Babies would have survived if hospital executives had acted earlier on concerns about the nurse Lucy Letby, a senior doctor who raised the alarm has said.
In an exclusive Guardian interview, Dr Stephen Brearey accused the Countess of Chester hospital trust of being “negligent” and failing to properly address concerns he and other doctors raised about Letby as she carried out her killings.
Brearey was the first to alert a hospital executive to the fact that Letby was present at unusual deaths and collapses of babies in June 2015.
The paediatrician and his consultant colleagues raised concerns multiple times over months before Letby, then 26, was finally removed from the neonatal unit in July 2016. The police were contacted almost a year later, in May 2017.
Speaking publicly for the first time, Brearey told the Guardian that executives should have contacted the police in February 2016 when he escalated concerns about Letby and asked for an urgent meeting.
Instead, he said, nothing was done other than to arrange another meeting three months later. “Discussing with police at that stage would seem to be a sensible action to take. If that had happened, it’s reasonable to conclude that [two] triplets, Child O and Child P, would be alive today,” he said.
Brearey was the lead clinician in the Chester hospital’s neonatal unit, where Letby murdered seven babies and attempted to murder another six in the year to June 2016, a court found.
She was found not guilty of two attempted murder counts. The jury could not reach verdicts on six further counts of attempted murder, relating to five babies.
Having given evidence several times in Letby’s trial, Brearey is now free to talk about the case for the first time.
Brearey, who still works on the neonatal unit, said executives were too quick to blame “failures outside the hospital” for the deaths of babies and should have launched a forensic review by February 2016 at the latest. That month he also requested an urgent meeting with executives, which did not happen until three months later.
By that time, five infants had died in unusual circumstances and Letby was known to be the only staff member who was present at every incident.
Letby was removed from the neonatal unit in early July 2016 when senior doctors demanded she be redeployed after the sudden and unexplained deaths of two triplet brothers within 24 hours of each other.
“You could argue all the events from May 2016 onwards were avoidable if they had acted appropriately,” Brearey said of executives at the trust. “If they had responded appropriately to the urgent meeting request in February 2016, then the same would be true from February 2016.”
Brearey said “things would have been different from October 2015” if the hospital had taken a “proactive” approach to the concerns.
Consultants raised concerns in October 2015 after the death of a four-week-old girl whom Letby murdered on her fourth attempt.
The infant was the fifth Letby killed in five months. She would go on to murder another two babies – two triplet brothers – and attempt to kill three more before she was eventually removed from the unit in early July 2016.
Brearey accused executives of “bullying” and “intimidating” senior doctors who raised concerns about the nurse and that it felt as if they were “treating us with as much suspicion as Lucy Letby”.
Brearey claimed there was an “anti-doctor agenda” among the trust’s senior leaders, most of whom had a nursing background. He said this partly led bosses to side with Letby instead of the consultants when they raised concerns from October 2015, because they treated it as “a case of doctors picking on a nurse”, Brearey said. “It just astonished me that attitude, which I think was shared with some [or] most of the execs.”
Executives commissioned two reviews into the neonatal unit in late 2016, one by the Royal College of Paediatrics and Child Health and another by an external independent neonatologist. However, neither was tasked with forensically examining potential causes of the rise in deaths or the suspected association with Letby.
The consultants were briefed on the results of these reviews at a “confrontational” board meeting in January 2017, when executives presented what was considered to be proof of Letby’s innocence.
One senior nurse read a statement from Letby in which she described how distressing the allegations had been. Brearey and his colleagues were ordered to apologise to the nurse and enter a mediation process with her, even though they felt their concerns about her harming babies had not been addressed.
He said: “We were all stunned. It’s still etched in everybody’s minds. It’s just the most horrific meeting I’m ever likely to attend really. We didn’t get into any sort of meaningful discussion with them, because it probably would have ended badly anyway. We all felt obviously very intimidated and bullied into agreeing to their demands.”
A second consultant paediatrician on the unit, Dr John Gibbs, told the Guardian that the hospital could have taken “more definitive action” by February 2016 at the latest.
Gibbs, who has now retired, said: “I think senior managers have to explain what they did and why they did it. Maybe they can justify it. I don’t know all the information they were receiving and how strongly they were being told that we consultants had it completely wrong.
“But in the end consultants are quite experienced. We are meant to be senior members in charge of patient care. We have ultimate responsibility for patient care, as well as the management, so if you’re not going to listen to the consultants, you’re in big trouble.”
Gibbs, who gave evidence 13 times during Letby’s trial, said he was “shell-shocked” by the January 2017 meeting. “To be told what the reviews showed without having seen them at all was a bit surprising, and then to be told we were to draw a line under the matter and that was it, and then to be instructed to send a letter of apology to Lucy Letby was just flabbergasting.”
Brearey said he was speaking publicly for the first time out of a “duty of candour” to the parents of the victims and the public.
He said some of the executives involved should be stripped of their “fat salaries” and “fat pensions” because of their “incompetence” in handling the matter. Senior executives at the hospital were earning salaries of more than £200,000 in 2018, according to public filings.
He added: “I’ll always look back on this and think: could I have done something sooner? Could I have pushed harder with the execs? Could I have gone knocking their door down to talk about these sort of things earlier in the year? And I suppose I have to live with those thoughts.
“But at the end of the day, I was doing what I felt was reasonable at the time. I thought some of their actions were a little neglectful – in fact, actually quite neglectful – in that time period, certainly in the six months from February  onwards.”
The Countess of Chester hospital trust said it was committed to ensuring lessons were learned. Its executive medical director, Dr Nigel Scawn, said: “Since Lucy Letby worked at our hospital, we have made significant changes to our services. I want to provide reassurance that every patient who accesses our services can have confidence in the care they will receive.
“And, most importantly, our thoughts are with all the families and loved ones at this very difficult time.”