The blurb for the latest in a long and growing line of documentaries on Lucy Letby (this one is entitled The Investigation of Lucy Letby and was released on Netflix last week) describes it as an insight into how “the horror unfolded”.
It’s not clear if the “horror” relates to the murder of seven babies and the attempted murder of seven others in the Countess of Chester Hospital in 2015-2016, for which Letby was convicted and is serving 15 whole-life terms. Or if it relates to the wrongful conviction of Letby, or to the ongoing horror experienced by the babies’ parents.
Legitimate reservations have been expressed about how this Netflix documentary was made, particularly the sensationalist use of police arrest and interview video recordings. But the substance of it and the other evidence that has emerged convinces me, as the former master of a busy Dublin maternity hospital, that there are compelling grounds to believe Letby is innocent. A year ago, writing in these pages, I said “may be”. Now I have no doubts.
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Last month, Action Aid Ireland published a new report highlighting the challenges that lone migrant parents, mainly women, experience when they leave state accommodation. Many face discrimination, unaffordable rents and inadequate supports. But first, Irish Times opinion editor Jennifer O’Connell is here to discuss some of the biggest stories of the week including the latest tranche of Epstein files released last Friday and a new Netflix documentary which questions the guilt of the UK’s “most prolific child killer” Lucy Letby.
The most startling revelations in the documentary relate to the prosecution’s chief independent medical expert witness who, on reading a newspaper report about an investigation into suspicious deaths of babies in a neonatal unit, volunteered his services. Having examined 32 cases of acute deterioration in this unit, this expert quickly found enough evidence “in about half of these” to believe that someone was trying to kill these babies. Based on his interpretation of tissue discolouration noted in some of the babies, and quoting a published scientific paper, this expert concluded that air had been injected (“air embolism”) deliberately into the bloodstream of some of the babies. The hunt for a killer was now on. Suddenly, other causes of deliberate harm were being identified: lethal doses of air injected into babies’ stomachs, babies dangerously overfed, lethal doses of insulin injected into intravenous fluid bags, a purposely dislodged breathing tube. It is still difficult to understand why Letby’s defence team did not call on an expert medical witness to challenge these assertions.
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The evidence compiled against her included duty rosters; ward hand-over lists which had been taken home and her so-called confessional diary entries and Post-it notes, which were written in response to occupational health counselling during the investigation. Perhaps most “damning” in the public mind was her blank demeanour in court.
Letby’s new barrister Mark McDonald is highly critical of the expert medical evidence used to convict his client. Firstly, the author of the scientific paper on air embolism claims that his work was misinterpreted and that there was no evidence of air embolism in any of the cases.
In 2025, an independent panel of 14 experts concluded, having examined all the cases: “We did not find any murders. In all cases death or injury were due to natural causes or just bad medical care.” However, the prosecution’s chief medical expert witness stands by his testimony in court.
So if Letby’s conviction is unsafe, what alternative explanation might there be for the deaths of those seven babies? What else might have gone so catastrophically wrong? And are there lessons for other maternity hospitals, including in Ireland?
Understaffing, poor support of junior staff and toxic interpersonal relations were also cited by one of Letby’s former colleagues as complicating factors.
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The testimony of a mother of one of the babies who died for me highlights the problems in the hospital at the time. In labour for hours with prolonged, premature rupture of the membranes and knowing that things were “not right,” she had to “insist” on having a Caesarean section. She was then reassured that the baby was doing well – until she was rushed to the baby unit to find her baby being resuscitated and ultimately dying. The international panel of experts concluded that this baby died from sepsis. Neither the mother nor the baby had been given antibiotics in time. To me, this represents a serious error of clinical judgment.
There were other red flags that were overlooked. In 2015 and 2016, the neonatal unit in the Countess of Chester Hospital accepted babies of 27 weeks and over – yet only one of the seven paediatric consultants was a specialist in neonatology. It would be expected that any paediatric consultant looking after babies this premature should have specialist training.
Six of the seven babies who died in the Letby case were premature, three weighing less than 3lbs. In a well-functioning maternity hospital, what happened to these babies could most likely have been avoided.
After Letby was taken off the roster, the death rate fell. This was presented as evidence against her; however, at the same time, the unit changed its admission policy to accepting only babies of 32 weeks and over.
After Letby’s conviction, a review of 4,000 admissions of babies was undertaken and additional cases of suspected murder and attempted murder by Letby were referred to the Crown Prosecution Service (CPS). Last month the CPS confirmed that it would not be bringing any further charges against her.
Former UK health secretary Sir Jeremy Hunt said that the increase in deaths and serious incidents in babies in the Countess of Chester Hospital may well be part of a nationwide crisis in the British maternity services.
Meanwhile, a coroner’s inquest into the deaths of five babies “murdered” by Letby has just opened and been adjourned to September. The report of the Thirlwall inquiry into how Letby was able to “murder and injure” babies has not been released yet. Letby’s case is also still under consideration by the Criminal Cases Review Commission.
There are important clinical lessons to be learned from the Letby case, particularly for smaller units struggling to look after complex patients who should be referred to bigger units. There are also lessons for the courts about how independent expert witnesses are used (or not used) – and for the police and media.
If this case ever goes to retrial, I believe that Letby will be found not guilty. The sooner this happens, the better.
Chris Fitzpatrick is a clinical professor in UCD’s School of Medicine and a former master of the Coombe Hospital, Dublin. He is retired from clinical practice and these are his personal views.
