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A senior doctor who initially raised concerns about Lucy Letby has expressed regret that he did not alert the police earlier. Dr. Stephen Brearey, who served as the lead neonatal consultant at the Countess of Chester Hospital during the time Letby was responsible for the murder of seven infants and the attempted murder of seven others, shared his reflections following the release of the Thirlwall Inquiry report. Brearey admitted he had “naively” believed that senior hospital management would respond appropriately to the serious suspicions raised about Letby’s involvement in multiple infant deaths.
The inquiry highlighted a persistent “toxic negativity” embedded within the NHS, which continued to deter staff from speaking out despite the presence of strengthened whistleblowing policies. It also uncovered significant deficiencies in regulatory oversight. Brearey described how his repeated warnings about Letby were disregarded by hospital leadership, noting that the hospital has since undergone a change in management. He also voiced concerns about the slow pace of cultural reform within the NHS to ensure such failings would not recur. “I was naively thinking that raising concerns with senior managers, they had the same values that I did and, once they got it, they would be thinking the same way,” he remarked.
During the time in question, Brearey coordinated with six other consultants who shared similar apprehensions regarding Letby’s conduct. Although the hospital conducted several internal reviews in 2015 and 2016 due to an increase in infant mortality, the police were not involved until May 2017, leaving Letby employed at the hospital until her arrest more than a year later. Brearey reflected on the importance of the group effort, saying, “I think one of the reasons we got through this and ended up picking up a police investigation is that the seven of us stuck together.” Nevertheless, he lamented the delay in involving law enforcement, acknowledging, “if we’d known what was ahead of us, we would have gone to the police earlier.”
After Letby’s eventual arrest in July 2018, Brearey noted the absence of psychological support for the hospital staff affected by the ordeal. He described how the neonatal team relied heavily on mutual support, likening their situation to soldiers suffering PTSD who remain on the front lines rather than being allowed to recover in a safer environment. He highlighted the emotional toll on staff members, particularly those who were parents themselves, explaining the challenges faced when everyday activities, such as dropping children off at school, became fraught with distress.
Lady Thirlwall, who chaired the inquiry, made 17 key recommendations designed to prevent similar tragedies. These included installing CCTV cameras on all neonatal cots and incubators, controlling access to insulin, enforcing mandatory safeguarding training for staff, establishing a unified NHS IT system, and improving data management. Brearey endorsed these measures, stating they would “either prevented or hastened an alarm to say things need to be looked at in more detail,” and believed their implementation would significantly reduce the risk of future incidents.
Regarding the broader cultural shift required within the NHS, Brearey expressed cautious hope but acknowledged the challenges involved. He noted that Lady Thirlwall’s recommendation for every manager to have an explicit duty to prioritize patient welfare seemed obvious but also unsettling that it had to be formally written into contracts. “It’s one thing writing into a contract is another thing actually enacting it into the entire organisation and that takes a cultural change and cultural changes take time,” he said. Brearey remains uncertain about the speed at which such change can realistically be achieved within the NHS.
In response to the inquiry’s findings, former executives of the Countess of Chester Hospital issued a joint statement affirming that they are carefully reviewing the report and its recommendations. They noted ongoing investigations and cautioned against making further comments at this stage, expressing sympathy for the families affected by these tragic events. Meanwhile, the hospital trust acknowledged its past failings and expressed sincere regret for what happened in 2015 and 2016. The trust stated its commitment to embracing the inquiry’s recommendations and highlighted the progress made under new leadership, emphasizing an improved governance structure, enhanced safety protocols, and a more open culture encouraging staff to speak up
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