Letby boss admits 'crass' letter to babies' families

Ian Harvey was medical director at the Countess of Chester hospital

The former medical director of the hospital where Lucy Letby murdered babies has admitted his communication with the children’s families was “crass and inappropriate”.

Ian Harvey was the most senior doctor at the Countess of Chester Hospital when the nurse murdered seven babies and tried to kill seven others between 2015 and 2016.

Giving evidence at the public inquiry into the crimes, he admitted a letter to the families - which included a single page with an attachment of medical notes regarding a review over the babies’ deaths - was “unthinking and insensitive”.

“I would only say that we were keen to share the information as soon as possible,” he said.

“We were aware there had been inordinate delays but I accept that doesn’t excuse the way in which this was done.”

He described a letter from a mother of one of the babies, who was begging him for information, as “heart-rending”.

Now retired, Mr Harvey denied concealing information from the babies’ families and denied a cover-up of consultants’ warnings about Letby.

Lucy Letby was handed a whole-life sentence for murdering seven babies and trying to kill seven others

He also denied threatening the doctors with referral to the General Medical Council regulator, adding that this was made instead by Letby’s father John.

However, Mr Harvey accepted a failure in his duty of pastoral care to the paediatricians trying to raise the alarm about Letby, who they noted had often been present when the babies died or came close to death suddenly and unexpectedly.

He said one of the greatest regrets of his career was the breakdown of relationships between the executives and consultants, and apologised to consultants “if they felt intimidated” by him.

Letby's trial concluded the nurse injected air into two triplet boys – referred to as Baby O and Baby P - on successive days in June 2016.

The Thirlwall Inquiry has been hearing evidence at Liverpool Town Hall since September

The inquiry has heard that neonatal clinical lead Dr Stephen Brearey raised concerns about Letby at a meeting a month earlier on 11 May.

Dr Brearey previously told the inquiry he felt the number of deaths in 2015 and early 2016 were "exceptional" and highlighted to Mr Harvey that it was "unusual" that six out of the nine deaths had occurred between midnight and 4am.

He said he told him that there had been a number of reviews, including one from an external neonatologist, and the only common theme was Letby having been on duty.

Mr Harvey said that "did not accord with my recollection of that meeting" and he did not remember Dr Brearey being "that detailed or that assertive".

Rachel Langdale KC, counsel to the inquiry, put it to Mr Harvey that Baby O and Baby P "should never have died after that 11 May meeting, should they?"

“[Letby] could have been off the ward and referred to the police then," she added.

Mr Harvey said: "I would not accept as a result of that meeting that the conversations we had and the approach that Dr Brearey and the nursing staff had, that there was anything that would have supported such action.

"Dr Brearey was entirely supportive of the action that came out of the meeting and it was highlighted that one of the actions was the reporting of any further collapses or incidents."

Job transfer

Mr Harvey went on: "At no stage during this meeting did I feel that it was being reported because there was worry that Letby was responsible for the deaths."

Letby was eventually moved to an administrative role in July 2016 after all the consultant paediatricians met with executives after the deaths.

Ms Langdale KC also asked Mr Harvey if he had sought permission from the babies’ parents for their children’s medical records to be used in a case note review of some of the unexpected deaths at the neonatal unit.

The murders at the neo-natal unit have drawn international attention and scrutiny

Mr Harvey said he could not recall whether he had done this but, when pressed by Ms Langdale, he said: “I almost certainly would have delegated that task.

“I have no recollection of following that through. If I didn’t, that is a very significant error on my part and I’m very sorry for that.”

He was also asked why he went ahead with a review of the neonatal unit by the Royal College of Paediatrics and Child Health when the reviewers told him they could not directly address the cause of the rise in unexpected deaths and collapses.

Ms Langdale said: “You were spending money and taking time on a review that isn’t going to answer the question you’ve got in front of you [that consultants paediatricians were concerned that Letby was deliberately harming babies]?”

Mr Harvey replied: “It was perfectly reasonable to explore with the relevant expertise, both medical and nursing, the full range of potential causes.”

'Pastoral care failure'

He was also asked why he told a hospital committee that the Royal College did not recommend any immediate action in respect of the increased mortality, when it had actually recommended the hospital start its own investigation into the doctors’ concerns.

Mr Harvey replied that he did not think it was the sort of immediate concern where “they [The Royal College] say you have to take action before we leave the building or stop this service now”.

Ms Langdale put it to Mr Harvey that, under his tenure as medical director, doctors were afraid they would lose their jobs for raising patient safety concerns.

He responded: “I accept I failed in a duty of pastoral care that I should have offered.”

But he said he did not seek to create a climate of fear on the unit.

He also denied telling Susan Gilbey, who took over as chief executive at the hospital, that she should refer consultants to the General Medical Council.

“I did not say that,” he said.

The Thirlwall Inquiry, sitting at Liverpool Town Hall, continues.