No - when I say something is selective I mean that what has been quoted may be accurate in itself but isn't representative. That's why I linked to the full hearing.
As well as the full hearing, you have this correspondence with Ian Harvey at the time. It shows that once she had completed her review, Harvey told Hawdon about the consultants' suspicions. She reacted with the assumption that their professional pride was wounded, not that she would therefore change her views on standards of care and cause of death.
Hawdon to Harvey:
I perceive a combination of understandable professional pride regarding standards of care on the unit along with concern over unexpected and unexplained events, both of which are entirely reasonable reactions, but both of these should not prevent accepting and learning what could have been improved.
Unexpected collapse in an otherwise stable baby is rare and I agree that there have been more cases than would be expected, especially those for whom there is no explanation of the PM cause of death is in question. The paediatricians infer more cases that I did not study.
There were insufficient details in records, and unlikely to have been possible to record in anything but real time to determine for each whether collapse and impossible resuscitation:
a) purely out of the blue and unexplained
b) a slowly deteriorating baby eg infection, shallow breathing, but signs missed until baby collapsed and resuscitation too late or not optimal, even in a busy unit competent nursing and medical staff and systems should be in place to prevent the majority of such cases.
In some I did have concerns regarding escalation and timing. If subtle signs are missed or not escalated or responded too, in some cases alarms going off is too late. Sadly even alarms are missed or ignored on occasions, which is below an acceptable standard of care. If units are "running hot" there should be situational awareness that risk of these is greater and workforce and workload managed appropriately. So there may have been an inherent system or leadership problem before change in designation.
c) sinister cause, which seems to be the concern of paediatricians, this could range from a member of staff who for some reason was not spotting or escalating the babies in b to active harm
Hint — avoid use of term down-grade
Please let me know if you would like to talk on phone
How will you proceed?
Jane
https://thirlwall.public-inquiry.uk/evidence/inq0014376-pages-1-3-of-emails-between-ian-harvey-and-dr-hawdon-dated-14-02-2017/