Judith Moritz
Special correspondent, reporting from the inquiry

Harvey is being asked about evidence that the inquiry has heard from Dr Steve Brearey, who says that he asked the medical director for a meeting at around the time of the inquest for the first baby to die, Baby A.

Harvey says this "doesn’t match either my recollection or documentation. He did not request a meeting - urgent or otherwise… nor did he take advantage of my open door policy to bring any concerns to me, nor did he approach my PA to arrange an appointment to meet me to speak.”

In the wake of the first cluster of deaths in 2015 and 2016, a “thematic review, external” was carried out on the unit to see if any “themes” could link them.

The lawyer asks if this was shared with the babies' parents.

"I can’t answer that," Harvey responds.

"Well it wasn’t, was it? So if not, do you know why not?" Langdale KC replies.

Harvey says: "I don’t, no."

Langdale says that one of the issues that the Thirlwall Inquiry will examine is whether the hospital provided the coroner with enough information to prepare for inquests.

For context: Stephen Brearey was lead neonatal consultant and was the first to raise concerns about Letby.

Judith Moritz
Special correspondent, reporting from the inquiry

Langdale says it's known that Lucy Letby was the ‘incident reporter’ (of Baby E’s death as a serious incident), but notes Harvey wouldn't have known her name then.

"But it’s clear that this unexpected death has been brought to your attention," Langdale asks, to which Harvey agrees.

He confirms that when Baby E’s case was looked at as part of the serious incident review process, there was no contact with the baby’s mother to discuss with her what she had experienced that night.

For context, Baby E is the baby boy whose mother walked into the nursery and found him screaming, with blood on his face, and Letby present, but not doing anything to attend to the baby. She has been convicted of his murder. The baby’s mother gave witness evidence at Letby’s criminal trial about what she’d seen.

Judith Moritz
Special correspondent, reporting from the inquiry

Ian Harvey is back in the witness box and Rachel Langdale KC is asking him about when he knew about the deaths of certain babies.

The inquiry has heard that Ian Harvey was sent an email about the cluster of three deaths in June 2015 (Babies A, C and D) but he was on leave and “didn’t receive the email in a timely fashion”.

On 13 August 2015 he was invited to a serious incident review meeting relating to the fourth baby to die, Baby E.

The lawyer asks if anyone in the meeting made reference "to the fact that the deaths of Babies A, C and D had happened just over a month before?"

"Not that I can recall," Harvey answers.

The inquiry is now starting again following a break for lunch.

We'll bring you the key lines from Ian Harvey - former medical director of the Countess of Chester Hospital – throughout the afternoon.

If you want to learn more about the expansive Thirlwall Inquiry, which looks at the circumstances around Lucy Letby's crimes, then you can listen to the BBC's podcast Lucy Letby: The Public Inquiry.

With weekly updates from Judith Mortiz, Michaela Howard and Rob Wood, the short episodes capture the latest of what you need to know.

You can listen on BBC sounds, or wherever you get your podcasts.

The inquiry has now taken a break for lunch, so let's catch you up with what's happened so far today:

• Ian Harvey, former medical director at the Countess of Chester Hospital, began giving evidence for the first time
• He says "it was only ever my desire to have a safe hospital" and that "we got things wrong"
• The hospital's atmosphere changed from positive in 2016, due to "issues on the neonatal unit", he says
• Harvey says the risk management strategy at the hospital was not effective at the time of the murders, and there were missed opportunities to report infant deaths

• Tony Chambers, former chief executive of the hospital, also finished giving his evidence this morning
• He denied pressuring whistleblowers and stalling the police investigation, something he branded an "outrageous statement"
• He also disagreed that executives were shutting down concerns about Letby

The inquiry has just paused for lunch, and will resume shortly at 14:10 GMT.

Stay with us throughout the afternoon as we bring you the key lines from Ian Harvey's evidence.

Judith Moritz
Special correspondent, reporting from the inquiry

Questioning now turns to the failure to report the deaths of three babies in June 2015 to the NHS England Serious Incident Framework., external

Ian Harvey is asked if failing to report the three deaths which happened in one month (this would normally have been the maximum number for an entire year) was a “missed opportunity”.

He says “potentially it was a missed opportunity.”

He adds the fact three deaths happened in one month (June 2015) “wasn’t viewed as a cluster that would have set off an alert that there was something linking them together”.

Rachel Langdale KC points out that it did set off the lead neonatal consultant Dr Steve Brearey to look at a summary of the cases, and conduct a thematic review.

Judith Moritz
Special correspondent, reporting from the inquiry

Harvey is asked if he is "quite a rigid thinker" and if once he makes a choice, he will "stand on it."

He says he doesn't think he is.

"I don’t think that is the sort of thing that would work, coming from a clinical background and I certainly tried to hear what everyone was saying," Harvey adds.

Judith Moritz
Special correspondent, reporting from the inquiry

Image source, Thirwall Inquiry

Ian Harvey is now asked about the failure to log the consultants’ concerns under the hospital’s ‘Speak Out Safely’ whistleblowing policy (which would have offered them protection).

Langdale says clearly the consultants were raising concerns but the policy was not employed.

Harvey agrees. "When the increased mortality was first raised, I viewed it as a clinical issue. The nature of the conversations were more to explain that increased mortality," he says.

Langdale describes that as a "serious error of thinking".

"You weren’t seeing what was really being said, were you," she puts to him.

Harvey replies: "I felt at the time that we were following what was a logical progression of investigation, based on the situation that we had been presented with, based on the information we were being provided with.

“Having reflected at length, I regret that I didn’t speak with the police in June/July 2016."

Judith Moritz
Special correspondent, reporting from the inquiry

The laywer asks if Harvey was ever concerned "there were unfounded allegations being made about a nurse?"

Harvey says he was "very mindful at this time of Stepping Hill.

"But it was the alternative story from Stepping Hill - which was the nurse who had been incarcerated inappropriately for six weeks and the effect that had on her life and her career and that was on my mind."

For context: In 2015, nurse Victorino Chua was convicted of murdering two patients and poisoning 20 others at the Greater Manchester hospital Stepping Hill.

Before Chua was found guilty, another nurse had been wrongfully arrested and jailed before charges were dropped.

Judith Moritz
Special correspondent, reporting from the inquiry

Langdale asks Harvey if he ever doubted that the consultants had "genuine misgivings" about Letby.

After a very long pause, he says: "I never doubted that Dr Brearey in particular had concerns. Those concerns were at the outset not fully voiced, and were difficult to follow on occasion but at no point did I doubt that the concern was real - as he perceived it."

Langdale follows up, pointing out the inquiry has heard medics other than Dr Brearey were concerned.

"At the time did you speak to any other doctors apart from the paediatricians? Did you ever take a walk onto the neonatal unit, or talk to younger doctors to see what was going on?" she asks.

Harvey says: "I did do visits to the unit but I don’t recall specifically going to the unit to talk to the junior doctors."

He adds that he had an open door policy for staff who felt that they had genuine concerns, and tried to make himself approachable.

As a reminder, Stephen Brearey was lead neonatal consultant at the Countess of Chester Hospital between June 2015 and June 2016.

Judith Moritz
Special correspondent, reporting from the inquiry

Counsel to the inquiry Rachel Langdale KC looks at the risk register documents used by the hospital, where risks were ranked on a matrix from minor up to the most severe - which were classed as “catastrophic”.

She says: “In terms of the risk of babies being murdered, that would rank presumably as catastrophic?”

Harvey agrees that it would.

He says that the increase in the number of baby deaths wasn’t logged on the risk matrix as catastrophic because they didn’t understand why the rise was happening.

The lawyer asks: "Murderers aren’t always caught red handed are they Mr Harvey?

"And when you say there was nothing concrete to substantiate concerns, we are looking at risk here aren’t we? You knew there was a risk, and are you saying that because it wasn’t concrete, anything that had been seen… that you didn’t classify it as a risk?"

Harvey says: "No I am saying that in the way it was phrased (on the risk register documentation), I don’t think any of us perceived it as the sort of risk that would be catastrophic."

Judith Moritz
Special correspondent, reporting from the inquiry

Ian Harvey is being asked about the “risk management” strategy within the hospital.

As medical director, he had responsibility for all medical staff.

Rachel Langdale KC asks Harvey: “How effective do you think the risk management system was at the hospital at the time for identifying the risk of babies being murdered?”

He pauses for a very long time. Then says: “I think that the answer is probably not well.. the answer is not.”

Judith Moritz
Special correspondent, reporting from the inquiry

In his written statement to the inquiry, Ian Harvey describes “a culture and atmosphere at the Trust which was generally positive. Senior medical posts in most specialities were sought after. It punches well above its weight".

In the same statement it says: “From 2016 there was a change in the atmosphere between the executives and the paediatric medical staff due to the issues on the neonatal unit."

Judith Moritz
Special correspondent, reporting from the inquiry

Ian Harvey says that his relationship with the hospital board was good and collaborative, and he would meet with Sir Duncan Nichol - the board chairman - on a fairly regular basis.

He describes him as having “a high level of gravitas and huge experience which I found invaluable”.

He is asked if Nichol had a role in the NHS at the time of the Beverley Allitt case (a nurse who murdered four babies in Lincolnshire in 1991).

He says that he did not know this, and they never discussed Allitt - though he was aware of her case.

Judith Moritz
Special correspondent, reporting from the inquiry

Ian Harvey is now asked about his career.

He is a consultant orthopaedic and trauma surgeon by training, and became medical director of the Countess of Chester Hospital in July 2012.

He applied for voluntary erasure from the medical register in June 2020, and is now retired.

Ian Harvey starts by saying: “I am sorry for the hurt that has been caused to the parents and the families of the babies.

"I extend that to the parents of the parents and families who were subject to the reviews but didn’t feature in the trial and aren’t part of this inquiry.

"It was only ever my desire to have a safe hospital and to be able to tell the parents what had happened on the neonatal unit and if I failed in those aims I am truly sorry.”

The lawyer says: "You say 'if I failed in those aims'. Reflecting now, do you think you did fail in those aims to secure patient safety and baby safety?"

Harvey says: "The simple fact that there was an increase in mortality is an indication that we got things wrong… I failed in my communications to the families, in the nature and quality of the information that they were given."

Langdale KC replies: "And did you fail to have Lucy Letby investigated by the police earlier and to be removed from the NNU?"

Harvey says: "I had expressed an opinion that we should approach the police and I sincerely regret that we did what we did at the time. I think looking at the process that we went through, I can understand why we did."

We're now hearing from Ian Harvey, who was medical director of the Countess of Chester Hospital at the time of Lucy Letby's crimes.

We've never heard him speak publicly before - and he'll be questioned about how he handled things.

According to written statements,, external Harvey was one of the senior manager with whom the first concerns about Letby were raised back in 2016.

Harvey was also tasked with carrying out an overarching review to identify if there were any potential issues contributing to the rise in neonatal deaths, the written statement said.

Judith Moritz
Special correspondent, reporting from the inquiry

Former hospital medical director Ian Harvey is taking his oath.

He’ll be questioned by counsel to the Inquiry Rachel Langdale KC.