News of avoidable baby deaths at University Hospitals Sussex NHS Foundation Trust, at the same time as a new Netflix documentary about baby killer Lucy Letby, raises disturbing questions about the safety of maternity units, writes Herald columnist Rosemary Goring.

There was a sense of shock but not of disbelief when a joint BBC/New Statesman investigation last week revealed evidence that at least 55 babies who died between 2019 and 2023 at University Hospitals Sussex NHS Foundation Trust (UH Sussex) “may have survived with better care”.

UH Sussex conducted 227 internal reviews into maternity deaths over this period, and concluded that in these 55 cases, different care “may” or was “likely” to have made a difference to the outcome. A review of nine stillbirths between 2021 and 2022 stated there were “missed opportunities in all cases”.

The quality of maternity care in the UK is a persistent problem, with serious failings and shortcomings disclosed with alarming frequency. Wes Streeting has said that “of all the issues that keep me up awake at night, maternity safety is top of the list”. Listening to the experience of parents whose babies have died in utero or shortly after birth  because of inadequate care is harrowing. It is a reminder of how very vulnerable babies and their mothers are around the time of birth and in the following days.

It is also a reminder of the case of Lucy Letby, the former neonatal nurse serving 15 whole-life sentences for the murder of seven infants and the attempted murder of seven others, while she was working at the Countess of Chester Hospital, between 2015-2016.

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Few subjects are more distressing or emotive, and it was with mixed feelings that I watched the recent Netflix documentary, The Investigation of Lucy Letby. Using previously unseen footage supplied by Cheshire police, it documents Letby’s arrest, when she is still in bed, and follows her, handcuffed in pyjamas and dressing gown, into the police car. It also draws on clips from her interrogations in police custody in which she is monosyllabic or non-committal.

Only once does she show emotion, when explaining why she wrote “I am evil I did this”. These were therapeutic notes written, at the urging of a counsellor, to express her feelings. They could be read as a confession, but equally they could be viewed as an expression of intense guilt at not being able to save the infants who died while she was on duty. It is probable we will never know either way.

Nobody can criticise Cheshire police for their investigation. The spike in infant deaths at the neonatal unit where Letby worked, and the suspicions this raised, demanded investigation. As the evidence began to point to Letby, despite her previously stainless career, one detective was palpably troubled at having to inform bereaved parents that their babies had been the victims of murder. After what they had already endured, this was a sickening additional blow.

Aspects of the documentary made me uncomfortable, not least when showing bodycam footage of Letby’s shock and confusion when arrested, and the offscreen wailing of her mother. Whether Letby is or is not a mass murderer, this felt unnecessarily intrusive. However, once she has been convicted and sentenced, the film focuses on doubts since raised over the safety of her conviction. As such, it acts as a useful refresher on the issues raised by this extremely disturbing case.

Those who follow Private Eye’s MD column, by Dr Phil Hammond, will be aware of the weaknesses in the prosecution’s case. In his indefatigable examination of every twist of the proceedings, and his interrogation of the evidence or lack of it, MD has been among the most dogged and dauntless critics of the Crown Prosecution Service  (CPS).

A slew of medical and legal experts has come forward to question the grounds on which Letby was convicted, among them the misinterpretation of medical evidence, the pivotal role of the prosecution expert, Dr Dewi Evans, who was adamant that only  intentional harm could explain the babies’ deaths, the absence of any observed or forensic evidence that Letby harmed the infants, and the inexplicable failure of the defence to provide an expert witness on Letby’s behalf.

An international panel of medical experts, chaired by the Canadian neonatal care expert Dr Shoo Lee, examined the medical records of the 17 cases central to Letby’s conviction. They concluded: “We did not find any murders. In all cases death or injury were due to natural causes or just bad medical care.” Even so, three judges said their statement did not undermine Letby’s conviction.

With so many conflicting opinions, it seems self-evident that, while it cannot necessarily be proved that Letby is innocent, nor can she be found incontrovertibly guilty. Only one thing is certain: that there are reasonable grounds to doubt the soundness of her conviction.

Letby has already twice been denied the chance to challenge her convictions at the Court of Appeal. Nothing has as yet come of her legal team’s application for her case to appear before the Criminal Cases Review Commission (CCRC) as a potential miscarriage of justice. Meanwhile, Cheshire Police’s investigation into corporate manslaughter and gross negligence manslaughter at the Countess of Chester Hospital continues.

It should be clear by now that nothing less than a full review of Letby’s case by the CCRC will satisfy those who believe she has been made a scapegoat for failings within the Countess of Chester Hospital. While some remain convinced of her guilt, it is in no one’s best interests, least of all the bereaved families, the justice system and future maternity patients, for the process of review to be denied or delayed.

It goes without saying that the impact of the ongoing controversy on the families of the babies who died quite simply cannot be imagined. No matter the outcome of any legal review or ongoing criminal investigation, the babies’ parents and wider families have been condemned to a lifetime of sorrow and grief.

Yet ignoring flaws in hospital care, and indeed the justice system, is not an option. The 55 cases of infants at UH Sussex who might have lived had they been better looked after is the starkest imaginable wake-up call. It signals beyond reasonable doubt that the institutions designed to protect and nurture the most vulnerable patients are too often capable of letting them down. In light of this, if there is even the remotest chance that Letby could be a victim of a miscarriage of justice, despite the pain it will cause those already grieving, that too  demands urgent action.  

Rosemary Goring is a columnist, historical novelist, and author of books on Scottish history. Her latest is Exile: The Captive Years of Mary, Queen of Scots.

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