Lucy Letby: Within reasonable doubt?

By Temi Olaojo

‘In summary, ladies and gentlemen, we did not find any murders.’ Those were the words of Dr. Shoo Lee, an expert neonatologist, concerning the deaths of 14 babies from June 2015 to June 2016 at the Countess of Chester Hospital in Chester. Over this period, from 2015-16, at the hospital, neonatal mortality rates nearly tripled. Calls in support of her innocence are growing and, although, upon first look, without any investigation, one might deem such calls to be part of the generic anti-establishment narrative that can pervade online spaces - those who are using Letby’s name for views and perpetrating conspiracy theories without any evidence. However, once the evidence is reviewed, calls for a re-examination of the case can easily be seen in a different light.

In English law, 'beyond reasonable doubt' refers to the standard of proof that the prosecution must establish. If there is any reasonable doubt in the minds of the jury, there cannot be a conviction. This is what is at the centre of the current discussion around Lucy Letby. Is there reasonable doubt that Lucy Letby committed the murders of vulnerable and defenceless newborn babies at the Countess of Chester Hospital from 2015-2016?

'The only thing that could be worse for the families, than Letby murdering their babies, would be if she hadn't, and that they have been made to live through all of this unnecessarily'

Many aspects of the case have been discussed and called into question leading up to, during, and now even after Letby’s conviction. The stakes are incredibly high. If Letby is innocent, as experts like Dr. Shoo Lee believe, then has an innocent woman been wrongly convicted? If she is guilty, as the trial established, what extent of trauma and pain does this continue to confer unto the families of the infants killed? Additionally, what does the discussion reveal about the public’s trust in the British legal system? ITV’s Lucy Letby: Beyond Reasonable Doubt documentary sets out to explore the doubts concerning Letby’s conviction.

The critical question is as follows: is there credence to the view that Letby’s convictions are unsafe? The existence of the documentary itself lends credibility to such a view, with the production laying out the case for those that believe the conviction is unsafe. Among those interviewed include Mark MacDonald, Letby’s barrister who was instructed in September 2024. The ITV documentary sets out the facts which seem to support a theory that something has gone wrong in Letby’s case. As one progresses through the documentary, it becomes difficult to not question how something could have potentially gone so wrong. From an objective standpoint, based on the evidence that has been presented in the documentary, there are clear failings from the Countess of Chester Hospital, the evidence provided by the prosecution to convict Letby and, it could be argued more damningly, from the defence.

Four crucial pieces of evidence were proposed by the prosecution: a shift chart, Letby’s handwritten notes that were suggested to be confessions, blood-test of the infants suggesting poison according to the prosecution and medical evidence from the babies’ notes to support theories of how Letby attacked them. Regarding the shift chart, leading medical statistician from the University of Warwick, Professor Jane Hutton, disputes the evidence and explains in the documentary that the prosecution made a specific selection of data in creating the shift charts. Prosecutors did not include all of the deaths that they regarded as suspicious, simply all of the deaths that Letby was present for. This revelation begs the question of how could such evidence not be challenged? Other challenges to the evidence include the conclusion that the tests used to determine insulin poisoning in babies should not be used as legal evidence, a disclaimer which is noted on the website of the hospital that conducted the tests.

In the trial, a previous research paper of Dr. Shoo Lee’s was used when discussing how Letby may have murdered the babies. Dr. Lee explains that his work was never intended for such a purpose, and distinguished between air embolisms in the veins, which is what his paper focused on, and air being injected into the stomach, which is what was suggested during the trial by the prosecution and Dr. Dewi Evans. After the trial, Dr. Evans later altered his opinion, stating that he did not believe that babies died from air in the stomach, but may have just collapsed due to this. MacDonald claims that this makes Evans an unreliable witness, and thus all the convictions are unsafe. Finally, at the time of the trial, Letby’s defence did not instruct any expert witnesses to the stand, despite working with expert witnesses in the lead up to the trial.

Participants in the documentary were critical of the medical establishment. Did the medical establishment at the Countess of Chester scapegoat Letby?

Another aspect to consider is Letby’s previous appeals. Despite all of these weaknesses in evidence that the documentary has pointed out, why were Letby’s two appeals rejected? Letby’s first appeal was regarding the first 13 convictions, and the second one was regarding the conviction for the murder of Baby K. The first appeal mentioned that Letby’s team believed that the judge should have instructed the jury to disregard the evidence of Dr. Dewi Evans. It also mentioned that a judge rejected Letby’s permission to appeal the evidence relating to insulin in the bloodstream. The specific areas of evidence that the documentary explores do not seem to be covered in detail in the appeals.

There are many significant themes that run through this case and the implications for what the documentary suggests are wide reaching. Participants in the documentary were critical of the medical establishment. Did the medical establishment at the Countess of Chester scapegoat Letby? The rise in infant mortality rates at the hospital coincided with it admitting babies that were much sicker than their usual patients, meaning they required more complex care than the hospital could provide. Dr. Shoo Lee stated that death or injury were due to natural causes ‘or just bad medical care’. Additionally, Professor Neena Modi, a neonatologist and former president of the Royal College of Paediatrics and Child Health, expressed how the infants’ medical records showed a failure by the hospital and by doctors, explaining that babies may not have died, had their complex issues been dealt with earlier.

Currently, the Criminal Cases Review Commission (CCRC) is reviewing Letby’s

conviction and has been since her lawyer Mark MacDonald submitted the report of the international expert panel, that included Dr. Shoo Lee, on February 3rd, 2025. The CCRC usually insists on new evidence to be presented, and the expert panel has not reviewed any new evidence, but the same evidence that was presented during trial that the defence did not adequately question. The documentary shows MacDonald being asked why this expert evidence was not presented by the defence at trial and MacDonald replies that he was instructed afterwards. A pressing question with unsatisfactory answers. However, despite the lack of answers in that respect, MacDonald makes a convincing argument that if Letby is innocent, should she remain in prison simply because the evidence was not presented at trial? Of course not.

Overall, the questions surrounding this case are loud, and they should be. The consequences of wrongful conviction are wide-reaching, as has been seen in the recent cases of the sub-postmasters and others. The British legal system is not immune to making mistakes, rare though they may be, and identifying possible mistakes is what will ultimately strengthen the system. The Lucy Letby case is a complex one and it remains to be seen what the CCRC will decide. Following Letby’s

trial, conviction and sentencing, the Thirlwall Inquiry, an inquiry into the deaths of the babies Countess of Chester Hospital, was commissioned. According to the Thirlwall Inquiry website, the purpose of the inquiry is to seek answers for the victims and their families. Lady Justice Thirlwall hopes to publish her findings in early 2026. Critically, the inquiry may help to determine if and how NHS failings played a role in the deaths of the infants. Depending on the results of the inquiry, its publication could support or quieten the theory of Letby’s unsafe conviction in the public opinion and conversation.

From an objective standpoint, based on the evidence that has been presented in the documentary, there are clear failings from the Countess of Chester Hospital, the evidence provided by the prosecution to convict Letby and, it could be argued more damningly, from the defence.

Ultimately, regardless of whether Letby’s convictions are unsafe or not, those that should be at the centre of the overall case are the 14 babies who were killed and their families. 14 babies died, and whether at the hands of Letby or not, there must be justice and as the Thirlwall inquiry suggests, there must be answers to the infinite number of questions that exist in this case.

ITV’s Lucy Letby: Beyond Reasonable Doubt? can be viewed for free on ITVX and

YouTube.

Image: Heute.at