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Merged Concerns over baby killer ignored? / Nurse Lucy Letby killed babies in her care

Ranb

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Doctor who helped catch Lucy Letby says 'babies could've been saved' if hospital acted sooner
https://www.itv.com/news/2023-08-18...r-who-helped-catch-lucy-letby-blames-hospital
The doctor who helped catch child-killer Lucy Letby has told ITV News that babies' lives could have been saved if hospital bosses had contacted police sooner.

Dr Ravi Jayaram, who is a consultant paediatrician at the Countess of Chester Hospital, said he repeatedly raised concerns about his former colleague months before police were alerted.

In an exclusive interview, he has detailed to ITV News how executives at the top of the organisation at the time told him to “draw a line” under his suspicions and to apologize to Lucy Letby for his accusations.
Can hospital administrators be held responsible for their actions when one of their employees kills someone?

Eventually, in April 2017 the trust allowed doctors to meet with a police officer who took their suspicions seriously.

"The police, after listening to us for less than 10 minutes, realised that this is something that they had to be involved with. I could have punched the air," Dr Jayaram said.

Shortly afterwards, an investigation was launched and Letby was eventually arrested.
The trust allowed doctors to meet with a police officer? What kind of power does the trust have anyway?

The article makes it seem like the hospital admin was valuing their reputations over the lives of babies. Am I missing something here?

Ranb
 
If what I've been reading about the conduct of the administrators is true, these people are irredeemable monsters. The hospital should be sued into ash, and Ian Harvey needs to have his ass dragged back to the UK and locked up for the rest of his disgusting life.
 
Am I missing something here?

Ranb

Yes.

A politically-based public healthcare system isn't always better than a for-profit private system.

There will be Royal Commission set up to deal with this case as there was with Grenfell Towers and no doubt heads will roll. The Hillsborough tragedy confirms that no personal responsibility will be given, aside from the horror of naming names.
 
The article makes it seem like the hospital admin was valuing their reputations over the lives of babies. Am I missing something here?

Ranb

If events unfolded as the whistle-blowers now contend, it seems almost as if the top administrators were practically co-conspirators. The parents of these murdered newborns must be out of their minds with rage.
 
The negligence of hospital management is breathtaking. I think manslaughter charges will be closely considered.

It would not surprise if more suspicious infant deaths are investigated.
 
If events unfolded as the whistle-blowers now contend, it seems almost as if the top administrators were practically co-conspirators. The parents of these murdered newborns must be out of their minds with rage.

I would suggest, sympathetically, that they will be out of their minds with grief, rather than rage.
 
If what I've been reading about the conduct of the administrators is true, these people are irredeemable monsters. The hospital should be sued into ash, and Ian Harvey needs to have his ass dragged back to the UK and locked up for the rest of his disgusting life.

Suing the hospital into ash will only harm the local people who are dependant on it and the many entirely innocent workers who provide local health care who had nothing to do with the neonatal unit. As a public hospital it is only the tax payer who will pay.

In any case under the UK compensation system dead babies do not result in large compensation payments, the large damages will be for any surviving but harmed babies.

The murderer has been convicted. Going after other individuals for negligence won't improve anything and may be harmful. As in other disasters it is more important to look forward and see what can be done to prevent something similar in the future, going after individuals actually avoids a system response.
 
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Doctor who helped catch Lucy Letby says 'babies could've been saved' if hospital acted sooner
https://www.itv.com/news/2023-08-18...r-who-helped-catch-lucy-letby-blames-hospital

Can hospital administrators be held responsible for their actions when one of their employees kills someone?


The trust allowed doctors to meet with a police officer? What kind of power does the trust have anyway?

The article makes it seem like the hospital admin was valuing their reputations over the lives of babies. Am I missing something here?

Ranb

It may be helpful to give a bit of background about how hospitals work. The modern hospital was created by Florence Nightingale, who also created the modern nursing profession. Historically the hospitals in Britain were very much managed by nurses, doctors were visitors. Junior doctors were on short term contracts and senior doctors were in private practice with admission rights. Nursing staff are in charge of wards, not doctors. Changes to wards happen with permission of the nursing hierarchy.

Hospital managers mostly come up trough the system, from a variety of backgrounds but almost never medical*. Administrative staff may be promoted into management (e.g. secretarial, HR, even PR), most often nurses end up in management, often finance people from the NHS finance departments will move sideways into general management. Very rarely are professional trained mangers employed. This is a long standing problem, the King's Fund was established to try and address this issue, there have been attempts at promoting executive MBA for health service staff, but due to the cost this usually is only available to senior mangers in post.

Then like many public organisations there are complex HR systems and rules, firing an individual is not easy short of criminal acts. Disciplinig doctors and nurses is easier through the professional regulating bodies. (One could ask whether Letby was reported to the Nursing Council.)

There has long been a call for professional standards in health service management, probably with required training. Managers who are incompetent could be reported to the professional standards body and then not eligible to just move into another job. This could mean that health service mangers had a statutory requirement to prioritise patient safety. At present patient safety issues are only addressed if they are an immediate issue, otherwise government targets e.g. waiting lists come first. A good example was that many older NHS hospitals lacked single room occupancy leaving them vulnerable to outbreaks of infection. This was a known issue.

*Doctors have a medical management system that is parallel to the rest of the NHS management system. This essentially manages doctors (and their treatment) and little else.

The result is that the nursing and general management hierarchy would feel that doctors should be sticking to managing doctors and not interfering with nursing management.

We surveyed all NHS provider chief executives about their professional background and qualifications, and supplemented the findings with desktop based research. The combined results established that a third of chief executives (CEOs) hold a clinical qualification. Of these 78 CEOs, 63% trained as nurses, 19% trained as medical doctors, 4% trained as pharmacists and 11% as allied health professionals (AHPs).
The diversity of professional and education backgrounds among them – while welcome given the breadth of perspective and experience it offers – reinforces the absence of a well-worn path into NHS executive management roles. Clinical CEOs come from varied clinical backgrounds, with 42% from mental health (including psychiatry) and 12% trained in paediatrics. The majority of clinical CEOs also work in the same sector as their clinical specialty.
i.e. about 6% NHS CEO medical qualified.
https://nhsproviders.org/media/5184...e-supporting-the-leaders-of-tromorrow_web.pdf

https://www.employment-studies.co.uk/news/career-paths-nhs-chief-executives
 
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What Planigale said above. The quality of NHS management is piss poor, speaking as a former senior nurse.

Also, the ignoring of anything approaching whistle-blowing by senior management is par for the course in the NHS. There is a long and ignoble history which is well documented and most of us have direct personal knowledge of these things.

There is a long tendency across the NHS not to involve the police in possible criminal matters: I have direct personal knowledge of staff being threatened with disciplinary action if they reported thefts and assaults to the police; Carrot Flower Queen, in her payroll days, exposed a long-standing set of frauds, which included blackmailing of some staff members, on one unit, which was never reported to the police - sadly one person who was involved in this and should have been sacked and prosecuted was later implicated in a patient death; I have been threatened by a charge nurse from the above unit as I subsequently employed the 2 staff nurses who blew the whistle on other incidents on that unit, and our management did not want to know and told me to STFU.

I could go on...

There is also a pattern of managers trying to do down medics: one of my managers actually said to me "We need to remove all power from the psychiatrists!". I have heard similar from across the country and wonder how much of this was actually soft signalled from the Department of Health, given the number of trust chief execs I know of who have gone on to work in the department.

This was all horrifyingly preventable.

In addition, the inquiry which Barclay announced will be toothless, as it lacks the power to compel witnesses and require them to testify under oath.
 
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What Planigale said above. The quality of NHS management is piss poor, speaking as a former senior nurse.

Also, the ignoring of anything approaching whistle-blowing by senior management is par for the course in the NHS. There is a long and ignoble history which is well documented and most of us have direct personal knowledge of these things.

There is a long tendency across the NHS not to involve the police in possible criminal matters: I have direct personal knowledge of staff being threatened with disciplinary action if they reported thefts and assaults to the police; Carrot Flower Queen, in her payroll days, exposed a long-standing set of frauds, which included blackmailing of some staff members, on one unit, which was never reported to the police - sadly one person who was involved in this and should have been sacked and prosecuted was later implicated in a patient death; I have been threatened by a charge nurse from the above unit as I subsequently employed the 2 staff nurses who blew the whistle on other incidents on that unit, and our management did not want to know and told me to STFU.

I could go on...

There is also a pattern of managers trying to do down medics: one of my managers actually said to me "We need to remove all power from the psychiatrists!". I have heard similar from across the country and wonder how much of this was actually soft signalled from the Department of Health, given the number of trust chief execs I know of who have gone on to work in the department.

This was all horrifyingly preventable.

In addition, the inquiry which Barclay announced will be toothless, as it lacks the power to compel witnesses and require them to testify under oath.

Certainly the Scottish Government see the medical profession as a barrier. Al least nominally NHS England wants to encourage the appointment of medically qualified Chief Executives. Managers are encouraged to aggressively mange medical. When medics raise issue the first response is 'it is just the doctors shroud waving again'.
 
Suing the hospital into ash will only harm the local people who are dependant on it and the many entirely innocent workers who provide local health care who had nothing to do with the neonatal unit. As a public hospital it is only the tax payer who will pay.

In any case under the UK compensation system dead babies do not result in large compensation payments, the large damages will be for any surviving but harmed babies.

The murderer has been convicted. Going after other individuals for negligence won't improve anything and may be harmful. As in other disasters it is more important to look forward and see what can be done to prevent something similar in the future, going after individuals actually avoids a system response.

I disagree. The buck stops at the top. The bosses have have to take responsibility for their own actions or inaction, as the case may be. Chief, Karen Rees, actually said she would take responsibility if she was wrong about rejecting the SEVEN highly specialised consultants' concerns and giving Letby the green light to carry on. Likewise, Eiran Powell, Alison Kelly (in charge of nursing), Ian Harvey, Stephen Cross, the NHS lawyer who warned against taking any action, and Tony Chambers, all of the Countess of Chester Hospital.

How is it harmful? The hospital is covered by indemnity.
 
I once worked at the Brompton Hospital and Marsden as part of the Frimley Group. Whilst I was in Finance with the CIPFA crowd, there was one starry eyed person whose dream was to be a hospital administrator. This is as much a sought-after profession as is any other. The attraction as far as I could see was prestige and a fat salary. However, with leader ship comes responsibility. You are responsible for:

  • the smooth running of operations
  • setting and reaching targets
  • forward planning and delivery of performance
  • corporate culture
  • handling and mitigating risk

Unfortunately, as we have seen in other public sectors* the bosses seem content to not rock the boat in anyway, seeing 'whistle blowers' as a mere nuisance. As we have seen, the seven consultants who urged Letby to be taken off nursing duty, were threatened with being reported to the GMC and actually forced to apologise to the murderer.

Yes, there was quite a culture of conflict within the hospital with consultants at loggerheads with the administrators - one was on garden leave for over three years - with all kinds of disputes going on.

In the case of embezzlement, malfeasance, expenses fiddling, yes, that can be brushed under the carpet and written off in the balance sheet. But what price patient safety, confidence and the destroyed lives of the rogue nurse's victims?

Anyone who has drawn up and carried out a risk assessment knows that it is possible to forecast and risk assess most eventualities one can think of, including professional medical liabilities, and 'acts of God', etc. However, how does it even cross one's mind that there might be a serial killer amongst the highly qualified specialist nurses. That is a curve ball factor. IMV the administrators appear to have failed to act once the risk was brought into view by seven on-the-job consultants.


*(cf the Post Office scandal and fat cat Venn sitting on millions of pounds of bonuses and pensions whilst sub-postmasters are still awaiting recompense for false convictions as a result of a faulty Horizon IT system of whcih Venn was fully aware)
 
Neonatal Nurse Lucy Letby killed babies in her care

This thread is to do with the criminology of the case. Issues about how and why the NHS failed to prevent the crimes is discussed here: http://www.internationalskeptics.com/forums/showthread.php?t=367787


So, the sentencing of neonatal Nurse Lucy Letby, convicted of seven charges of murder and a further six of attempted murder is scheduled to happen tomorrow, Monday (21 August 2023). The only possible sentence according to statute is a whole life tariff, although it is possible Letby’s silk, Ben Myers KC, will argue mitigation such as diminished responsibility and the judge might defer sentencing for ‘further reports’. There is some outrage that convicted defendant has been allowed to refuse to turn up to face the music to hear her sentence and the impact statements of the victims. Some of the attempted murder charges overlap with the murder charges (for example, you can be guilty of both if they are on separate occasions). There were two verdicts of ‘Not Guilty’.

More details of the verdicts and charges can be found here on the Crown Prosecution Service webpage:
https://www.cps.gov.uk/cps/news/luc...ound guilty of,six counts of attempted murder.

Where the eleven-man jury failed to reach a 10-1 verdict (whether of guilty or not guilty), this resulted in a hung jury and these were six of them. One includes Child K, which is the point Dr Jayaram, who gave testimony, and was one of the ‘gang of four’ doctors who pressed for Letby to be removed from the neonatal unit became convinced of her malevolence. Dr Jayaram testified he saw Letby standing by Baby K’s cot doing nothing despite K being in a state of collapse. The pathologist reported that K’s liver showed injuries consistent with those of someone having been in a serious car accident.
Thus the judge, Justice James Goss, will also have to decide whether to let CPS know whether they can have another 28 days to bring the six hung verdicts back for a new trial or whether to just ‘keep them on file’. Given that police are now reviewing 4,000 other cases, including Letby’s time in 2012 at Liverpool Women’s Hospital, these might well be tried again.

Justice Goss of the Kings Bench has a reputation as a hardline judge, thus his remarks in sentencing are likely to be vituperative and utterly eviscerating, given Letby’s refusal to attend*. Although, bear in mind judges are also supposed to exhibit mercy.

Why did she do it?

IMV – my observation only – Letby shows a peculiarly childlike aspect to her personality. Her ability to disassociate implies to me an early childhood trauma. Not saying it is anything like child abuse but her father seems a strong domineering figure in her life, even turning up to her grievance hearing at the hospital to provide a witness statement, whilst Lucy sat impassively. The father received an apology from the doctors who complained about his daughter as well as Letby herself. The father was present at her home the morning she was arrested, having stayed overnight after returning from holiday in Devon. In her twenties, Letby still holidayed with her parents, John and Susan, three times a year. After her arrest and police search he tidied up her bedroom. He had designed the duvet cover embossed with the words, ‘Sweet Dreams’.

During police interviews and the trial itself, Letby appeared disassociated from the accusations, remaining calm and collected. The only time she showed any emotion was when from behind a screen she head the voice of the registrar on whom she had crush, the prosecutor, silk Nick Johnson KC claimed, to give evidence against her, whereupon she tried to flee in tears and had to be persuaded back. She claimed not to know what ‘in commando’ meant. She claimed the married registrar was ‘just a friend’, as though she needed to keep up an air of girlish innocence. This is what makes me consider a halted point in her childhood psychology. Some psychologists believe that certain psychopaths became such because of arrested psychological development in childhood. For example, Mary Bell, a child killer aged 12, who showed no remorse, had been used by her prostitute mother for use by clients whilst still a toddler. One of the boys in the James Bulger murder came from a background of dire poverty and incest. Obviously, Letby is middle class and has devoted parents. But her strange lack of emotion and childishness, together with an ability to dissociate from unpleasant circumstance such as a stressful court room hearing leads me to suspect an arrested childhood development. An abused child will bear the pain by means of placing their mind and emotions elsewhere, as it were, for example seeing themselves floating above their body or outside of it. With Letby, this appears to involve an overbearing father, not dissimilar to writer Sylvia’s Plath’s predicament, who as you know, had a Daddy Complex resulting in a persistent impulse to commit suicide and eventually did so. In one of her scribbled notes, left for the police to find, Letby writes, ‘I do not deserve Mum and Dad’.

It is possible her parents realised Letby’s lack of empathy at an early age, hence all the girly décor with motivating slogans such as ‘sparkle’ and encouraging a career in care, with her father overseeing her career advancement. That is not to say he has done anything wrong and it might be the first time the parents have even become fully aware of what their daughter had got up to with her 'caring' qualifications and vocation.

*Although there is no effective way of enforcing attendance given the sentence is ‘Life’ already.
 
Yes.

A politically-based public healthcare system isn't always better than a for-profit private system.
I'm not sure what you mean by a "politically based" healthcare system. The NHS is public but it is not political in any sense.
There will be Royal Commission set up to deal with this case as there was with Grenfell Towers and no doubt heads will roll. The Hillsborough tragedy confirms that no personal responsibility will be given, aside from the horror of naming names.

I remind you that the person responsible for these murders will be spending a long time in prison. She has been caught and she will answer for her crimes.

As for anybody else involved: well, I'd rather that we concentrated on finding out why the murders weren't detected much sooner and how to remedy the faults so that next time (and statistically there will be a next time) the murderer is stopped sooner.

Nobody set out here to cover up the murder of babies (except Ms Letby) just as nobody set out to murder Liverpool football fans at Hillsborough. What happened was incompetence and you can't eradicate incompetence by throwing the last person who demonstrated it into jail. That isn't going to deter the next incompetent person from being incompetent. It might, however, persuade them that they need to conceal their mistakes.
 
Certainly the Scottish Government see the medical profession as a barrier. Al least nominally NHS England wants to encourage the appointment of medically qualified Chief Executives. Managers are encouraged to aggressively mange medical. When medics raise issue the first response is 'it is just the doctors shroud waving again'.

An aside, but the chief execs of my trust during my last decade in work (2003-13) were firstly a nurse by trade (I remember him from when he was a charge nurse and he was a twat then), then a finance bod, then someone who came up through the NHS graduate management scheme and lastly a medic. The medic was probably the worst of the lot, leaving us under a cloud only to re-surface later at 2 trusts whose subsequent difficulties mirrored those we'd had.

The first 2 of those enacted some controversial ideas and promptly buggered off to promotions at Quarry House.

The neighbouring acute trusts were led by a former accountant and someone who started as a management trainee in the 60s: one is partly seconded to the DoH and the other was sacked for gross misconduct, eventually.
 
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I'm not sure what you mean by a "politically based" healthcare system. The NHS is public but it is not political in any sense.


I remind you that the person responsible for these murders will be spending a long time in prison. She has been caught and she will answer for her crimes.

As for anybody else involved: well, I'd rather that we concentrated on finding out why the murders weren't detected much sooner and how to remedy the faults so that next time (and statistically there will be a next time) the murderer is stopped sooner.

Nobody set out here to cover up the murder of babies (except Ms Letby) just as nobody set out to murder Liverpool football fans at Hillsborough. What happened was incompetence and you can't eradicate incompetence by throwing the last person who demonstrated it into jail. That isn't going to deter the next incompetent person from being incompetent. It might, however, persuade them that they need to conceal their mistakes.
:thumbsup:
 
I once worked at the Brompton Hospital and Marsden as part of the Frimley Group.

Did the Royal Brompton switch? These days it's part of the Guy's and St Thomas' group. Just curious, as I lived down the road from the Frimley Park hospital and my children were born there. Why a central London hospital would be in the Frimley group is a mystery.
 
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