The Thirlwall Inquiry, which has been ongoing for eleven weeks, recently reached what may be its most pivotal juncture. This inquiry is specifically investigating the tragic case of Lucy Letby, a nurse who was convicted for the murder of seven infants and the attempted murder of seven others while working in the neonatal unit at Countess of Chester Hospital during the years 2015 and 2016. The inquiry, named after its chair, Lady Justice Thirlwall, aims not to reassess Letby’s guilt or innocence but to delve into systemic failures within the hospital that permitted such atrocities to occur. More than a year has passed since Letby’s trial concluded, yet the wounds and questions surrounding the incident remain fresh.
In an effort to shed light on accountability, the inquiry convened at Liverpool Town Hall, where former nursing director Alison Kelly, medical director Ian Harvey, human resources director Sue Hodkinson, and chief executive Tony Chambers addressed the inquiry collectively for the first time. Unlike previous testimony from hospital consultants, these executives had not been called to testify during the criminal trials, nor had they participated in any media interviews, which allowed them to present new insights regarding the case.
During the initial proceedings, Lady Justice Thirlwall indicated that the inquiry would also contemplate the existence of potential corporate manslaughter charges against the hospital trust, which artfully shifted the focus towards systemic accountability rather than individual culpability. The executives, aware of the gravity of their situation, expressed remorse and offered condolences to the families who suffered unfathomably. Hodkinson addressed the audience, stating, “There isn’t a day that goes by that you’re not in my thoughts,” reflecting on the significance of those affected by Letby’s actions. Kelly, on the other hand, acknowledged the difficult decisions made at the time, albeit emphasizing that they were made with the best intentions.
As the inquiry unfolded, the focus turned closely to how hospital executives responded to concerns voiced by medical consultants about Letby’s conduct. A significant lag occurred between the alarming reports raised by doctors and the eventual removal of Letby from her duties. This period, stretching over months and culminating in the police becoming involved nearly a year later, raises critical questions regarding oversight and responsiveness within the hospital’s management system.
Executives were posed with challenging inquiries regarding failings and missed opportunities. Tony Chambers, during questioning, repeatedly hesitated to identify personal failings, only acknowledging collective issues rather than taking individual responsibility. Nicholas de la Poer KC, representing the inquiry, challenged him on this, prompting Chamber to concede that he bore accountability as the trust’s officer.
Further contentious discussions emerged regarding the nature of communications with affected families. Ian Harvey, the former medical director, acknowledged that he had previously sent out a letter in 2017 that was “crass, inappropriate… unthinking and insensitive.” His admission illuminated a failure to establish the kind of transparent communication that should have been paramount in such a delicate situation.
Perhaps the most intriguing development was the insight into the interactions between hospital managers and Letby. Kelly, while addressing her conduct during the grievance process that followed Letby’s initial removal from duty, accepted that her meetings with Letby constituted a conflict of interest. Chambers, recalling a personal meeting with Letby and her parents, reportedly reassured her, saying, “Don’t worry Lucy, we’ve got your back,” a statement that arguably reflects the inappropriate support the hospital extended towards an accused individual rather than focusing on safeguarding vulnerable infants.
An unsettling narrative emerged involving Letby’s father, who, following his daughter’s dismissal, reportedly pressured hospital executives, expressing his agitation and even threatening to escalate the matter to regulatory bodies. This incident raises profound questions about the environment cultivated within the hospital, as several managers faced scrutiny regarding their treatment of both consultants raising concerns and the accused nurse.
As the inquiry continues, the threads of systemic accountability interwoven with personal responsibility remain delicately balanced. The broad implications of this case will undoubtedly affect policies going forward. The inquiry’s future findings, anticipated in the form of Lady Justice Thirlwall’s report next autumn, hold the potential to usher in significant changes to protocols in neonatal care and hospital management, aimed at preventing such precipitated failures in the future.
