his apparent inconsistencies by Letby’s lawyer who accused him of making up theories on the hoof. Moreover, the judge told the jury that they did not need to be certain of the murder method in every case in order to convict.
I am no lawyer, but it seems to me vanishingly unlikely that any of this will be accepted as grounds for appeal, especially since Letby has already had two appeals turned down (and the reliability of Dr Evans as an expert witness was specifically raised in one of them). It is not really new evidence at all. The same is true of the claim made by Dr Taylor in the press conference that Baby O died of shock due to an unnecessary injection. Taylor spoke with great confidence and passion, but he admitted that he had not seen the medical records and was working from a report written by an expert who believed in Letby’s innocence long before she had seen the medical records herself (she appeared on a Channel 5 documentary earlier this year). Taylor seemed unaware that his theory was discussed at some length in the original trial and was rejected by the jury. Again, it is not new evidence.
What is considered admissible in the court of appeal is not necessarily what matters in the court of public opinion. If it achieved nothing else, the press conference fed doubts about Letby’s guilt among the public and that may come in handy if she is charged with more murders. She only needs 3 out of 12 jurors to believe that she has been framed.
Meanwhile, as Hayek said 50 years ago: “It is often difficult enough for the expert, and certainly in many instances impossible for the layman, to distinguish between legitimate and illegitimate claims advanced in the name of science.” I have no idea whether Taylor’s view of how Baby O died is more plausible or evidence-based than Dr Bohin’s view, and I doubt you do either. For those of us who are not medical experts and did not hear the competing theories tested in court, a lot of it comes down to trust. Sceptics will naturally tend to trust experts who come up with theories that exonerate Letby.
Evans has made himself available for interviews with many people since the trial, including those who believe in Letby’s innocence. This can be interpreted as a desire for candour and openness or as a sign that he loves the limelight. There is a suspicion that he gets a little too invested in whichever ‘side’ he is giving evidence for and has said that he is still sore over the one case he ‘lost’. This is not the language of an impartial witness. It should, however, be remembered that his interpretation of events was endorsed by the neonatologists Martin Ward Platt (who died in 2019) and Sandie Bohin, and that a range of other medical experts supported the prosecution case in court.
There is a constellation of circumstantial evidence to embroider the case, but at the heart of the matter is the science. It seems to me that undermining the scientific case that there was a murderer at the CoCH is Letby’s only conceivable path to freedom because if murders were committed, she is the only suspect. It is a very tall order, but I don’t object to people making the case and it is certainly preferable to the nonsense being talked about statistics when I first wrote about this. But as it stands, nothing has come to light that seems likely to get her an appeal, let alone win it.
PS. Mark McDonald’s track record of getting killer nurses out of prison is not exactly enviable. He has spent years appealing on behalf of Ben Geen. There are remarkable similarities between the Geen case and the Letby case. Like Letby, Geen was treating patients who were unwell but not at death’s door and yet they would suddenly collapse (in Geen’s case they were A & E patients). Like Letby, Geen is suspected of causing patients to collapse so that he could be the hero who helped them recover. As with Letby, nobody saw him directly causing harm. And, as in the Letby case, statisticians have raised objections that are irrelevant (the Court of Appeal said in 2009 that “the danger of approaching this particular case on the basis of academic statistical opinion, however distinguished, is [that it is] divorced from the actual facts”). A further similarity is that Geen seemed normal, as one of his colleagues explained recently in The Spectator.
The inquiry has produced a tonne of new information, including the fact that Letby “failed her final year student nurse placement because she was "cold" and lacking empathy with patients and families”. It also appears that the condolence card to the parents of Baby I that Letby wrote and photographed was never sent - or at least was never received - and that in contrast to Letby’s claim that she was close to the parents, her mother said: “We saw her around on the odd occasion, but we didn't have much to do with her. She was always the most reserved of the nurses. I remember thinking she seemed miserable compared to the others and I never saw her interact with parents much. Now I have seen the medical records, I am absolutely shocked at how much 'care' she provided to our baby. She is all over her notes. I have noticed a lot of the 'care' was when I wasn't present.”
This disagreement between Evans and Bohin rather undermines the sceptics’ claim that the medical experts rubber-stamped each others work.