Hospital boss doctored a review into baby deaths to make it look like two infants murdered by Lucy Letby died of natural causes, inquiry found

A hospital boss doctored a review into baby deaths to make it look like two infants murdered by Lucy Letby died of natural causes, a public inquiry found.Ian Harvey, 68, changed the document without the ‘shocked’ author’s knowledge and used it to mislead the board at the Countess of Chester Hospital into allowing the former neonatal nurse back on to the ward.In the end Letby, 36, never returned to work after doctors pressurised senior executives into calling the police.In her 822-page report, published on Tuesday, Lady Justice Thirlwall was scathing of the conduct of medical director Mr Harvey and other ‘dysfunctional’ leaders at the hospital, who she said ‘completely failed’ to protect babies from harm.The Appeal Court judge, who oversaw the £18.5million inquiry, said that three infants could have been saved had managers acted sooner to suspend Letby and bring in police sooner.Instead they ordered pointless reviews – one by the Royal College of Paediatrics and Child Health and another by neonatologist Dr Jane Hawdon – which never explained why babies were dying.Dr Hawdon told the inquiry she was commissioned by Mr Harvey, a retired orthopaedic surgeon who was paid £175,000 a year, to review the medical notes of 17 babies – 13 deaths and four ‘near misses’ – who collapsed at the hospital between June 2015 and June 2016.But, Lady Justice Thirlwall said, he ‘failed to mention any concerns about deliberate harm to babies by a staff member, nor that the deaths were unexpected or unexplained’.‘He should have done,’ the judge added. Letby murdered the babies in the hospital between 2015 to 2016 The Countess's former medical director Ian Harvey admitted altering the review without Dr Jane Hawdon's knowledge The babies were murdered at the Countess of Chester HospitalDr Hawdon, then a consultant neonatologist at Barts Health NHS Trust, in London, initially concluded the deaths of five of the infants, Babies A, D, I, O and P, were unexpected and unexplained and needed ‘a broader forensic review’.But after being sent Baby D’s post-mortem by Mr Harvey, she emailed him back to say she agreed with the pathologist that her death had been due to pneumonia.As a consequence, Mr Harvey amended her report to say Baby D’s death was due to natural causes without her consent.The report said: ‘When giving evidence, Dr Hawdon informed the Inquiry she was not consulted by Mr Harvey before he did this, and that she was not aware of any of Mr Harvey’s amendments until she was informed by the Inquiry.’It was only later, when Dr Hawdon was informed of the pathologist’s evidence to the inquiry that Baby D had died ‘with’ pneumonia and not ‘of’ the infection that she decided it was ‘no longer a plausible contribution to (her) death’, the report said.Letby was convicted of murdering the full-term baby girl by injecting her with air on a night shift in June 2015.Dr Hawdon also accepted under questioning that another baby – a twin boy known as Baby E – should also have been included on her unexplained deaths list.She said she was told he died of a gastric bleed but accepted the cause of the bleed was unknown. Letby was convicted of murdering the twin by ramming a hard medical instrument into his throat and injecting him with air, in August 2015.While giving her evidence to the inquiry, Dr Hawdon was shown a copy of her review which had the words ‘necrotising enterocolitis‘, also known as NEC, next to Baby E’s name.She told the judge she did not make this addition to her report and NEC – a debilitating bowel condition that can be potentially fatal for premature newborns – ‘did not fit well with the pattern of health issues that preceded Baby E’s collapse’.The report said: ‘In Mr Harvey’s oral evidence, he accepted that he made amendments to Dr Hawdon’s report.’Dr Hawdon also said she ‘assumed’ Mr Harvey would follow the NHS’s duty of candour and share the findings of her report with the babies’ parents, which should have been a ‘given’.But, the judge found, he did not do so.Some excerpts were sent to some of the parents, but only six months after Dr Hawdon had completed her review. The excerpts were in medical language and described by one mother as ‘not meaningful at all’.Dr Hawdon said she was ‘shocked’ when she was shown what had been sent.The mother of Baby C, a premature baby boy who was murdered by Lucy Letby in June 2015, told the inquiry: ‘There was no introduction to the report, who had written it, what date it was written on. It wasn’t signed and dated by anybody. There was no context.‘We’d been told that these in-depth investigations had taken place and not revealed any cause for concern. Yet, we were sent a couple of pages of a report that didn’t look at all in-depth to me… Or, if it was, then it was woefully inadequate to call that a thorough investigation. I was upset, distressed, extremely annoyed, perplexed.’She said she got the impression ‘something significant’ was being hidden from them.Other parents had no clue any investigations were being carried out into their babies’ deaths, or that their children’s medical records had been shared without their knowledge.Letby is serving 15 whole life sentences for the murder of seven infants and the attempted murder of seven more – one of whom she attacked twice.READ MORELucy Letby's barrister is damaging her chances of freedom, two experts who abandoned her innocence fight warn