Countess of Chester Hospital Executives Testify at Thirlwall Inquiry

The Thirlwall Inquiry, now in its eleventh week, potentially experienced its most significant period. Established to examine the circumstances that allowed Lucy Letby to murder seven infants and attempt to murder seven others in the neonatal unit of the Countess of Chester Hospital during 2015 and 2016, the proceedings are named after its chair, Lady Justice Thirlwall, to highlight her role rather than Letby’s. Although Letby’s trial concluded over a year ago, unresolved questions persist, and many attendees at Liverpool Town Hall wish to avoid hearing her name. Despite ongoing debate, the inquiry’s scope does not cover Letby’s guilt but instead investigates the management of concerns on the ward and the locus of accountability. This particular week was vital for addressing the latter point. In the grand ballroom of the hall, under its chandeliers, the Countess of Chester’s former directors—Alison Kelly (nursing), Ian Harvey (medical), Sue Hodkinson (HR), and ex-chief executive Tony Chambers—made their initial public statements. Unlike other witnesses, such as hospital consultants, these executives were not called to provide testimony during the criminal trials and have avoided media interviews, thus their current disclosures offer fresh insights. Lady Justice Thirlwall, upon inaugurating the public inquiry—which is not a criminal proceeding—stated that Cheshire Police were examining the possibility of a corporate manslaughter charge against the hospital trust. Potentially aware of this, the executives appeared to select their words with precision. All shared the same legal counsel and commenced their testimony by offering an apology to the victims’ families, some of whom were present. Ms Hodkinson addressed the hall, saying, “There isn’t a day that doesn’t go by that you’re not in my thoughts.” Ms Kelly, in turn, remarked that she did not get “everything right at the time, however the decisions I made were done with the best intentions.” The families’ reception of these statements remains unstated, though their legal representatives posed some of the questions. A significant portion of the testimony centered on how the executives addressed warnings from consultants attempting to alert them about Letby, and the timeline of knowledge among staff. The nurse was found guilty of offenses committed between June 2015 and June 2016, yet several months elapsed from the time doctors voiced concerns until her removal from duty, and nearly an additional year passed before law enforcement became engaged. Each manager faced inquiries regarding shortcomings and overlooked chances, though admissions were infrequent. Former chief executive Mr. Chambers was questioned four times about his most significant personal failing. He responded in the plural, referring to the executives’ communication with the infants’ families, and was subsequently challenged. Nicholas de la Poer KC, counsel to the inquiry, remarked: “You use the word ‘our’ not ‘my’. You’re not advancing any personal failure on your part?” Mr. Chambers responded: “Thank you for pulling me up on the language there. I accept that as the accountable officer for the trust I must take some responsibility – must take responsibility – for that.” Mr. Chambers was not the sole former executive to identify inadequate communication with the babies’ parents as a failing. Mr. Harvey confessed to dispatching a letter in April 2017, which he now recognized as “crass, inappropriate… unthinking and insensitive.” The former medical director conceded that the leadership had not shared information with sufficient transparency but refuted any accusation of a cover-up. Several managers stated their efforts to reconcile a duty of candour with a duty of care towards Letby. The executives were all questioned about their interactions with Letby, leading to the revelation of several notable new details. Ms. Kelly acknowledged that her meeting with the nurse, after Letby had filed a grievance complaint for being removed from duty, constituted a conflict of interest. She stated: “I have reflected a lot on the conversations I had with Lucy Letby, and if I knew then what I know now, that would not be my normal practice.” Mr. Chambers met with Letby and her parents in December 2017, following the upholding of her grievance complaint, and guaranteed her reinstatement to nursing duties. He expressed astonishment at her resilience and commented, “don’t worry Lucy we’ve got your back.” A noteworthy detail that surfaced concerned the involvement of Letby’s parents, particularly her father, after her removal from duty. Former HR director Ms. Hodkinson recounted how John Letby made agitated phone calls, exerting pressure on those managing his daughter’s situation. Mr. Chambers added that a “very angry” Mr. Letby had threatened to report the consultants to their regulatory body, the General Medical Council, and “was threatening guns to my head and all sorts of things.” The executives were also challenged regarding their insufficient support for consultants attempting to voice their suspicions, and they conceded that these individuals had not received protection as NHS whistleblowers. Direct testimony from the former leaders for the first time illuminated the prevailing atmosphere at the Countess of Chester Hospital during that timeframe. The questioning occasionally became highly personal, with managers asked about the environment they had fostered. Ms. Kelly denied fostering a “culture of fear” but acknowledged the existence of animosity between doctors who suspected Letby and nurses who supported her. Concurrently, Mr. Chambers maintained that he had acted professionally, despite some witnesses alleging oppressive, overbearing, and bullying conduct. Mr. Harvey was questioned about his conduct and stated regarding the consultants: “If they felt that they were intimidated then that certainly wasn’t the intent or the purpose, but I would apologise to them for that.” The testimony provided by the executives, delivered before a full public gallery and rows of lawyers, proved compelling. Ultimately, however, the critical factor will be Lady Justice Thirlwall’s assessment of the evidence, which will not be disclosed until her report is published next autumn.