The Lucy Letby case and how the hospital dealt with it

[brad465]

Whole life sentence given.

https://www.bbc.co.uk/news/live/uk-66551231

Letby receives whole life sentence - meaning she will never be released​

Justice Goss has just given Lucy Letby a whole life sentence for the murder of seven babies, and the attempted murder of six more.
This means she will never be released from prison.

 

[transportphoto]

Justice Goff quoted to say "I sentence you to prison for life. I direct that the early release provisions do not apply. A whole life order on every offence and you will spend the rest of your life in prison." as part of his sentencing.

Am I correct in the understanding that if the defence were to appeal, they'd have to appeal each of the thirteen whole-life-orders successfully to be able to determine an early release provision to apply?

Either way, the years are likely to be somewhat grim for Letby - deservedly so.

 

[AlterEgo]

She’s a weak and sad person who will turn into a husk of a person in prison, so there’s some good news for everyone.

 

[Cowley]

Access control is a good point - this already happens on maternity wards (or should do).

Cameras might provide evidence of 'gross' violence such as blunt force or stabbing but I don't think they would detect something as subtle as poisoning. For example in a routine blood test, the nurse is using sample tubes labelled with text about 2mm high and a tiny needle. You would have to have a high definition camera very close to the patient and even then the movement of the action might not result in clear footage.

I guess it could have shown up the rapid health decline in the babies after she’d injected them with air/insulin etc though?

There was also one case where her clocking on didn’t quite match up with attack that CCTV would have been able to prove for certain.

She’s a weak and sad person who will turn into a husk of a person in prison, so there’s some good news for everyone.

I thought the way she tried to control certain things in the courtroom was quite telling as well.

 

[brad465]

She’s a weak and sad person who will turn into a husk of a person in prison, so there’s some good news for everyone.

This is what those demanding the return of the death penalty for the likes of her fail to understand, there are situations where the death penalty is a relative reward.

 

[adc82140]

This is what those demanding the return of the death penalty for the likes of her fail to understand, there are situations where the death penalty is a relative reward.

My feelings exactly. Let her stew for decades in prison. I doubt any of the other inmates will want anything to do with her, so it'll be a lonely existence.

 

[trebor79]

This is what those demanding the return of the death penalty for the likes of her fail to understand, there are situations where the death penalty is a relative reward.

My feelings exactly. Let her stew for decades in prison. I doubt any of the other inmates will want anything to do with her, so it'll be a lonely existence.

Mixed views here, I'd support death penalty for cases like this. But prison does at least afford some opportunity for psychological assessment and learning so that some future event of a similar nature may be averted. I doubt she will ever reveal her motivation, in fact I wouldn't be surprised if she doesn't fully understand herself why she's done this. The whole thing is tragic really for everyone involved.

 

[birchesgreen]

My feelings exactly. Let her stew for decades in prison. I doubt any of the other inmates will want anything to do with her, so it'll be a lonely existence.

Well some inmates might want to do something with her... something pretty violent.

 

[61653 HTAFC]

Well some inmates might want to do something with her... something pretty violent.

Quite. I hope that whichever prison she is sent to, she's watched extremely closely and nothing she could use to harm herself is ever allowed within fifty feet of her. Hopefully she'll rot for decades thinking about what she's done. For a case like this, the death penalty would be a mercy she doesn't deserve.

 

[fandroid]

My own puzzlement in this is why didn't the occurrence of four sudden collapses (3 died) in babies' health in two weeks trigger alarm bells everywhere in the hospital. That rate was worse than expected in a whole year. My memory is fading a bit of my time as a Trust Governor but I have a feeling that someone would compile the stats on a monthly basis and then put it in a report for the board and the governing body. By which time only the pedantic report reader would spot it and question it. Luckily we did have a few of those at UCLH, but that wouldn't have been quick enough.

It really should have triggered alarms right up to chief exec level. As it was, Nurse Letby, in what now looks like a fairly carefree fashion, carried on killing more babies.

Taking her off the ward should have been recognised as appropriate action, even by her, without, at that point actually apportioning blame. If that meant staff levels dropped too low, then the hospital had to bite the bullet and to transfer sick babies away and cut the number of births they were prepared to handle. That drastic measure has happened at various hospitals in recent years, so is not an outrageous thing to contemplate

 

[Pete_uk]

She’s a weak and sad person who will turn into a husk of a person in prison, so there’s some good news for everyone.

What's not as sad as the suffering she put the babies and families through is the fact that she could have had a great life ahead of her.

Now as you say, a lonely future of watching her back awaits.

 

[Enthusiast]

It really should have triggered alarms right up to chief exec level.

It did. Unfortunately the Chief Exec. was reluctant to involve the police for reasons best known to him. He preferred to "draw a line" under the matter, following a meagre investigation. So keen was he to do this that he ordered the consultants who raised their concerns to write a letter of apology to Ms Letby for any distress she may have been caused by the Trust's investigation.

 

[mac]

While I'm glad she's got what she deserves I've a couple of things I don't understand if the evidence against her was so good why did it take 7 months to give it to the court and then why did the jury take 3 months to find her guilty but only on 7 babies but not the others

 

[Mogster]

It did. Unfortunately the Chief Exec. was reluctant to involve the police for reasons best known to him. He preferred to "draw a line" under the matter, following a meagre investigation. So keen was he to do this that he ordered the consultants who raised their concerns to write a letter of apology to Ms Letby for any distress she may have been caused by the Trust's investigation.

Letby was clearly an intelligent and highly manipulative individual.

However the senior management got this situation very very wrong. People are happy to take up these £250k posts, oddly they then seem surprised when they are required to make critical decisions. They appear even more surprised when they find out they will be held personally accountable if those decisions turn out to be wrong. What do they expect? What do these grifters think the NHS is paying them £250k pa for???

 

[transportphoto]

why did the jury take 3 months to find her guilty but only on 7 babies but not the others

The Jury would have had to feel that there was proof beyond reasonable doubt for each of the charges. I can’t remember whether majority verdicts were allowed in this case.

I seem to recall the jury took twenty-two days to consider their verdicts and that this was broadly equivalent to one day per charge.

If the jury had reasonable doubt, or couldn’t come to a verdict, they wouldn’t be able to return on that charge - this obviously being an issue for the handful of charges not sentenced.

Edit - a jury finding reasonable doubt would likely mean a not guilty verdict.

 

[SteveM70]

Also the deliberation process will have been somewhat slowed by the fact that the evidence for each charge was broadly similar but subtly different to each of the others, so they’ll have had to spend time checking information and ensuring they get each one right

 

[Brush 4]

Life is definitely a worse outcome than the death penalty and therefore appropriate. In the criminal hierarchy of crimes, anything involving children or babies is the worst for both men and women, possibly worse for women locked up in a prison full of them, some of them mothers. Starting tonight, right now, and for the next 40-50 years, Letby will face shouted threats from other cells about what they will do to her given half a chance. Going out for communal activities will be fraught with danger and fear. Some wardens may 'look the other way'. She can never relax or sleep until exhaustion takes over.. That is a far worse punishment than the release of death. Ian Huntley of the Soham murders has had his neck slashed and face scalded by boiling water, so far......

 

[Cowley]

Also the deliberation process will have been somewhat slowed by the fact that the evidence for each charge was broadly similar but subtly different to each of the others, so they’ll have had to spend time checking information and ensuring they get each one right

It was an incredibly complex case and I’ve been following it quite closely these past few months. I’m not surprised that it took so long really.

The Jury would have had to feel that there was proof beyond reasonable doubt for each of the charges. I can’t remember whether majority verdicts were allowed in this case.

If I remember correctly one of the jurors had to leave a few weeks ago for either personal or health reasons. The judge then said that he would accept a verdict of 10 to 1, obviously he wanted as little ambiguity as possible from the jury with this case and the prosecution/police etc have done a good job with what they had.

 

[Ianigsy]

Why single out the NHS? Managerial, and administrative, incompetence seems to pervade throughout life at the moment, both in the public and private sector.


Why is it extraordinary? There may well be 'criminal negligence' in this case, but likely as not it may not be quite so straightforward. Yes, the talent pool is probably fairly small, and the threat of criminal prosecutions will likely make it even smaller.

If there wasn't chief exec., board ,senior management layers, comms departments etc, their work would fall on medical staff , who really are better doctoring, surgeoning, nursing etc rather than dealing with finances, press and public enquiries, administration, discipline etc.

Ironically it looks as if the increasing professionalisation of management is creating a culture of running organisations by spreadsheet and promoting managers who don’t understand what it is their staff actually do, so there’s no trust on either side. There are times when I’ve had to explain why a particular file hasn’t been worked yet, and the answer is often that in order for me to do my job in Leeds, I need an original document to make its way down from Glasgow and the customer’s file from Newcastle.

 

[MotCO]

Public industry management structures often seems to resemble the civil service model.
1. We always need "x" numbers of management level, each managing about "n" numbers of staff.
2. We have always done things this way, so why change.
3. Do not dare to criticise "the system" - otherwise your career prospects are dim.
4. Staff promotion / selection boards tend to favour "people who fit our own image", sometimes in preference to those best fitted for the job.

We have seen time after time that parts of the senior civil service are clueless when it comes to some aspects of business, e.g. defence contracts, national IT systems for the NHS, etc., etc.

I have spent a lifetime working in the NHS at various levels, and I can agree with a lot of what you are saying. I also think that there are three types of manager:

1. The 'yes' men and women. They are in it for themselves and want to get to the top. They don't won't to upset their managers, so will toe the party line and say and do what is necessary to advance their career.
2. The '9 - 5 ers'. They will just do their shift and that's it. They are all for a quiet and easy life.
3. The ones that do care and want to make a difference. They may find career advancement slow, but they will get a sense of achievement and job satisfaction.

With regard to the Letby case, I can understand why they (mostly types 1 and 2 above) want to sweep it under the carpet and keep it quiet. What should have happened is that abnormal events (such as high death rates) in a department should be flagged and investigated. This could be due to surgical malpractice, wilful murder, equipment failure, unsafe procedures etc. Everything should be one to reduce the abnormal events, whether this means rooting out poor clinicians to retrain or leave, or calling in the police as in the Letby case. It may not all be sinister; one incident was found to be that the oxygen and anaesthetic pipes in an operating theatre had fallen out and were replaced by a cleaner, unfortunately the wrong way round; the answer was to change the thickness of one of the pipes so that such an incident could not recur.

 

[AndrewE]

What struck me about this case is the level of antagonism between the medical staff and the "management" and how that reminds me of the Stafford scandal, where administrators had a different agenda to the ones who had taken the Hippocratic oath: https://en.wikipedia.org/wiki/Stafford_Hospital_scandal

Press reports suggested that because of the substandard care between 400 and 1,200 more patients died between 2005 and 2008 than would have been expected for the type of hospital,[3][4] based on figures from a mortality model, but the final Healthcare Commission report concluded that it would be misleading to link the inadequate care to a specific number or range of numbers of deaths.[5][6]

The Healthcare Commission criticised the foundation trust board, which was led by chief executive Mr Yeates and chairman Ms Brisby, for holding in camera board meetings and "for making cutbacks to staffing and services in order to make millions of pounds' worth of surplus at the end of each year," because "bosses focused on the Trust achieving millions of pounds surpluses over a three year period, in order to gain Foundation status",

 

[Busaholic]

Unnecessary deaths in the NHS, if not murders, are nothing new, sadly. My older brother, aged 5, died in a small NHS hospital in 1951, bleeding to death on the evening of his Friday operation to remove his tonsils, the only staff member present being a 17 year old trainee nurse as her supervisor had gone on a break and no doctors were there overnight. I was only two, nearly three, but my mother never recovered from his death and it seemed to precipitate a couple of medical conditions which then blighted her remaining not-so-long life.

Lucy Letby is pure evil, and I'd put her on a level with Myra Hindley, another to be given (eventually) a whole life tariff. She will though, I am sure, be kept out of the clutches of other prisoners for the foreseeable future, misguided though some may find that prospect.

 

[61653 HTAFC]

Life is definitely a worse outcome than the death penalty and therefore appropriate. In the criminal hierarchy of crimes, anything involving children or babies is the worst for both men and women, possibly worse for women locked up in a prison full of them, some of them mothers. Starting tonight, right now, and for the next 40-50 years, Letby will face shouted threats from other cells about what they will do to her given half a chance. Going out for communal activities will be fraught with danger and fear. Some wardens may 'look the other way'. She can never relax or sleep until exhaustion takes over.. That is a far worse punishment than the release of death. Ian Huntley of the Soham murders has had his neck slashed and face scalded by boiling water, so far......

This was the reasoning behind my comment that she needs to be watched extremely closely in prison. Not only because she'll inevitably have a target on her back, but because she may try to "take the easy way out" if given the opportunity. I've seen comments from the parents of one of the victims hoping she has a long and miserable life in prison, and that's my position too. If another inmate decides to do something drastic to boost their standing with their fellow inmates, they'd be doing Letby a favour by going a bit too far.

I understand the concerns over privacy but in my opinion the benefits outweighs the drawbacks.

If a consultation which is supposed to be confidential might be recorded, many people (myself included) would think twice about speaking to a doctor about certain health concerns. Doctors do in fact often make fun of patients with "embarrassing ailments" among themselves, as a way of letting off steam and dealing with stress. When it's just stories that doesn't bother me so much, but if there was also video footage or audio it would become a very different animal. Particularly if it were to leak.

 

[SuperNova]

I do feel that this "Church of the NHS" hero worship we've endured in recent years is partly responsible. People start to believe their own hype.

What an utterly bizarre comment.

Maybe if senior managers had listened to their professionals they’d have acted. An act that can be seen in almost every line of work every day.

 

[GusB]

The whistle was blown and it was ignored by the senior management at the time. To then insist that a line is drawn and to threaten the whistleblowers is utterly unacceptable; to make them apologise for doing the right thing is downright disgusting. Those at the top need to be brought to account for this.

On my next point, I'm rather torn; should those whistleblowers have defied their bosses' instructions and gone to the police regardless? I can understand the reluctance to do so; the threat of not being able work again in your chosen profession isn't something to be taken lightly, though.

As for Letby, she's in for an absolutely horrible time in jail. Other prisoners will be doing their utmost to get to her and I honestly can't see her getting much sympathy from staff. She will be forever looking over her shoulder.

 

[adc82140]

What an utterly bizarre comment.

Maybe if senior managers had listened to their professionals they’d have acted. An act that can be seen in almost every line of work every day.

Not bizarre in the slightest. The attitude that the NHS can do no wrong leads managers to become complacent.

 

[SuperNova]

Not bizarre in the slightest. The attitude that the NHS can do no wrong leads managers to become complacent.

That’s your perception.

 

[WelshBluebird]

What struck me about this case is the level of antagonism between the medical staff and the "management" and how that reminds me of the Stafford scandal, where administrators had a different agenda to the ones who had taken the Hippocratic oath: https://en.wikipedia.org/wiki/Stafford_Hospital_scandal

Of course, the issue with these kind of things is that it can be easy to point the blame in one place, rather than actually identify what happened and why.

In that specific example, whilst yes the management were obviously at fault, you also have to ask why they felt they needed to cut care like that in order to achieve Foundation status? The ins and outs of NHS management isn't something I know a lot about admittedly but from that link at least it sounds like there was a degree of pressure from government to reach that status, and so governments who pushed that also share part of the blame surely!

To bring it back on topic, whilst yes obviously the management should have listened to the doctors who were raised warnings, I wonder what pressure that management is under when it comes to reporting these kind of issues and if there are "benefits" for a hospital / trust to be seen as good, and "punishments" for being seen as bad. Targets and pressure to meet them can be a good thing, but they can also pressure staff to hide the bad things.

 

[Parjon]

What struck me about this case is the level of antagonism between the medical staff and the "management" and how that reminds me of the Stafford scandal, where administrators had a different agenda to the ones who had taken the Hippocratic oath: https://en.wikipedia.org/wiki/Stafford_Hospital_scandal

Indeed. And how many went to prison for the 400-1200 deaths that occurred at mid staffs...

I have no doubt in my mind that staffing costs in the NHS would plummet if people were actually held to account for what they do, don't do, get in the way off, cause or ignore. The parasites that bleed the system dry and provide no value at all would have nothing to do with such personal responsibility.

 

[trebor79]

One thing that really puzzles me. At the trial it was stated that she killed the first baby by injecting air into the veinous system. That could only have been determined by post-mortem examination, not years later when a criminal investigation started.
So if that was known at the time, why wasn't it immediately obvious that there had been a deliberate act that had led to that death and an investigation started then?