This article is taken from the July 2025 issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering five issues for just £25.
The protestors got a shock when they went to the pub after demonstrating outside Liverpool Town Hall in March. Around 70 people had come from as far as Somerset and the Netherlands to demand the release of Lucy Letby, the former nurse who is serving 15 whole life sentences for the murder and attempted murder of babies at the Countess of Chester Hospital (CoCH) between June 2015 and June 2016.
Inside the town hall, the Thirlwall Inquiry was hearing closing submissions. Outside, demonstrators were singing “You’ll Never Walk Alone” and waving placards reading “Let her be free” and “Jail all the lying bastards who framed her”. Afterwards, they retired to a nearby Wetherspoons — but soon beat a hasty retreat after being sworn at and threatened by angry locals.
The confrontation with hostile Scousers was a reminder that social media is not the real world, and yet supporters of Letby are not all online misfits. They now include the journalists Peter Hitchens and Private Eye’s medical correspondent Phil Hammond as well as the Conservative MP David Davis.
The Thirlwall Inquiry uncovered details that shone further light on Letby’s character, such as when she failed her final year student nurse placement because she was “cold” and lacked empathy, but it was drowned out by a succession of news stories claiming to have found holes in the prosecution’s case.
Pro-Letby activists resent being called conspiracy theorists, but if the former nurse is innocent, only a conspiracy can explain her incarceration. Letby herself cried conspiracy at her original trial in 2022–23. The testimony of doctors and parents contradicted her version of events so often that she had little choice but to call them liars. Why would they lie? Because, she said, four consultants were using her as scapegoat for poor standards of care at the hospital. This is the theory most of her supporters have settled on. If true, she is the victim of the most sensational miscarriage of justice in English history, but it is hard to swallow.
No one was blaming the doctors for the spike in neonatal deaths, and hospital managers were keen to draw a line under it. A forensic investigation would have only drawn attention to any negligence — and the reputation of the CoCH has hardly been improved since the world learned it was harbouring a serial killer. Even if the doctors had wanted to frame Letby, it is hard to explain how they persuaded numerous colleagues, the police, the Crown Prosecution Service, multiple medical experts and two juries to go along with their evil scheme.
It has been suggested that the police cherry-picked incidents at which Letby was present and that this manufactured coincidence tricked a statistically naive jury into convicting her. But the jury deliberated for 100 hours, acquitted her of two counts and failed to reach a verdict on six others. Letby’s supporters say that her mere presence on the ward when babies collapsed and died is not enough to prove her guilt. The jury clearly agreed.
The reality is that those 13 months of infant deaths saw a dawning realisation amongst CoCH staff that something terrible and extraordinary was happening. It was noted from the outset that Letby was the one common denominator. This drew her sympathy rather than suspicion at first, but by the time she was taken off the ward in July 2016, junior doctors had nicknamed her “Nurse Death”.
A case note review produced by the neonatologist Jane Hawdon in October 2016 — long before the police were involved — identified five “unexplained” deaths. As Hawdon told the Thirlwall Inquiry, “unexplained and unexpected deaths are unlikely to be from natural causes.” “Something was seriously wrong,” said Nicholas Johnson KC in court. “They just couldn’t put their finger on it.”
It all began when three babies unexpectedly died, and another narrowly escaped death in the space of two weeks in June 2015, shortly after Letby obtained her QIS (neonatal “qualified in speciality”) qualification that allowed her to look after intensive care babies. In one of the many “coincidences” in the case, her QIS course had highlighted the dangers of air embolism which, the prosecution alleged, would become her favourite method of murder, accounting for the collapses of all four babies in June.
On 30 June, reflecting on the death of Baby A, one of Letby’s colleagues messaged her to say: “There’s something odd about that night and the other 3 that went so suddenly.” Letby’s reply was typical of the way she gaslighted other nurses to normalise what was going on: “What do you mean? Odd that we lost 3 and in different circumstances?” But her colleague did not take the bait. “Were they that different?” she texted back, reminding Letby that they were “similar in being full arrests in babies that were essentially stable”.
Full arrests in babies that were essentially stable. There were a lot of those when Staff Nurse Letby was around, especially when the parents had left the hospital. They followed her from the nightshift to the dayshift, abated when she went on holiday and stopped altogether when she was moved to a desk job. They were not minor incidents dredged up from the past in a fishing expedition to frame an innocent nurse.
The harm done to Baby G left her with permanent brain damage. The collapse of Baby N was so serious that the family were asked if they wanted to call a priest. Baby’s M’s collapse was so bad that the doctors considered giving up on the resuscitation. These episodes lodged in the minds of those who witnessed them because they were — as the nurse said — “odd”.
Baby M “looked well, he was settled. There wasn’t any major concerns, no red flags”, according to a doctor who examined him, but he suddenly stopped breathing shortly after being treated by Lucy Letby. Baby N was doing so well that he was expected to go home on the day that he nearly died.
A constant theme in the Letby case is medical staff, some of whom had decades of experience, witnessing things that they had never seen before. Collapses came out of the blue with infants who had been stable and doing well. Oxygen levels would suddenly crash, breathing would suddenly stop and resuscitation was often surprisingly ineffective.
When babies were revived, their recoveries were almost as sudden and total as their collapses. None of it made sense. Dr Harkness said that the collapse and death of Baby A was “incredibly unexpected. This was a completely stable, well baby who had no reason to deteriorate”. Dr Brearey said he could “think of no natural, normal cause for why [Baby N] deteriorated multiple times”.
The death of Baby I in October 2015 stuck in the memory of Dr Beebe because “it had never happened to a baby I had been involved in the care of before or since, at any of the neonatal units I worked at”. For Dr Brearey, it set “a few alarm bells going”. It was the fifth unexpected death in as many months.
None of this proves that the collapses and deaths were caused by Letby, but it does show that there was something exceptional going on in the hospital. Letby’s supporters are on a hiding to nothing when they claim that there was a mere spike in natural deaths that were only later badged as suspicious.
One of the few people who did not remark on how extraordinary and unprecedented the incidents at the CoCH were was the one person who was always there when they happened. There was a lot that Nurse Letby did not notice or remember about this period. Internet records show that she frequently looked up the parents of babies who had died on Facebook, including searching for the mother of one set of twins on Christmas Day, but she could not recall doing so when asked about it in court.
She looked up the parents of Baby D three days after her death and then again four months later but when interviewed by the police said she couldn’t remember her and in court said she “didn’t really remember” the traumatic evening on which she died. During the trial, she said she had “very little independent memory” of the night Baby C died, and yet she said that she searched for his parents on Facebook because “you don’t forget about babies you cared for and what happened”.
If there was a conspiracy against Letby, the conspirators were very lucky to pick a scapegoat who was so evasive and shifty when she gave evidence in court. How fortunate they were that she brought 257 handover sheets home with her and when asked why she kept them said: “Because I collect paper.” How serendipitous that when the police searched her house, they found notes in which she wrote “I killed them on purpose because I’m not good enough to care for them” and “I AM EVIL I DID THIS”.
They were lucky that she had shocked a colleague by saying, “He’s not leaving here alive, is he?” during Baby P’s resuscitation. They were lucky that she had been falsifying medical records and sending misleading messages to colleagues. And they were incredibly lucky that she was always present when unprecedented medical emergencies occurred, often when she was not even the child’s designated nurse.
Amongst the unusual features of the deaths and collapses was skin discolouration, which many of those present had never witnessed before. The shift leader on duty when Baby A died recalled he was “very white with sort of purply blotches and very cyanotic”. Two doctors recalled purple or pink rashes on Baby A, which they had only ever seen on other babies in the Letby case. On Baby B, at least two doctors and three nurses recalled purple blotches, and Letby’s own notes say that she was “cyanosed in appearance … colour changed rapidly to purple blotchiness with white patches”.
Dr Rachel Lambie said she had “never seen anything like it before”. Senior neonatologist Caroline Bennion recalled that Baby B was “white with purple blotches” and that she had “never seen a baby look that way before”. Dr Breary said the “unusual” rash on Baby O’s chest was something he had “never seen before or since”. Dr Harkness said that he had only ever seen the “strange purple patches” on Baby E on another baby in the Letby case (Baby D). It would be tedious to give further examples, but there are many.
When so many doctors and nurses are dumbfounded by symptoms they have never seen before, it logically follows that the cause of the collapses was something they had not encountered before. Air embolism, so rare that most doctors have no personal experience of it, fits the bill. If it wasn’t that, what was it?
Letby’s supporters believe they have found the answer, thanks to the retired Canadian neonatologist Professor Shoo Lee who was involved in Letby’s first appeal, after a literature review he had co-authored in 1989 about air embolism in neonates was cited in the original trial. The study noted the presence of unusual rashes in a handful of cases, and the prosecution argued that the skin discolouration witnessed by CoCH staff supported a diagnosis of air embolism. Lee disagrees, saying that the only rash that is truly diagnostic of air embolism — i.e. uniquely associated with the condition — is what he now calls “Lee’s sign” with “pink red blood vessels superimposed on the cyanosed background”.
This argument did not sway the judges at the Court of Appeal, who described Lee’s new evidence as “irrelevant and inadmissible” because it was “aimed at a mistaken target”. Nobody in the original trial claimed the unusual blotches were proof of air embolism, they said; only that they were consistent with air embolism. It is not disputed that skin discolouration can be a symptom of air embolism. It would be surprising if it were not since, as the Appeal Court judges noted last year, it is “indicative of circulatory collapse”.
In an interview that was perhaps too candid for someone hoping to be an expert witness in a retrial, Lee told the Sunday Times that he asked Letby’s legal team what would be required to get a new appeal, and they said, “you have literally got to find a different person or thing that caused the death”.
He then convened an “international expert panel” of mostly neonatologists and paediatricians who looked at the medical records and found innocent explanations for every collapse and death. Their findings were announced at a televised press conference in February 2025 organised by Letby’s PR company, Maltin PR, who are representing her pro bono. Her new lawyer, Mark McDonald, has filed their report with the Criminal Cases Review Commission which is her only route to a new appeal.
Last year, Lee published an updated version of his air embolism study, apparently hoping that the Court of Appeal will see it as new evidence, but both studies remain more helpful to the prosecution than to the defence. His 2024 paper notes that air embolism in neonates typically results in “acute clinical deterioration, with desaturation, bradycardia, hypotension, collapse and drowsiness”, with “cyanosis”, “pallor” and “mottling” being amongst the more common symptoms. All were frequently reported in the Letby case whereas “Lee’s sign” was only reported in two of the 117 cases documented in his study.
The “international panel” includes some high-flying neonatologists, and their opinions deserve to be taken seriously. Yet it is difficult to do so when they float ideas that have already been raised and refuted in court. They claim that the mother of Baby A passed her antiphospholipid syndrome (a rare blood disorder) on to the child, and he died of thrombosis as a result.
Aside from there being no physical evidence of thrombosis, Professor Sally Kinsey, a haematologist at Great Ormond Street Hospital, testified in court that blood tests proved that neither of the twins had antiphospholipid syndrome. The panel further asserts there is “no evidence” that Baby G was overfed, but the evidence shows she was being given 45ml of milk every three hours, each time on an empty stomach.
After projectile vomiting three times, she still managed to aspirate 45ml of milk through the nasogastric tube — and a further 100ml was aspirated later. As the neonatologist Dr Sandie Bohin explained in court, “basic arithmetic” shows that she was overfed.
At times, the panel’s critique amounts to little more than a stamp of the feet from people who have their fingers in their ears. They claim that there is “no evidence” that Baby K’s endotracheal tube was dislodged, despite eye-witness testimony saying it was. They claim there is “no evidence of air embolism” in the Baby A case — but, even if you discount the unusual rashes, Professor Owen Arthurs, a highly experienced paediatric radiologist at Great Ormond Street Hospital, said that the line of gas in front of the child’s spine was not found in babies who died of natural causes and was consistent with “air being administered”.
Asked in court if he had ever seen so much gas in a baby before, he said he had only seen it in another baby on the indictment. Dr Andreas Marnerides, a pathologist at Guy’s and St Thomas’ Hospital, found air in the brain of Baby A and testified that he believed the child had been given an intravenous injection of air. Are they in on the conspiracy too?
Perhaps the most remarkable of the panel’s claims involve insulin. Letby is clever, but she was never as clever as she thought she was. She knew that excessive insulin could kill a child, but she did not know that synthetic insulin leaves a biological footprint. When insulin is produced naturally, its by-product C-peptide is produced at a much greater rate, typically resulting in levels of C-peptide being five to ten times higher than the level of insulin. In the two babies poisoned with insulin, C-peptide levels were vastly lower.
In Baby F, insulin levels were “extremely high” whilst C-peptide levels were “undetectable”, according to Dr Anna Milan, a clinical biochemist who worked at the laboratory that conducted the tests. It is one of the great failings of the CoCH that they failed to spot evidence of insulin poisoning that Professor Peter Hindmarsh, a paediatric endocrinologist at University College London, told the court was unambiguous. Nevertheless, Shoo Lee’s experts — none of whom are endocrinologists — flatly state that C-peptide levels in both babies were “not low for preterm infants”.
We were told a different tale two months earlier. One of the most curious acts in the Letby circus was the press conference held in December 2024, also organised by Mark McDonald and also starring a neonatologist flown in from Canada. At that event, Dr Richard Taylor told the world that the insulin tests were simply wrong.
He then accused a doctor, who was not named but was easy to identify (and was swiftly outed by Private Eye), of accidentally killing Baby O by lacerating his liver with a needle. “I would be unable to sleep at night,” he said, “knowing that what I had done had led to the death of the baby and now there is a nurse in jail convicted of murder.”
It was soon pointed out that the possibility of the doctor damaging Baby O’s liver with a needle (actually a cannula) was discussed at length in court and rejected. It was not, therefore, grounds for appeal. Within two months, that press conference had been wiped from history, the insulin tests were now correct but not suspicious, and Shoo Lee’s panel had decided that Baby O’s liver had been damaged during childbirth.
This is also unlikely to stand up in a court of law — a review carried out on the morning he died found no injury to the liver, his haemoglobin levels were fine until his last hours of life, and even Letby accepted that the liver injury happened “on her watch” — but it shows how flexible scientific opinion can be in the cause of freeing this woman.
The Court of Appeal will make light work of McDonald’s submission if it ever reaches them. Letby will probably ensure it does not. The big question about her case is why she did not call any medical experts of her own. The only plausible answer is that she feared they would be tripped up under cross-examination and make her look even more guilty.
Her appeal now rests on the idea that she was poorly advised by her lawyer, Ben Myers KC and should have called the likes of Shoo Lee, but to do this she will have to waive privilege and allow the court to see the notes of her meetings with Myers. No innocent person would hesitate to waive privilege in this situation. Letby has not done so, presumably because she knows it would blow up in her face. So why fight for an appeal at all? Perhaps because it allows her to do what she has always done and control the narrative. Safely locked away in HMP Bronzefield, Letby still knows how to get attention, attract sympathy and manipulate others. She must be smirking at all the latter-day Lord Longfords fighting for her release.
