A telling phrase rang out from the latest trial of Lucy Letby. The prosecutor claimed that she had been caught “virtually red-handed” attempting to murder Baby K, by her colleague Dr Ravi Jayaram. Jayaram had come upon Letby standing over and watching the baby, it was said, as the baby “desaturated”, losing oxygen.
As the baby’s breathing tube had reportedly been dislodged and the alarm had apparently not sounded, the inference was that Letby had removed the tube herself and paused the alarm, intending the baby would die (as Baby K eventually did three days later). But this inference depended, almost entirely, on the reliability of Dr Jayaram’s version of events, about which he was challenged in cross-examination. Letby denied doing any harm.
Having heard their opposing accounts, a unanimous jury took just over three hours to find Letby guilty of the attempted murder of Baby K. The “red-handed” incident was no longer an inference; it was a fact. One that the judge could and did assert in his sentencing remarks, before condemning Letby to a 15th whole life order for her crimes.
Letby had refused to appear for sentencing at her earlier trial, but for the retrial of this charge, the 34-year-old stood in the dock of Manchester Crown Court. As she left to resume her jail term, she paused to say quietly, back into the court: “I’m innocent”. A statement that must have added to the distress of the family of Baby K, who described having to endure a “long, torturous (sic) and emotional journey – twice”.
During my time in office as a commissioner at the Criminal Cases Review Commission – the body responsible for investigating alleged wrongful convictions and referring cases for a new appeal where there is a real possibility of success – I encountered many safe verdicts that had been built on circumstantial evidence.
We cannot know whether Letby is innocent. Only Letby herself knows that. But we can say that she was never caught “red-handed”; she was not seen committing those acts and there is still no definitive forensic evidence linking her to them. I am not a lawyer, but every criminal practitioner knows that “indirect” evidence, especially where it exists in multiple strands, can be powerful and compelling evidence of guilt, underscored by the unlikelihood of coincidence.
In another contested case from 20 years ago, a male nurse, Benjamin Geen was convicted of killing two patients and harming others by injecting them with overdoses of drugs. He was not caught in the act, but on his arrest, as he arrived at the hospital for work, he was found with a syringe in his fleece pocket which contained one of the drugs (and traces of others) that he was alleged to have used. Although he and his supporters continue to claim he is innocent, that syringe is a significant obstacle to his chances of a successful new appeal.
However, circumstantial evidence also has the capacity to mislead juries into reaching the wrong conclusion, perhaps never more so than when it appears plentiful, and in almost complete absence of direct evidence.
At first glance, the case against Letby seems overwhelming. She pleaded not guilty to 22 charges of murder and attempted murder, arising from the deaths and collapses of an abnormally high number of newborn babies in the neonatal unit of the Countess of Chester Hospital.
The incidents in question occurred between June 2015 and June 2016, while Letby, then in her mid-20s, was working there as a neonatal nurse. According to an analysis of the staff shift patterns, she was the one person present at every event.
Letby was first arrested in 2018 and the trial took a painstaking 10 months, from October 2022 until August last year. She was alleged to have injected the babies in her care with air, or forced air into them through tubes leading to fatal air embolism, and also caused them internal bleeding and trauma. She is also alleged to have poisoned two with insulin and overfed two others with milk. The trial heard from her colleagues and from medical experts, led by Dr Dewi Evans, who attested to Letby’s methods.
There was evidence too of her morbid fascination with her crimes, searching families on Facebook, hoarding confidential documents about the cases at home and revealing her own thoughts in scrawled notes which include the now notorious admission, “I am evil, I did this”.
The jury returned seven guilty verdicts on murder and seven guilty verdicts on attempted murder. They acquitted her on two counts of attempted murder and were unable to agree verdicts on six further counts of attempted murder, including the case of Baby K.
For her crimes, Letby was sentenced to 14 whole life orders. The trial judge, Mr Justice Goss, told her she had acted “in a way that was completely contrary to the normal human instincts of nurturing and caring for babies and in gross breach of the trust that all citizens place in those who work in the medical and caring professions.”
Letby, Goss said, claimed that she never did anything that was meant to hurt a baby and only ever did her best to care for them. “That was but one of the many lies you were found to have told in this case” she was told. Doctors had to “think the unthinkable” when they became suspicious of her.
The verdict was met with an avalanche of publicity; Cheshire Police released their own in-house documentary revealing how they had successfully investigated Britain’s worst serial killer of babies. And with the reporting came many reminders of the double tragedy faced by families whose babies had died or suffered serious harm – only to later be told that one of the people caring for them had been responsible.
I was not alone, however, in finding the case perplexing. While the Crown did not have to explain why Letby had committed the crimes, there was no indication whatsoever as to motive, nothing to suggest any profound psychological flaw that such crimes might require.
There was testimony, in fact, that Letby was a diligent, compassionate and hard-working nurse. Her parents supported her. So did many of her friends. Much was made of her apparent confession, “I am evil, I did this” scrawled on scraps of paper.
On first look, it certainly looked like evidence of a troubled mind, but on closer inspection others have since suggested, this could easily be an expression of a deterioration of mental health and self-loathing at the association with the deaths of the babies and the increasing suspicions of doctors who worked with her.
