Culpability of consultants in Letby case

[curaçao]

Why did any of the 7 consultants who suspected Letby nit go to the police themselves? If you had strong suspicions that someone had committed murders, wouldn't you feel you had a strong moral duty to go to the police? OK maybe it was protocol to report it to managers, but surely they had a moral duty to whistleblow and report their suspicions to the police
But they are trying very hard to deflect blame onto managers who wouldn't even have known Letby nor understood the medical stuff

The consultants followed exactly what they were meant to do then went above and beyond to flag concerns. They were embarrassed, threatened and ignored by other clinicians who should have fully investigated. At least 2 children would be in school today if this had happened.

Although fundamentally there's only 1 person responsible. Would we be so keen to pass the blame if she wasn't a pretty blonde?

I thought they did go to the police? I must have misread

This is really lazy and I’m basically copying what I’ve said on other threads but I really think there needs to be more awareness of the utter failings of the GMC in this country and how it leads to more harm (both for doctors and for patients in the longterm). The GMC is not fit for purpose.

The whistleblowing consultants were threatened with a GMC referral. It’s clear from who has spoken out publicly that at least some of the doctors are BAME. The GMC has been found to be institutionally racist by the courts. There’s a low level of trust in the GMC from the profession in general but many of my BAME colleagues are (rightly) convinced that they would not get a fair hearing (and to make matters worse we pay 100s of pounds a year to the GMC for the privilege). It’s an entirely different ballgame of case but google Dr Arora for an example of how vindictive the GMC can be. Or Dr Sellu, Dr Day or Mr Karin. The suicide rates for doctors under investigation are shocking. I’ve read somewhere that the mortality of a GMC referral is the same as open heart surgery. The GMC is a very easy way for corrupt trusts to bully whistleblowing doctors into staying quiet. It’s also a very easy way for trusts to pin a failing system on an individual.

Besides, even if the consultants go directly to the police (and as paediatricians they likely know the local force relatively well due to child protection medical etc) what would happen? The police talk to the management who say this is a known problem of a group of doctors bullying a nurse. The clinical director has already investigated and found no evidence. The doctors have already apologised and we’re considering referral to the GMC. What overworked police force is going to have the time or justification to peruse it further? In fact by going to the police the doctors may well have signed their own warrant on there GMC referral and potentially end their career.

I’m sure those doctors will always be haunted by these events. I’m sure they’ll always regret doing more. That’s obvious from seeing the interviews they’ve given. But they are easily some of the least to blame in facilitating Letby’s crimes.

I agree.

What was the cause of death for these babies.
Was teh pathologist at the hospital - surely they would raise questions at so many deaths.

They did. It just took a long time

A lot were just unascertained which was another factor that caused concern. Babies went from being completely healthy to gravely unwell very quickly. It does happen but shouldn't have been happening that often. Usually when a small child dies it is not unexpected and the parents are aware of how unwell they are.

They were all men, right? Just saying…

This is the crux of it.
The GMC has become so weaponised against doctors in the past decade it is now leading to direct patient harm.
Simply being under investigation is so traumatic it leads to a dramatic increase in suicide rates. Is it any wonder the consultants wanted to avoid referral.

What would the police have done? They had no direct evidence she was doing anything. The drs told the trust who "investigated". Say they contact the police, they get in touch with management at the hospital who say "don't worry, we've investigated. The drs reporting have a vendetta against the nurse". The police say ok, well then you've investigated and found nothing, we trust your procedures. The dr then gets suspended/ sacked/ struck off and is unable to work again. Letby carries on.

You must be a hospital manager or similar. No-one in their right mind would think those that relentlessly pushed for an investigation into these deaths are culpable.

No one is passing the blame. Letby is guilty.

Management is also guilty of ignoring the Drs, threatening them etc.

Just like every other systemic failure (baby P etc) we have to look at what should have been different to avoid a repeat. (For what it's worth, sometimes feels like no lessons are learned)

There’s also a huge crisis in paediatric pathology - the BBC covered it recently. When giving a cause of death doctors are asked for the most likely (on the balance of probabilities) cause. It’s much more likely to expect something like NEC or the other pathologies premature/small babies are vulnerable to than murder. If the parents/doctors are content with the given cause then there may not have even been a post-mortem (and due to the staffing problems babies may have had to go to a mortuary far away which makes it even more difficult to spot patterns as it’s highly unlikely to be the same pathologist doing multiple PM’s from the same hospital).

Fuck me. Are you actually blaming other people for these babies dying?

If Management didn’t want to play ball with the police the initial investigation, the police wouldn’t have got anywhere either. The consultants would have been disciplined and she would still be working.

I am going to guess the consultants who had huge concerns and tries to do something, probably know more about how the NHS works and what options they had to them

The actual fuck has that got to do with anything?

Because you can't, there are guidelines and protocols that have to be adhered to. The consultants followed the procedures to the latter.

Remember they had suspicions but no hard and fast evidence, so they call the police, what do you think would have happened? Nothing, except the consultants would be up before the GMC quicker than you can say 'nefarious purposes'. Why would nothing happen? because again the police are also bound by protocols, they can't just march on to a ward, arrest someone on someone else's say so, and start investigations it doesn't work like that, and thank goodness it doesn't work like that.
Perhaps read the court transcripts (if you can stomach it) might give you a better understanding of what happened.
The parents where failed, but not because of the paediatricians or the other members of the nursing team. The parents where failed by those who refused to act once the whilst was blown, allowing Lucy to continue her heinous crimes.

As the senior managers at fault were all actual clinicians - director of nursing and medical director, and the CEO was also a clinician...then there is a structure for their professional bodies to take action.

I'm currently on secondment elsewhere but in my substantive role I'm a Clinical Director. I had no training to take up that post. It is only because of the support and experience of my non clinical colleagues that I didn't end up ignoring a patient safety issue myself. The director of nursing at my trust was known to never accept criticism about nursing staff and brushing off complaints. As a fairly new Clinical Director (title is misleading, I am more like the Clinical Lead of a specific unit) she saw me as an ally and hinted that if I didn't support her I would end up having nursing resource lost from my unit. It wasn't an empty threat as she had done that to another colleague. It was only when I mentioned it in passing to a non clinical senior manager that I realised what was happening. Action was taken and I basically pulled up my big girls pants and started doing my job properly.

As a pp said, nurses are put on a pedestal. Both within the health service and outside. And yes, as a Consultant it is frightening how much influence I have in that hospital, even when I'm talking absolute bollocks, or, in this case, perpetuating some dangerous practice.

I needed to have that experience to find some humility. I'd argue that many of my fellow consultants and senior nurses need to experience something similar.

What is apparent though is that already the narrative is management bad, clinician good....even when it is a clinician who was the murderer and clinicians who swept it under the carpet.

It's as though the 12 Recommendations from the Allitt Inquiry (Grantham) were completely unknown to the Nursing Managers at the Countess of Chester.

The main lesson from our Inquiry and our principal recommendation is that the Grantham disaster [Allitt] should serve to heighten awareness in all those caring for children of the possibility of malevolent intervention as a cause of unexplained clinical events. The report makes 12 detailed recommendations to tighten procedures to safeguard children in hospital. I have instructed immediate action to be taken on the 11 that are my responsibility. The Home Secretary has accepted the recommendation concerning coroners. (Statement in Parliament from the then Secretary of State for Health.)

One of those recommendations was that nursing staff can and should be closely monitored where any 'adverse events' involving children have been or are being observed in hospitals.

Another was about 'chain of command' and 'chain of communication' which the consultants may well have followed. We do not know, prior to the Letby Inquiry, the full details.

https://api.parliament.uk/historic-hansard/commons/1994/feb/11/beverly-allitt-report

Bullshit. Police are not answerable to hospital management.

Police have their own authority. You have no idea what the police would have done if 7 consultants had presented their concerns to them.

I think at all levels (registrars, consultants, nursing staff, hospital management, RCPCH and even the police) there was a genuine inability to believe it could be true. In every case there was a phase of rejection and a need for permission to think the unthinkable. I don't blame the consultants either for their initial inability to accept it or for becoming unsure when they reported the belief they had just come to terms with, and were met with disbelief.

I’m going to bite. I work in healthcare and I have concerns about a clinicians competency. I have raised these concerns over and over to senior managers. They do listen to me but as I am not a clinician myself my concerns are often dismissed or explained away. Although I know a few of my colleagues agree and are worried they are always shouted down. Even when we have had incident reviews looking at mistakes this person has made, they have not really highlighted the competency issues of this clinician specifically, now it’s being seen as a ‘witch hunt’ causing them stress so I am having to be careful what I say or do around this person and some of us have been alluded to being bullies. I wouldn’t let this person treat my family, they fob everyone off and refuse to make decisions passing work on to everyone else, very forgetful, repetitive, slow and they make mistakes. It’s only that everyone else and a robust system is propping them up and we are all vigilant that nothing more awful has happened but it’s the kind of thing that keeps me awake. They are all small errors or mistakes that in isolation aren’t terrible but there is a distinct escalating pattern and it’s worrying. I personally think this person should retire before something happens but they will not as they are money orientated.

This is not just about me losing my job, which would be terrible for me, I feel very stuck - perhaps I am biased against this person, you begin to doubt yourself. I don’t have anything ‘big’ to take to the GMC and it would be obvious it was someone internal. Maybe I am making something out of nothing. You can’t call the police on hunches alone if you don’t know if there is a crime. Management are meant to be there to be held accountable and manage risks. The management team failed these babies, and the doctors and nurses who raised the alarm. It appears they were worried about competency of LL not an intentional crime

Kindly, shut up.

Exactly this.

And the murderer is a woman who accused those men of bullying so what's your point?

People are passing the blame - on this it's on to the consultants who actually tried to do something. The actual murderer barely gets a mention