Lucy Letby: Countess whistleblower calls on bosses to apologise

Dr Ravi Jayaram was one of the hospital staff members who became aware of the rise in sudden an unexpected collapses involving babies at the neonatal unit in 2015 and 2016, but police were not contacted until 2017.

Letby has now become the most convicted child killer in UK legal history, having been found guilty of murdering seven babies and attempting to murder six more at the Countess of Chester Hospital between June 2015 and June 2016, while working as a neonatal unit nurse.

Following the verdicts, in an emotionally charged statement on his Facebook page, Dr Jayaram said while he was "relieved" the criminal justice system had worked, there remained concerns about why it had taken so long for hospital bosses to take action.

He wrote: "My heart goes out to the families of the babies affected by this although nothing can ever undo the evil that was inflicted on their children.

"My colleagues and I have lived this for the last eight years and the period of the trial has been the most difficult part of this. I am proud of all the frontline colleagues with whom I work, for managing to carry on providing excellent care to babies and children under such pressure.

"There are bad people in all walks of life and many of them are very good at hiding in plain sight. There are also people in highly paid positions of responsibility in healthcare whose job it is to ensure patient safety.

"I am relieved that the often-maligned criminal justice system has worked properly this time. However, there are things that need to come out about why it took several months from concerns being raised to the top brass before any action was taken to protect babies, and why from that time it then took almost a year for those highly paid senior managers to allow the police to be involved.

"The truth of what happened during that time will shock you to the core as it comes out. The safety of patients should come above any risk of reputational damage and sometimes the right decisions might be difficult and unpopular, but executive level managers are paid to do just that.

"There are people out there now, still earning six figure sums of tax-payers money or retired with their gold-plated pensions, who need to stand up in public to explain why they did not want to listen and do the right thing, to acknowledge that their actions potentially facilitated a mass-murderer and to apologise to the families involved in all of this.

"However, I suspect the response will be fudge and misinformation and it is now my mission moving forwards to make sure that they are held to account.

"There is a long history of whistleblowers who raise concerns in the NHS not only being ignored but then being portrayed as the problem, sometimes to the point of their careers being destroyed.

"What happened here was history repeating itself but the patient safety issue that was ignored was beyond anything that the NHS has tried previously to cover up. There needs to be fundamental change in the culture and governance of NHS institutions and it should start right now."

Countess of Chester Hospital neonatal unit head consultant, Dr Stephen Brearey, first raised Letby’s association with an increase in baby collapses in June 2015.

He told the Guardian that deaths could arguably have been avoided from as early as February 2016 if executives had “responded appropriately” to an urgent meeting request from concerned doctors.

“Discussing with police at that stage would seem to be a sensible action to take,” he told the newspaper.

“If that had happened, it’s reasonable to conclude that [two] triplets, Child O and Child P would be alive today.”

Dr Brearey also told the BBC that he felt as though hospital management were “trying to engineer some sort of narrative or way out of this that didn’t involve going to the police”.

Detective Superintendent Paul Hughes, Cheshire Police senior investigating officer in Operation Hummingbird – the investigation into baby deaths and non-fatal collapses at the neonatal unit – said the doctors provided the catalyst for the investigation.

In an interview with the Standard, Det Supt Hughes praised senior consultants, Dr Stephen Brearey and Dr Ravi Jayaram, for being "brave" in coming forward with concerns over the relatively high number of unexplained and unexpected deaths and non-fatal collapses.

He said: "We met with Ravi and Stephen and they were great explaining to me what was the catalyst for our investigation, which was unexpected and unexplained.

"So, initially what we thought we were dealing with was a spike in numbers – when, in real terms, the spike was not important.

"Stephen particularly, I recall, explained to me that in neonatal medicine, albeit that the babies are young, they are expected to grow, and if – or when – a baby is going to die or collapse, it's expected and they've already told parents and processes are put in place, such as priests or vicars or blessings, all put in place because they know it's going to happen.

"Very, very rarely, they have an unexplained collapse which sometimes leads to death, and when that happens they are always able to explain why.

"He said in these cases it was unexpected and, looking further down the line, they are unable to explain why, and the build-up of unexpected and unexplained have led them to continue to ask questions."

Det Supt Hughes added he was asked to look at reviews which were carried out as part of the investigation.

He added: "Stephen and Ravi...have also been very brave in coming forward and they put this ahead of their careers, in my view, in doing what they've done.

"If it wasn't for their ongoing determination, you know, would there have been more [cases]? I don't know.

"They've done well and they explained it in very simple terms to me. That has been the golden thread of our investigation."

He added: "The consultants as a group of people say [in July 2016] something's wrong – and they were certainly right to trust their gut feelings around that, weren't they?

"I still don't think anybody actually believed that somebody had been killing and trying to kill infant babies."

Letby was moved to clerical duties after two triplet boys died under her care and another baby boy collapsed on three successive days in June 2016.

Three months later she learned of the allegations against her in a letter from the Royal College of Nursing union and registered a grievance against her employers.

It emerged during legal argument at Manchester Crown Court, in the absence of the jury, that the grievance procedure was resolved in Letby’s favour in December 2016.

However a number of consultants were also required to apologise to Letby formally in writing, the court heard.

The Government announced it is to hold an independent inquiry into the case.

Dr Nigel Scawn, medical director at the Countess of Chester Hospital, said on Friday: “Since Lucy Letby worked at our hospital, we have made significant changes to our services and I want to provide reassurance to every patient that may access our services that they can have confidence in the care that they will receive.”