Lucy Letby was likely to have harmed more babies than those she has been convicted of murdering on a hospital neonatal unit, a senior doctor has told a public inquiry.
Dr Stephen Brearey, a consultant paediatrician who raised concerns about the nurse, told the Thirlwall inquiry he believed Letby “didn’t start becoming a killer” in June 2015 and that she may have had earlier victims.
“The incidents occurring in the indictment period and before the indictment period were babies deteriorating that should have triggered an incident,” he said.
“On reflection it’s likely that Letby didn’t start becoming a killer in June 2015, or didn’t start harming babies in June 2015, and I think it’s likely that her actions prior to then changed what we perceived was abnormal.”
The inquiry, chaired by Lady Justice Thirlwall, is examining the events surrounding Letby’s conviction for murdering seven babies and attempting to murder seven others in the year from June 2015 at the Countess of Chester hospital in north-west England.
Brearey, the neonatal unit’s lead clinician at the time, was asked to clarify whether he believed that babies were murdered or harmed by Letby at the hospital before June 2015.
“I think that’s likely, yes,” he said.
Brearey said no one had suspicions prior to this date that Letby was interfering with newborns but there were now a number of cases that “appear suspicious”.
Asked by Peter Skelton KC, who is representing the parents of seven of Letby’s victims, to explain whether any consultant colleagues had concerns about the nurse before June 2016, Brearey said: “At the time we just thought we were going through a busy patch.”
He added: “If we had a thermostat for the level of work and number of events that we can’t quite understand, I think it was turned up over those years.
“So our perception of what is normal for a neonatal unit in terms of number of collapses you might expect in a week, a month, or a year had changed.”
Brearey was asked how he handled concerns raised by junior doctors about the unusual nature of the deaths of three of Letby’s victims, who died over a two-week period in June 2015.
The three deaths, and a fourth baby who survived, prompted a review by Brearey and the neonatal unit manager, Eirian Powell, into whether they were linked.
The review ruled out a number of potential common factors but found that Letby was the only member of nursing staff on duty for each one, the inquiry has heard.
Brearey said Powell raised Letby’s association with the four incidents at the end of a meeting on 2 July 2015 and he responded: “Oh no. Not Lucy, not nice Lucy.”
Asked by Rachel Langdale KC, counsel to the inquiry, why he said “oh no” when Letby’s name was mentioned, Brearey said: “Some part of my mind was thinking the worst really.”
Asked to clarify whether in that first meeting – a year before Letby was removed from the unit – there had been “suspicion and concern” about a staff member harming babies, Brearey said: “I don’t think suspicion would be the right word at that time but concern, yes.”
Langdale then asked: “Your mind jumped to something at the time, didn’t it?”
Brearey replied: “The concern that someone might be harming babies.”
It was another year before Letby was removed from the neonatal unit, in early July 2016, after she had murdered another four babies and attempted to kill another six.
She was moved to a clerical role in the hospital’s risk and patient safety department, where she remained until her arrest in July 2018, more than three years after her killing spree began.
Brearey, who still works on the neonatal unit at the Countess of Chester hospital, began his evidence by apologising to the families of the babies who died.
He said: “Sorry. Sorry for my part in not being able to protect your babies. I can just say that I tried my best and I acknowledge that at times my best was not enough. This apology is to parents of babies on the indictment but also parents of babies that are involved in the ongoing police investigation. I hope you all get the justice you deserve.”
Letby, now 34, is serving 15 whole-life prison terms. She maintains her innocence and her legal team is understood to be planning a legal challenge to the Criminal Cases Review Commission.
The inquiry continues.
