The common theme of the murders committed by Lucy Letby, Beverley Allitt and Harold Shipman is the failure of colleagues to consider that someone in the caring profession could act with malice towards patients in their care (Lucy Letby joins grim list of Britain’s most notorious serial killers, 18 August).
Perhaps we should consider the contrary – that people with psychopathic traits would preferentially join these professions so as to be in a position to exert control and harm patients who are inevitably vulnerable.
One possible solution is to have effective surveillance of clinical practice. For instance, a record of all staff present at the death of patients would have picked up Shipman earlier, and it did raise concerns with Letby. The Francis inquiry into failings at Mid Staffordshire unfortunately did little in this regard, and the result is that further disasters will continue to happen.
Dr Chris Clough
Former medical director, King’s College hospital
• Part of the answer to Polly Toynbee’s yearning for a rational explanation of Lucy Letby’s murders (Faced with evil like Lucy Letby’s, we yearn for a rational explanation. Sometimes there is none, 18 August) can be gleaned from the parallels in the more than 200 murders carried out by the GP Harold Shipman.
Serial killers are facilitated by incompetent investigations. Getting away with the first murder, without it even being detected, creates a feeling of omnipotence and excitement. They also develop their skills to further avoid detection. That leads to the next, and the next. Shipman was only caught when he tried to gain financial benefit from his crimes. Letby would have carried on indefinitely if she had not been moved from the neonatal ward.
David Canter
Emeritus professor, University of Liverpool
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