Grief can be an unspeakably intimate thing.
To be with a parent in the immediate aftermath of losing their child is to see them at their most utterly vulnerable; broken, and undone. But families trusted Lucy Letby, the intensive care nurse who seemingly cared so diligently for their sick babies, to be with them through the worst. She sobbed with the unsuspecting parents of the newborns she had secretly murdered in their hospital cots, helped them take hand and footprints as keepsakes or bathe a tiny lifeless body one last time. Sometimes, months later, she would ghoulishly trawl their Facebook accounts as if hungry for more.
One mother, whose son was four days old when Letby killed him, wrote in her victim impact statement that it felt like something from a horror story to learn that his murderer had actively watched the family grieve. But Letby herself wasn’t present to hear those words. Having gorged on the parents’ suffering, she denied them even the meagre satisfaction of seeing justice finally catch her up, refusing to attend court for sentencing. Instead she absorbed the news that she would die in prison privately, in her cell.
Nor did she offer the families any answers as to why she killed and maimed their babies, seemingly with such casualness that nobody close to her noticed anything seriously amiss. “Work has been shite but … I’ve just won £135 on the Grand National!!” she texted a friend, hours after trying to murder twins, adding a cheery horse emoji. The nearest thing to a confession was a series of ambiguous notes found by police, in which she wrote that she had killed babies because she wasn’t “good enough” and felt she would never be able to have a family of her own. By murdering other women’s children, was she trying somehow to deprive them of what she felt she couldn’t have herself? Or was she simply addicted to the attention, the drama, the intense emotions surging through a neonatal unit when a baby suddenly collapses? As the judge noted, only Letby really knows why she did it. But the more urgent question facing a public inquiry is how she got away with it for so long.
Time after time, official inquiries into NHS disasters identify a history of lone whistleblowers repeatedly trying and failing to raise the alarm, while management tries frantically to avoid a scandal. At first glance, the Countess of Chester hospital’s response to a puzzling cluster of deaths in its neonatal unit seems to fit that grimly familiar pattern. Two paediatricians, Stephen Brearey and Ravi Jayaram, made heroic efforts to warn that the ward might have a killer in its midst, but were seemingly met with disbelief from hospital executives. Yet trying to make sense of the Letby case by slotting it into a familiar, well-worn groove risks falling into the same fatal trap the trust apparently did. What matters about this case is the ways in which it doesn’t fit the usual pattern trusts have learned to look for, and even sometimes confounds it.
This isn’t the age-old story of doctors closing ranks around an incompetent colleague, or some godlike consultant escaping scrutiny because no junior is permitted to question the great man’s methods. If anything, it’s the opposite: a young nurse who, when senior doctors identified her as the common link in a series of unexpected baby deaths and pushed for an investigation, responded by brazenly accusing them of bullying her. Unbelievably, the hospital’s ensuing grievance inquiry not only concluded there were no grounds for involving the police, but accused the doctors of making Letby feel “isolated and vulnerable” by voicing suspicions. Brearey and Jayaram were allegedly advised to write grovelling letters of apology to a woman we now know was a murderer.
If Letby escaped detection for so long partly because she didn’t look like most people’s idea of a serial killer – so “beige” and “vanilla”, as one detective put it, with her Zumba classes and Ibiza holidays and bedroom decorated with soft toys – it’s perhaps equally significant that she did look like many people’s idea of a victim.
The story she spun of a young woman pushed around and picked on is certainly common enough, not just in the NHS, to sound superficially convincing. At the time, hospitals were being rightly urged to take workplace bullying seriously, with inquiries into previous scandals identifying it as an aggravating factor. And poor care is an infinitely more common cause of death in hospitals than serial killers.
What the inquiry must explore, however, is why the hospital seemingly found it easier to believe in poor Lucy, the fictitious victim of doctors supposedly seeking a scapegoat, than in the rare but horrific scenario advanced by their consultants. Were they seeing what they wanted to see, avoiding a police investigation that would panic parents and potentially destroy the trust’s reputation? Or were they simply seeing what they expected to see, a cautionary lesson for anyone with a tendency to interpret any set of facts through the prism of their own fixed views?
Given what the trial uncovered, families are right to demand a judge-led inquiry capable of compelling witnesses to testify, not the more toothless version initially offered by ministers. But it’s equally important that it be led by someone with an open mind, informed but not blinkered by past experience or expectations. For the families who suffered so grievously at Letby’s hands, nothing less will do.
Gaby Hinsliff is a Guardian columnist
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