Welsh doctor in Letby case says NHS managers who fail should be sacked

Martin Shipton

A retired Welsh consultant paediatrician who gave evidence in the trial of notorious baby killer Lucy Letby has backed calls for senior NHS managers to be disqualified if they are found unsuitable to carry out their roles.

Barrister Sir Robert Francis KC told the public inquiry into how Letby, a nurse at the Countess of Chester Hospital in Chester, was able to kill seven infants and attempt to kill seven more, that there is currently no regulator “with the teeth” to sanction poorly performing directors.

Doctors, however, can be deemed unfit to practise by an independent adjudicator. Letby targeted babies at the hospital between June 2015 and June 2016.

‘Fit and proper’

Sir Robert, who chaired the inquiry into care failings at Mid Staffordshire NHS Foundation Trust, told the Letby inquiry: “The result, I’m afraid, is that people who haven’t done terribly well one way or the other may leave one job, and you will then find they pop up in another, because there is no overall certification as to whether someone is a fit and proper person at any given time to do these roles. So I am in favour of there being a system of regulation that at least has that element to do it.”

Sir Robert said he believed there should be a way of disqualifying someone from becoming a chief officer or senior director of an NHS organisation.

In a report to inquiry chairwoman Lady Justice Thirlwall, he wrote that external scrutiny of NHS bodies depends on intervention by NHS England or the Care Quality Commission – both of which he said were not “fully equipped” for the job.

Sir Robert’s Mid Staffordshire inquiry revealed the neglect of hundreds of patients at Stafford Hospital between 2005 and 2009 and made sweeping recommendations for change.

‘Complicit’

Some families have told Lady Justice Thirlwall they feel senior management at the Countess of Chester hospital were “complicit” in Letby’s deadly activities. They accused some senior leaders of “facilitating murder” by ignoring concerns raised by consultants.

But former managers at the hospital have claimed they were not informed about staff suspicions that Letby was deliberately harming babies in the neonatal unit until late June 2016. She was removed from the unit weeks later, although police were not called in by the hospital until May 2017. There had been plans to return her to her usual duties before police were called.

Letby, 34, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.

The inquiry is expected to sit at Liverpool Town Hall until early next year, with findings published by late autumn 2025.

Regulatory body

Agreeing with Sir Robert’s call, Dr Dewi Evans from Carmarthen, whose evidence helped convict Letby, told Nation.Cymru: “Plaid Cymru proposed a regulatory body in a Senedd debate earlier this year. Labour Health Minister Baroness Morgan failed to support the proposal.

“The failure of management to listen to the concerns of senior consultants at Chester has been devastating, allowing Lucy Letby to continue her carnage for so long. The murder of two little triplets in June 2016, over 12 months after the first fatality, could have been avoided if the health board had listened to the doctors and placed their duty of care to the public ahead of their desire to safeguard the ‘good name’ of their organisation, and their own positions of course.

“Sadly, this is typical of the mindset of NHS management across the UK. The current ‘scandal’ involving maternity care at Swansea’s Singleton Hospital shows no sign of the health board accepting responsibility for its failures, desperately blocking the efforts of the families’ wishes to appoint a fully independent review of maternity care. I believe that if I was parachuted into my former department [ he headed the paediatric and obstetrics departments at the hospital in the 1990s and 2000s], I’d identify the problems and weaknesses within weeks, and provide effective remedies. Which is why of course I’m not holding my breath!

“In the corporate world of our NHS leaders their position of power will always take priority over the needs of families and vulnerable infants. And thanks to Eluned Morgan’s decision to abolish CHCs (Community Health Councils) when Health Minister, following [former UK Health Secretary] Jeremy Hunt’s earlier decision to abolish legal aid for families seeking advice when suspecting clinical negligence, the general public has no independent body whose role is to protect the public from unsatisfactory care in our hospitals.”

Devastated

A Welsh Government spokesperson said: “Our thoughts are with all the families devastated by these dreadful crimes. It is important families get the answers they need and we welcome the independent Thirlwall inquiry, which started last month.

“Excellent and compassionate leadership within NHS Wales is critical to delivering the best health outcomes for the people of Wales.

“Health professional regulation is reserved to the UK Government and we understand it is considering the position regarding the regulation of NHS managers.”