Lucy Letby - programme on ITV now

[Viviennemary]

I think this must be a new programme and not a repeat. Experts are being wheeled out to try and say Letby is innocent. I'm not convinced at all. None of them were even at the trial or worked with Letby. It's all theories and opinions..

Do you understand that it's not down to the expert witness to express his opinions now and the key point is the Defence did not ask him to testify for a reason which logically is either the case of his evidence was flawed, it could no longer support the case, was otherwise invalid or there was an element of discredit. There can virtually be no other reasons that I can think of and her Defence had a duty to act in her best interest and be truthful to the Court (overriding). Make of that what you wish.

The role of the Thirlwall inquiry is not to conduct a criminal investigation so naturally it will not decide on LL's guilt in respect of any baby deaths. It is also distressing to the parents, but the parents are an active part of it and they are legally represented with some spot on, crucial submissions from their legal teams which were not shouted about in a way LL's barrister does and which deserve far more attention.

The cramped conditions in the NICU were recognised by all concerned as a risk for infection. This was addressed only in July 2016, when they changed the number and spacing of the cots, at the same time as taking Letby off the wards.

I had to go around a NICU unit when pregnant in London, 1992, previous pregnancy lost, and it was just so reassuring. There's not a chance in Hell I would have been reassured in the CCOH after watching this documentary.

Did you mean to be so ridiculous?

But why was it accepting babies it clearly couldn't care for?

Okay. We know the expert witness was willing to testify. He has said so. So your theory, that he wasn't willing, doesn't hold water.

So an alternative is that the defence didn't want to call him. Okay. That agrees with several legal commentators. One explanation for that is that the defence witness wrote his reports to argue against the prosecution witnesses' reports, but the prosecution was allowed to change their story. Another is that the defence expert could not explain the insulin cases. That's cutting edge science. We saw in the documentary that researchers are working on that explanation now.

Thirlwall is not meant to decide about Letby's guilt, because it assumes she is guilty. The hearing is supposed to look for signs of guilt that were missed. That's what makes it an excellent resource for understanding whether such signs existed or (as in the case of Liverpool) not.

Because it's the NHS maternity unit, open your eyes. Nobody says they were an excellent unit and they clearly were far from it but likely had no other choice than to keep these babies in at the time probably due to lack of staff/space elsewhere. Obviously nor right. But another obvious point is that this was going on for years before LL, and yet significantly increased mortality rates followed LL.

I watched it yesterday... it clearly has heavy involvement from The Guardian Newspaper.

As someone who was a clinican in a hospital setting, I have always had my doubts about the claims made by the accusers in this case. None of the behaviour they have reported seemed a) out of the ordinary for a nurse or b) indicated malicous intent.

The lead medical expert who provided testimony, is confirmed to be a paediatrician not a neonatal-specialist, and Dr. Ravi testified that there woudl be no reason that a 25w preemie's tube would become disloged spontaneoulsy. I had very little experience in neo-nates and even I have witnessed that a couple of times.

These were very very neo-natal babies that required high levels of specialist care. On the unit I worked on they had 2x rounds a day caring for the same level of infants that were reported in the case. These babies are so premeture you can see through their skin to their organs.

The head nurse on the ward asked repeatedly to be allowed to close it to new admissions, but this wasn't always allowed.

There was some financial incentive to admit vulnerable children. I don't want to overstate this because I can't tell what part it played. But if you take, for example, baby G, who was born in Chester, she was transferred out for special care but Chester put pressure on the parents to agree to return there before she would normally have been cleared because of a cost to them.

I get the impression though that it was more a case of the doctors there not recognising their own limitations.

I never said the defence expert witness did not want to testify, I said they were not called, a fundamental difference.

The insulin cases according to the documentary were in no way groundbreaking as it's supposedly a known fact that babies' insulin levels can show as higher with no harm caused and for natural reasons - what point are you trying to make, which contradicts the programme we both watched?

The prosecution did not "change their story", what are you talking about here?

The Thirlwall inquiry does not decide on anybody's guilt, including LL's, and it does not start from the assumption she is guilty, it assumes there were issues at CoC that warrsnt an inquiry to improve standards of care and that's absolutely correct.

The hospital started taking a higher proportion of vulnerable babies (lower birth rate, more preterm) from April 2015, which coincides with the period when Letby was charged with murdering babies.

In 1992 I was led around a state of the art at that time NICU Unit, albeit The Royal Free.

The Chester NICU looked like something from the 70s. Seriously shocking. Plus I have read some Court reports and the babies and their families seem to come from lower income families

And this is relevant how...?

Relevant to what?

That's interesting, do you have a source for this, please? I'd be interested to find out more about this point.

I only ever read that CoC ceased looking after babies born pre-32 weeks gestation after the 2015/16 baby deaths imvolving LL, in July 2016, which implies provision of such care was not new at that unit only the year before, one of the sources is below:

www.theguardian.com/uk-news/2017/may/18/police-investigating-baby-deaths-at-countess-of-chester-hospital

To this case? This thread? Overall?

Sorry - you're not on top of the agreed facts here.

Thirlwall absolutely does work on the assumption that Letby is guilty. The whole point of the enquiry is to work out whether her crimes could have been prevented.

The prosecution certainly changed their story, that is to say, departed from the claims in the expert reports shared with the defence, several times during the trial. This was duly reported in the press at the time.

What the documentary showed us was researchers working on proving the rate of insulin clearance for a particular population of premature neonates - certainly groundbreaking.

And yes, you did start by saying that in your opinion, the defence witnesses did not want to testify - look back at your first post.

You have very strong opinions here it seems but you aren't getting the detail of your claims right

Proportion of more vulnerable children increased - they weren't new to the ward. And yes, stopped from July 2016.

Have a look at nurses' testimony at Thirlwall and at the hospital's preliminary investigation of the deaths (also Thirlwall) for both comments and numbers.

They were pretty unhappy with the state of the unit, to be fair. They were fundraising for a new one.

Relevant to the fact that the COCH was accepting very premature babies in a unit that was clearly unfit for purpose. Did you watch the documentary?

Are you for real?

Are you? Not even engaging in any conversation linked to you. Except for insults and Guardian links. Show some empathy.

I will look at that.

In terms of my first comment, it states correctly that the Defence did not call the witnesses and asks if the reason was they refused to testify. It's been clarified further down the thread that they did not refuse and I've elaborated on the point as to why, potentially, they were not called.

In relation to Thirlwall, technically you're not correct. It stems from LL's conviction, yes, but its purpose is not assessing criminal guilt but looking at CoC processes, it is clearly set out in its terms of reference:

^"The inquiry will investigate 3 broad areas:
A. The experiences of the Countess of Chester Hospital and other relevant NHS services, of all the parents of the babies named in the indictment.
B. The conduct of those working at the Countess of Chester Hospital, including the board, managers, doctors, nurses and midwives with regard to the actions of Lucy Letby while she was employed there as a neonatal nurse and subsequently, including:
(i) whether suspicions should have been raised earlier, whether Lucy Letby should have been suspended earlier and whether the police and other external bodies should have been informed sooner of suspicions about her
(ii) the responses to concerns raised about Lucy Letby from those with management responsibilities within the trust
(iii) whether the trust’s culture, management and governance structures and processes contributed to the failure to protect babies from Lucy Letby
C. The effectiveness of NHS management and governance structures and processes, external scrutiny and professional regulation in keeping babies in hospital safe and well looked after, whether changes are necessary and, if so, what they should be, including how accountability of senior managers should be strengthened. This section will include a consideration of NHS culture.
A non-exhaustive list of questions arising out of the terms of reference is set out in the annex."^

It's not the purpose of the inquiry to decide on anyone's guilt or innocence. LL's criminal liability has already been decided by the Court and the inquiry is not looking into this issue, it looks at how things worked at the CoC. Having said that, I understand what you are saying in that it 'assumes' her guilt, I mean, it's a legal fact, nothing to assume here.

To be clear I don’t know about LL guilt.

So much of the facts of this case have been obscured by the intense personalities involved that getting to provable facts have been difficult. Dr Ravi, Dr Wynne and the other Dr have all pinged my attention as well as her new Barrister. All of these people trade on their reputation first and are attracted to being the hero, rather than systematic procedure and due process.

I think she will eventually be found not at fault not because she may or may not have murdered neonates, because there simply is not a pattern of malicious behaviour that is provable beyond reasonable doubt.

Yes, we both agree that it's not Thirlwall's job to assess guilt. Thirlwall assumes Letby is guilty, as point B in your list (and Thirlwall's direct comments) show.

Hall - again, we seem to be on the same page now and to agree he was willing to testify.