Victims of Chester
Photo by Christian Bowen on Unsplash
There will be many words written about Lucy Letby. The Thirwall enquiry is trying to understand the events leading to Letby’s arrest and conviction for 7 murders. Over recent days Thirwall has taken evidence from Chief Executive, Tony Chambers, and Medical Director, Ian Harvey. It is reasonable to say that neither came out of their sessions especially well.
When I first wrote about this in Augst 2023, my intention was to comprehend events from the perspective of Dr Brearey and Dr Jayaram, Paediatricians at the Countess of Chester, who first raised concerns about Letby some 9 years ago.
Despite alerting Senior Clinical staff and Managers of Letby's proximity to and possible involvement unexpected neonatal deaths, Drs Brearey and Jayaram and their Paediatric colleagues were first ignored, then threatened and finally made to apologise to Letby for their genuine and (as it turned out) correct concerns about her actions.
Imagine having to come to work day after day, month after month, suspecting that one of your own staff was causing the deaths of many babies? Imagine how it felt when Ian Harvey tried to close down debate (‘no further emails’) and implied that he was prepared to refer both Doctors to the GMC? Finally imagine having to apologise to her and having to work alongside her again?
Whistleblowers are often persecuted because they challenge the status quo in hospitals; Senior managers are more likely to want to 'draw a line' (in Tony Chambers’ words) - although I am beyond understanding how anyone could want to 'draw a line' under the deaths of babies in their Hospital. Facing the uncomfortable truth, that a group of experienced neonatologists might just be right, was more difficult. Ignoring genuine concerns, and pushing back against them, was simpler.
Tactics commonly used by NHS Trusts against whistleblowers include harassment, isolation, adverse performance reviews, GMC referral and even dismissal (see my blog on Martyn Pittman here). Clinical staff at Countess of Chester Hospital, ignored when they raised concerns, can certainly confirm how it felt.
It is hard to imagine how these professionals carried on working. But they did. Like all whistleblowers, they put the safety and welfare of their patients ahead of personal concerns about the hospital's reputation or even their own career. Their actions made management uncomfortable, because the maintenance of the status quo and the deflection of external scrutiny is easier than thinking the unthinkable.
It should not have been an 'unthinkable' idea that Letby could have been a murderer. There are past precedents - both Beverley Allitt and Harold Shipman killed patients while working in the NHS, and both cases led to significant changes in safeguarding procedures and revalidation cycles for doctors.
Personally, I pay tribute to the bravery, professionalism and dedication of the paediatricians I am privileged to call colleagues. But I also understand the extreme pressure they must have felt before Letby's arrest. I am glad that they have been vindicated. I am sad that they had to keep working without the support of Chief Executive Tony Chambers, Medical Director Ian Harvey or the RCPCH. They also faced the threat of a potentially career-ending referral to the GMC. We should be grateful to them for their exposure of a killer at some cost to themselves. They set an example for us all.
As for the Tony Chambers and Ian Harvey - shame on you both.
If you are experiencing difficulty having your concerns listened to by NHS, maybe consider 1:1 Coaching with a trained Executive coach. Start by booking a confidential 30 minute conversation here.