Southport killer's psychiatrist denies 'failure'

Axel Rudakubana went on to murder three children three months after being discharged from mental health services

A psychiatrist said he was unaware the Southport killer had previously been caught carrying a knife, despite the fact it was recorded in medical notes, a public inquiry has been told.

Anthony Molyneux took on Axel Rudakubana as a patient from July 2022 and discharged him in April 2024, three months before the then 17-year-old murdered three children at a Taylor Swift-themed dance workshop.

He said he had "no suspicion" that information, plus further disturbing references to the teenager's obsession with violence, was recorded in patient notes and "would not have gone looking" for it.

Asked if he had "failed in his duty" to check them more thoroughly, he said: "I don't accept that submission."

Dr Molyneux, neurodevelopmental lead at Alder Hey Children's Hospital in Liverpool, told the Southport Inquiry he had taken a verbal handover from Rudakubana's previous psychiatrist, Dr Lakshmi Ramasubramanian.

Giving evidence at Liverpool Town Hall, Dr Molyneux said: "I believe that I took reasonable steps to glean a reasonable level of assurance from the notes and the verbal handover I had."

He added he was "100% confident" that CAMHS had done everything it could to assess and treat Rudakubana when he was discharged with a note saying his risk to others was "minimal".

On 29 July 2024, Alice da Silva Aguiar, nine, Elsie Dot Stancombe, seven, and six-year-old Bebe King were fatally attacked by the knifeman.

Ten others, including eight children, were seriously injured.

Rudakubana, from Banks in Lancashire, was jailed for life with a minimum term of 52 years in January.

Bebe King, Elsie Dot Stancombe and Alice Aguiar were killed in the 29 July 2024 attack

Under questioning from Nicholas Moss KC, lead counsel to the inquiry, Dr Molyneux said he had not read the reference to a March 2022 incident in which Rudakubana's parents had reported him missing.

Lancashire Police later found him on a bus where he admitted he had a knife and had wanted to stab people.

The inquiry heard the teenager's medical records also contained a reference to an attack on a school pupil with a hockey stick at Range High School in Formby in December 2019, during which he was found to have carried a knife in his backpack.

And there was reference to another incident in 2019, when teachers had noted that Rudakubana had researched the 2017 Manchester Arena suicide bombing and referred to it as a "good battle".

The knifeman murdered the three children three months after being discharged from mental health services

Dr Molyneux said he was unaware at the time he was treating Rudakubana and found the bombing comment "particularly chilling".

Mr Moss suggested that the system within CAMHS at Alder Hey for "keeping track of risk information" was "very poor".

"I would say it should have been better, and we have since taken steps to improve it," Dr Molyneux said.

He also suggested when he did home visits with Rudakubana's family, the teenager's parents did not mention any violence or risk to others and appeared to "stage manage" what information was given to clinicians.

Dr Molyneux explained that he was aware that the teenager had been referred to the anti-extremism service Prevent, but believed the service had concluded there was "nothing to see here".

Mr Moss asked if it would have been important for Dr Molyneux to be aware of the risk information referred to in the notes.

"Of course, I think it's crucial someone in my position ought to know those things at the time," the doctor replied.

'Significant blind spot'

Mr Moss suggested his treatment would be "deeply flawed" without knowledge of such matters.

Dr Molyneux said: "Let's just say it would be a significant blind spot."

He said the teenager came across as an "unremarkable, sullen, untalkative, gawky teenage boy" during their sessions together.

The psychiatrist said he did ask Rudakubana about whether he had thoughts of harming others, which the teenager denied.

Without any evidence to contradict him, he said he took the teenager's answers "at face value".

The inquiry heard he was first referred to the Child and Adolescent Mental Health Service (CAMHS) in 2021 after his conviction over the hockey stick incident.

He was first seen by Dr Ramasubramanian, who told the inquiry she had read in his Electronic Patient Records that he had been caught carrying a knife in March 2022 - but did not know he had told police he was thinking about stabbing people.

During her evidence to the inquiry, she said while young people with anxiety carrying knives for protection was not uncommon, she would have considered that additional detail a "red flag".

Dr Ramasubramanian said when she took on Rudakubana as a patient she reviewed his records and was "reassured" by the fact Prevent and another specialist service called Forensic CAMHS - specifically for young people considered a risk to others - had not accepted referrals.

She said that meant she did not consider risk to others as a significant concern and could "focus on the here and now".

Dr Ramasubramanian said she requested to hand over the teenager's case to another psychiatrist because of "disrespect and initimidation" from his father, Alphonse Rudakubana.

She said: "This is the very first time in my entire career as a doctor where I've had to request a change of psychiatrist because of how I was made to feel by a parent.

"It's quite unprecedented in my opinion."

She said when she handed over his case to Dr Molyneux in June 2022, she could not recall whether she mentioned the hockey stick incident in 2019 or Rudakubana carrying the knife on the bus in March 2022.

When asked by Harriet Wakeman, counsel to the inquiry, whether any assessment of the teenager's risk to others had "fallen by the wayside", Dr Ramasubramanian said "yes".

The inquiry continues.