Letby defence expert slams 'unfair' justice system over not being called to testify

A former defence medical expert in the Lucy Letby case says it was appalling that he was never called to testify and that the justice system may have deprived the defendant of a full medical rebuttal. Dr Mike Hall told the Mail’s Trial podcast that he does not go as far as claiming Letby is innocent, but he questions whether the jury heard enough evidence to reach the convictions. Letby, 35, was convicted of murdering seven babies and attempting to murder seven more after two trials at Manchester Crown Court, and is serving 15 whole-life terms.

Hall was the primary medical expert on Letby's defence team and sat through almost every day of her 10-month trial. He said not calling him was not necessarily wrong legally, but in terms of natural justice it seems appalling that Lucy Letby did not have the opportunity of having her case presented. Although he would not go so far as to say he thought Letby was innocent, he said he did not believe the jury heard enough evidence to meet the threshold for conviction or to be sure the former neonatal nurse inflicted harm.

The 11 members of the jury (one woman was discharged before deliberations began) were unanimous in finding Letby guilty of attempting to murder two twin baby boys — Baby F and Baby L — with insulin. In the absence of direct forensic or witness evidence, the blood test results from both boys, which suggested the insulin had been administered, were critical for the prosecution. However, key pieces of circumstantial evidence — a confession note in which Letby wrote “I am evil…I killed them on purpose,” nursing handover sheets discovered during searches of her home, text messages and comments to colleagues and parents, and the looking up of parents on Facebook months and even years after children died or were harmed — were cited by the prosecution as proof she was a killer.

Dr Hall pointed out that, in line with normal legal directions, the trial judge told the jury that whatever Mr Myers said to them, in his speeches or during the cross-examination of witnesses, was not evidence and should not be treated as such. But the medic claimed that this was a problem because – however well Mr Myers rebutted or challenged the evidence of the lead prosecution experts, Dr Dewi Evans and Dr Sandie Bohin, or the local doctors and nurses from the Countess of Chester Hospital, who also took the stand – it was not the same as hearing an alternative opinion from an expert witness. “What the judge said to the jury was you have to ignore what Mr Myers said because it doesn’t count, it has to be a witness that says that,” he said. “So Dr Evans and Dr Bohin made some statements which were, certainly in my opinion, incorrect. And it is my position, that me or someone else should have got into the witness box and said, ‘Actually what they said, that’s not quite the way it was, or that’s not quite what that meant,’ (for) clinical events (that) were occurring.”

Ben Myers KC, Letby’s first defence barrister, has faced criticism for not calling any medical experts in her defence. Hall suggested the trial system was worrying because it encouraged lawyers on both sides to withhold the truth at times. “It’s their job to identify those bits of the truth which suit their case and to try not to allow other bits of the truth to emerge,” he said. “And at its most extreme, that happened in this case when nobody was called by the defence. So there’s a whole raft of truth there which wasn’t allowed to emerge. Now, that’s part of the game, but it’s not, in my view, natural justice.” He claimed both Dr Evans and Dr Bohin overstated how well several of the babies were before they collapsed and claimed he would have told the jury as much if he had been called. Letby has twice applied and failed to appeal her convictions, but new medical reports from an expert panel have been submitted to the Criminal Cases Review Commission, the body which investigates potential miscarriages of justice, in a bid to get the Court of Appeal to look at her case a third time.

Hall said that he agreed with the new expert panel that there was no evidence to suggest Letby killed babies by injecting them with air in order to cause fatal air embolisms. Although he admitted he could not rule it out and accepted that suggesting it was a possibility could have had a bearing on why he wasn’t asked to give evidence in her defence. “There was no evidence of any of the babies being injected with air,” he added. “But unfortunately, it is possible for babies to be injected with air without there being evidence. So if any doctor is being honest, I think they would have to all say, ‘No, we can’t rule that out.’ But we really don’t think there’s any evidence of it or that it’s at all likely.” He also claimed Mark McDonald, Letby’s new barrister, was pursuing a high-risk strategy by airing the findings of these new experts in public at press conferences before the world’s media because he believes there are mistakes in their reports. And he agreed that this could potentially hinder Letby’s chances of a new appeal. “Some of what the expert panel said was not what the court heard, it was not all correct,” he added. He pointed to Baby O, a triplet Letby murdered on her return from a holiday in Ibiza, in June 2016. According to the expert panel, the traumatic liver injury found on his post-mortem was not inflicted by Letby but was caused by his quick Caesarean-section birth. However, Dr Hall said this explanation was not credible. “Just prior to the collapse, the haemoglobin was higher than it was just after birth,” he said. “So there’s no evidence there had been any bleeding and if there were these subcapsular haematomas you would have expected there to be some change (with the haemoglobin).” Asked for his opinion on the cause of Baby O’s death, Dr Hall admitted: “I don’t know why he collapsed. He wasn’t as well as the prosecution expert witnesses said he was. He hadn’t been well overnight, actually. His feeds had been increased quite quickly, within 24 hours. So I think there were reasons why he might be unwell. (But) why he collapsed and didn’t respond to resuscitation is really open to speculation. There were aspects of the resuscitation which may have fed into his condition during the resuscitation. I don’t know that I have an easy explanation to it. But that doesn’t mean to say someone must have murdered him.”

To listen to the full interview, search for The Trial of Lucy Letby: The Inquiry now, wherever you get your podcasts or enjoy ad-free by subscribing to The Crime Desk.