Letby Inquiry Risks Making NHS Staff More Defensive, Lawyer Warns
The barrister representing Lucy Letby says the public inquiry into the neonatal deaths at the Countess of Chester Hospital could deepen a culture of blame and suspicion in the NHS, making patients less safe.
The barrister representing Lucy Letby has warned that the public inquiry into the deaths on the neonatal unit at the Countess of Chester Hospital risks intensifying a culture of blame and suspicion across the NHS, ultimately making patients less safe. Mark McDonald, a criminal defence and human rights barrister who has acted for Letby for the past two years, said he fears what will follow because medics must be able to ask questions, raise concerns and admit mistakes without fear. A defensive staff, he argued, is dangerous for everyone.
McDonald said he has spent thousands of hours examining the evidence, speaking to experts and reviewing what happened to the babies who died or became seriously unwell on the unit. He said he has worked with nearly 30 experts, including internationally recognised specialists in neonatology, pathology, insulin and statistics. On the basis of that work, he said he is convinced that Letby is innocent and that her convictions represent one of the most serious miscarriages of justice in modern British legal history.
In his view, the failures were not confined to one individual. He said Letby was failed by the police, the NHS, the criminal justice system and a wide range of experts who simply got it wrong. His work on the case, he added, has raised wider concerns about the evidence and conclusions surrounding the deaths on the neonatal unit, and about what lessons are being drawn from the case for doctors and nurses working in neonatal medicine.
The intervention comes as the public inquiry examines the circumstances surrounding the deaths and the response of the hospital and the wider health system. McDonald’s central concern is that the inquiry’s conclusions could reinforce a climate in which clinicians are reluctant to speak up, question senior colleagues or acknowledge errors. He argues that such a climate would undermine the openness needed to identify problems early and protect patients.
His warning places the inquiry at the centre of a broader debate about how the NHS handles serious incidents, how it supports staff through investigations and how it balances accountability with learning. For neonatal staff in particular, the case has become a reference point for anxieties about being second-guessed and about the consequences of raising concerns. McDonald’s position is that the lessons drawn from the case must not come at the cost of the candour on which safe care depends.
The barrister’s comments also highlight the tension between the pursuit of justice for the families affected and the need to maintain a health service in which mistakes can be discussed openly. He does not dispute the seriousness of what happened on the unit, but he argues that the response must be calibrated so that it does not deter the very behaviour that allows problems to be detected and addressed. The inquiry’s findings will be closely watched by clinicians, hospital leaders and patient groups alike.
McDonald’s intervention is significant because of his direct involvement in the case and his access to the detailed evidence assembled over years of legal work. His conclusion that the convictions amount to a miscarriage of justice is contested, and the inquiry will weigh competing accounts of what happened. What is not in dispute is the wider question he raises: whether the NHS can investigate serious failures without creating an environment in which staff become more guarded, less willing to ask questions and less able to admit when something has gone wrong.
For patients, the stakes are practical. A health service in which staff fear blame is one in which concerns may go unreported and errors may be repeated. McDonald’s argument is that the Letby case and the inquiry that follows it will shape that culture for years to come, and that the wrong lessons could leave patients less safe rather than better protected.
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