Former Medical Director Admits “Crass” Communication with Families of Letby’s Victims

The individual who previously served as medical director at the hospital where Lucy Letby committed murders of infants has acknowledged that his interactions with the families of the children were “crass and inappropriate”. Ian Harvey held the position of the most senior physician at the Countess of Chester Hospital during the period from 2015 to 2016, when the nurse murdered seven infants and attempted to murder seven additional infants. During his testimony at the public inquiry investigating these crimes, he confessed that a letter sent to the families—comprising a single page accompanied by an attachment of medical records pertaining to a review of the infants’ deaths—was “unthinking and insensitive”. He stated, “I would only say that we were keen to share the information as soon as possible.” He added, “We were aware there had been inordinate delays but I accept that doesn’t excuse the way in which this was done.” He characterized a letter received from the mother of one of the infants, who was pleading for information, as “heart-rending”. Mr. Harvey, who is now retired, refuted claims of withholding information from the infants’ families and denied allegations of a cover-up regarding warnings about Letby issued by consultants. He further denied having threatened the medical practitioners with a referral to the General Medical Council regulator, asserting that this threat was instead made by Letby’s father, John. Nevertheless, Mr. Harvey acknowledged a lapse in his obligation of pastoral care toward the paediatricians who were attempting to alert authorities about Letby, noting that these doctors had observed her frequent presence when infants died or experienced sudden and unexpected near-fatal incidents. He stated that a significant regret of his professional life was the deterioration of relations between the executive staff and consultants, and he offered an apology to consultants “if they felt intimidated” by him. Letby’s trial determined that the nurse injected air into two triplet boys, identified as Baby O and Baby P, on consecutive days in June 2016. The inquiry has been informed that Dr. Stephen Brearey, the neonatal clinical lead, voiced concerns regarding Letby at a meeting held a month prior, on May 11. Dr. Brearey had previously informed the inquiry that he considered the mortality rate in 2015 and early 2016 to be “exceptional” and pointed out to Mr. Harvey that it was “unusual” for six of the nine deaths to have taken place between midnight and 4 am. He stated that he had informed Mr. Harvey about several reviews, including one conducted by an external neonatologist, and that the sole recurring factor was Letby’s presence on duty. Mr. Harvey responded that this “did not accord with my recollection of that meeting” and that he did not recall Dr. Brearey being “that detailed or that assertive”. Rachel Langdale KC, serving as counsel to the inquiry, suggested to Mr. Harvey that Baby O and Baby P “should never have died after that 11 May meeting, should they?”. She further commented, “[Letby] could have been off the ward and referred to the police then.” Mr. Harvey replied, “I would not accept as a result of that meeting that the conversations we had and the approach that Dr Brearey and the nursing staff had, that there was anything that would have supported such action.” He added that Dr. Brearey fully endorsed the measures decided upon at the meeting, and it was emphasized that one such measure involved reporting any subsequent collapses or incidents. Mr. Harvey continued, “At no stage during this meeting did I feel that it was being reported because there was worry that Letby was responsible for the deaths.” Letby was ultimately reassigned to an administrative position in July 2016, following a meeting between all consultant paediatricians and executives after the deaths occurred. Ms. Langdale KC additionally inquired of Mr. Harvey whether he had obtained consent from the parents of the infants for their children’s medical records to be utilized in a case note review concerning some of the unforeseen deaths at the neonatal unit. Mr. Harvey stated that he could not remember if he had performed this action, but when questioned further by Ms. Langdale, he responded, “I almost certainly would have delegated that task.” He added, “I have no recollection of following that through. If I didn’t, that is a very significant error on my part and I’m very sorry for that.” He was also questioned regarding his decision to proceed with a review of the neonatal unit by the Royal College of Paediatrics and Child Health, despite the reviewers informing him that they could not directly ascertain the reason for the increase in unexpected deaths and collapses. Ms. Langdale posed the question: “You were spending money and taking time on a review that isn’t going to answer the question you’ve got in front of you [that consultants paediatricians were concerned that Letby was deliberately harming babies]?” Mr. Harvey replied, “It was perfectly reasonable to explore with the relevant expertise, both medical and nursing, the full range of potential causes.” He was additionally asked why he informed a hospital committee that the Royal College had not advised any immediate measures concerning the heightened mortality, despite the fact that it had actually recommended the hospital initiate its own inquiry into the doctors’ concerns. Mr. Harvey responded that he did not perceive it as the type of immediate concern where “they [The Royal College] say you have to take action before we leave the building or stop this service now.” Ms. Langdale suggested to Mr. Harvey that, during his leadership as medical director, physicians feared job loss for bringing forth patient safety issues. He replied, “I accept I failed in a duty of pastoral care that I should have offered.” However, he asserted that he did not intend to foster an atmosphere of apprehension within the unit. He also denied instructing Susan Gilbey, who assumed the role of chief executive at the hospital, to refer consultants to the General Medical Council. “I did not say that,” he stated. The Thirlwall Inquiry, convened at Liverpool Town Hall, remains ongoing.