Month: September 2023

Letter to the BMJ

Rapid response to:

John Launer: Thinking the unthinkable on Lucy Letby

BMJ 2023; 382 doi: https://doi.org/10.1136/bmj.p2197, published 26 September 2023, cite as: BMJ 2023;382:p2197

Dear Editor

I am a coauthor of the report of the Royal Statistical Society https://rss.org.uk/news-publication/news-publications/2022/section-group-reports/rss-publishes-report-on-dealing-with-uncertainty-i/. It is deeply distressing that the police investigation into the case of Lucy Letby and the subsequent trial made all of the mistakes in our book. The jury was never told how the police investigation arrived at that list of “suspicious” events and how it was further narrowed down to the list of charges. This is a case in which a target was painted around a suspect by investigators. We call it confirmation bias, in statistics. It is also often referred to as the Texas sharpshooter paradox.

Thanks to amateurs who report their work on Twitter and YouTube, we now know how the list of charges in the Lucy Letby case evolved. It is utterly scandalous that this history was not revealed to the court. Here is the broad picture. 

Doctors reported Lucy to the police, against the wishes of the hospital board.

They told the police the exact period she had been on the ward and gave them the files on all deaths in that period and on some of the incidents: namely, exactly and only those “arrests” at which Lucy had been present.

What qualifies as an incident, what is an arrest?

There is no medical category “arrest, resuscitation” under which such events are logged in hospital administration. Probably there were about five times as many such events when Lucy was not on duty, but nobody has ever looked. There is no medical definition of such an event. No formal criteria.

“Unexpected, unexplained, sudden” are also not defined in any formal way. Nor is “stable”.

Next the absolutely unqualified, long retired, paediatrician Dewi Evans, who has a business helping out in civil child custody cases, went through those medical files looking for anomalies about which he could fantasise a murder or murder attack. His ideas that milk was injected into the stomach or air into the veins were far fetched, and later not confirmed by any other evidence. On the contrary, the actual evidence certainly contradicts the idea that Lucy Letby actually attacked any child. He never gave alternative medical explanations, as would have been the obligation of a forensic scientist. All the deaths had had a post-mortem and a coroner’s report. Every single event on the charge sheet has absolutely normal explanation. Lucy was never seen doing anything wrong.

The medical experts for the prosecution merely confirmed Evans’ diagnosis, they also did not do the job of a forensic scientist.

The defence had no experts. They had brought in one paediatrician. But at the pre-trial hearing he said he wasn’t qualified in endocrinology, toxicology, etc etc etc. 

This was Texas sharpshooter, big time. Plus utterly incompetent defence. 

Richard Gill

Member of Royal Dutch Academy of Sciences

Past president of Dutch statistical society.

Conspiracy theory, conspiracy theorists

The following text was sent to me by one of my many correspondents, wondering what to do with it, and not daring to publicise his or her ideas. I said that I could post it, so that he or she could remain anonymous. I’m not saying that the opinions here are my own opinions. One can certainly call them speculations. There is so much we don’t know, and so much that does not seem to make sense, that I think they are not idle speculations; but still, speculations they are. I will add to this post some further comments of my own, concerning the general social phenomenon that people with strange and unwelcome ideas are put away as nutty crackpots; then, if several others appear to have the same nutty crackpot idea, then they are obviously evil conspirators. The history of science is a history of crackpots: Galileo, Copernicus, Darwin, Einstein. At least, they were thought to be crackpots and they were first ignored and later fought by the establishment, the latter happening when a few people started to endorse their ideas. That’s when they became really dangerous.

From here on and till further notice, the words of my anonymous correspondent.

I’ve made several posts recently arguing that Lucy Letby didn’t get a fair trial. Some people have responded by calling me, and other with similar opinions, conspiracy theorists which led me to ask myself whether there was any conspiracy involved in the whole Lucy Letby story. What I have written here is an actual CONSPIRACY THEORY and is not based on any relevant specialist knowledge and is highly speculative so you can disregard it if you like. However, if you’re looking for a ‘possible’ explanation for the very odd police investigation, the hopelessly weak evidence used against her, the bizarre nature of the trial and the other strange observables in this case, it might be worth reading on. This is not necessarily my opinion, but my attempt to make sense of an incomprehensible conviction. It is also largely motivated by ensuring Letby is granted an appeal and a fair retrial.

If this case wasn’t political from the beginning, it certainly is now. I don’t think it was ever about justice, it was always a face-saving exercise, initiated by another failing, underfunded hospital, who knew there was doctor/consultant negligence involved in most of the unexpected deaths and events on the ward, many of which happened when Lucy wasn’t on shift. Babies dying as a result of negligence or understaffing is a bomb waiting to go off, which would have decimated the already dwindling public confidence in our NHS. That would be very damaging for the politicians who rely on public support to stay in power. Because the NHS is funded by the government and ultimately of course, the electorate.

The government, which means the electorate, fund the police too, through grants to each local force. In the last few years, the reputation of the police and public sentiment towards them has justifiably fallen dramatically and must be close to an all-time low. Is it possible that the government and senior officers were desperate to restore some faith in the police force? Cracking the ‘crime’ of the century would go down well with the public! We’ve seen how political and senior police heads roll when they screw up. This investigation was very high profile, very emotive, very long and expensive and, with their reputation in the gutter, it was important for the police to come out triumphant.

The police were called in to investigate unexplained deaths on the ward and to assess if a crime had taken place. EVERYONE who worked on that ward during that period begins the police investigation as a potential suspect. But the police began their investigation, of a potentially unfathomably serious crime scene, by strolling in and meeting with senior doctors and consultants for a briefing. They then proceeded to investigate as instructed by the doctors and consultants. Those doctors and consultants were SUSPECTS! These are the same doctors and consultants who made the accusations. Since when, in any potential murder enquiry, has the person/persons reporting the crime been discounted as a suspect before the police even reach the crime scene? Their potential negligence or the possibility that they may have been the murderer was never investigated. 

And it would look terrible for the NHS if all those doctors/consultants in just one department of just one hospital were found to be negligent by the police and their neonatal ‘expert’ (with no neonatal experience). Oh the damage that would do to the NHS, and of course the government, who pay those negligent consultants’ generous wages, but underfund the hospital so badly. It’s SO much less damaging to their reputations to pin everything on one lone murderer. It certainly takes public attention away from the failures of the more powerful parties, if the public have a single villain to target with their fury and hatred. Not to mention the money it’d probably save the NHS/government in medical negligence compensation lawsuits.

The Crown Prosecution Service (CPS) and the Criminal Justice system (CJS) are also funded by the government. Following a hugely expensive investigation by the CPS and a trial costing the electorate £Millions, can you imagine the implications for our national institutions, if she’s granted an appeal and exonerated? For starters: 1. The CJS isn’t fit for purpose. 2. The CPS isn’t fit for purpose. 3. The police force isn’t fit for purpose. 4. The NHS isn’t fit for purpose and 5. The sheepish police and CPS have to begin a new, highly expensive investigation that might lead to more highly expensive criminal proceedings against negligent doctors. Far cheaper and less damaging to leave one woman sat in a cell for the rest of her life. Plus it pleases the electorate, many of whom think she should be tortured and executed ASAP. All those votes gone if she’s even granted an appeal! Countless more millions votes gone when those services are found to have failed and she’s exonerated!

And then there’s the shame they’d all face when they have to get on their knees and give Letby a grovelling apology and pay her very substantial damages. In summary, her acquittal would be a very bad day for a lot of very powerful people and institutions. It would shatter the electability of the government who have overseen all those institutions for the last 13 years. 

A plausible alternative is that it was no one’s fault, not even the government. Perhaps just a statistical spike that anyone with a basic understanding would realise is not as unusual as it was painted by the prosecution. In fact, a leading independent statistician says a full analysis, including dozens of relevant factors (rather than just an amateur’s edit of a rota) shows that if there was a ‘murderer’ on the ward, an “unnamed nurse” and a doctor, were both more likely culprits than Letby. 

Very weirdly, Ben Myers KC, for Letby, agreed with the prosecution to exclude from the trial, statistical evidence that more or less proved her innocence, because it was confusing? It need be no more confusing than the information in this paragraph. It simply needs an independent expert to do the analysis and present the conclusions to the Jury. Why did you agree to exclude it Mr Myers? And why did you agree not to contest an absurd insulin reading, that forced Letby to say, the insulin must have been administered maliciously when there are multiple other explanations for the reading? I also understand Mr Myers had two paediatric medical experts of his own who reviewed Dr Evans’ reports and listened to his testimony. I understand they were in the courthouse waiting to testify in Lucy’s defence, waiting to challenge Dr. Evans’ testimony. Waiting and waiting in a nearby room, but never called to testify by Mr Myers. Why? And where is Mr. Myers now? There are multiple questions hanging over his defence of Letby, but he remains silent. There’s no reason for his silence…..or is there? Myers needs to explain how and WHY he failed to successfully defend her.

She was locked up for 3 years, put through a 10 month trial, found guilty and handed down the harshest sentence possible – after the Judge let jurors leave for ‘personal reasons’ and accepted majority verdicts. The CJS has a huge incentive to prevent a retrial and her possible exoneration after the way the case has been handled. 

So in summary it was in everyone’s interest that she was found guilty, except hers, and it’s in everyone’s interest that she doesn’t get an appeal, except hers.

And now it is me, Richard Gill, speaking again.

But of course, it seems to many that I also believe in idiotic conspiracy theories, and worse still, am influential enough to spread them around, like a virus. Who would believe that a British court could ever wrongly convict an innocent person! I have been labelled a crackpot and a conspirator and much worse, ending up with a recent ban on editing Wikipedia, where I had been urging editors to take account of the fact that being convicted of a crime is not synonymous with having committed a crime; and that Lucy was appealing against her conviction. Seems that Wikipedia editors in the UK do not realise that in most of the civilised world everyone has a right to an appeal, and that moreover, till the appeal is over, people are not comfortable with stating that their guilt is a fact.

Not only all that, but the Wikipedia article about myself was being vandalised by vile idiots. Fortunately some sensible people noticed this and managed on the whole to rapidly revert the vandalism. But now that I’ve been banned the Wikipedia article about me is being filled up with the most idiotic garbage.

Anyway, that’s enough for this moment, but this post will get extended soon, I am sure.

The post-it note

Is Lucy’s post-it note a confession? Whether you will see it as a confession or a cry of innocent anguish depends on whether *you* have a heart and a brain. If you read it carefully, you will see that Lucy does not say that she killed those babies. She says that *they said* she killed those babies. Yes, she does say she is evil. She thinks she is clearly a bad nurse who apparently couldn’t save those babies, despite her (possibly too energetic, and certainly not well supervised) attempts. More seriously, she had had an affair with an older married man, a doctor, who later dumped her and betrayed her. She spoke out about doctors’ mistakes and about the catastrophic hygienic circumstances in which she and her colleagues had to work. For two years, doctors had tried to have her taken off that ward, because she pissed them off. Her colleague nurses loved her for her forthrightness and lovely character. She is so sorry for the suffering she caused her parents and step-brothers. She is considering suicide. She has PTSD.

This deciphering of the note was created by https://x.com/chrisjclarkesq?s=21&t=1S47Jut6K2dqjKzr1sc-4A , known as Mycroft on ‘X’, that is the ‘X’ formerly known as Twitter.

Contempt of court

“Contempt of court” means disrespect of a court. Now, it is certainly true that I am disrespectful of the court which convicted Lucy Letby. I think that the trial was unfair and that the judge did not understand what was going on. Nor did the jury. The jury was incomplete and the verdicts were not unanimous, yet the sentence was the heaviest possible. The defence made little attempt to defend their client and the UK tabloid newspapers had convicted Lucy long ago. On one of the days that she was arrested, the TV vans were in her street, before the police arrived to knock on her door and take her away. Six years of police investigation by a team of 60 to 70 police inspectors, including a large PR department (read: a little troll farm), did not find any conclusive proof of any wrongdoing by Lucy Letby at all. Yet already Cheshire Constabulary have signed a contract with Netflix and ITN for a documentary on their fantastic work nailing the UK’s most horrific female serial killer ever.

Now, “contempt of court” is also a very serious criminal offence in the UK, but as such, it has a very narrow definition. The definition involves the motive of the perpetrator. This is like killing someone. Killing a person might be murder. But it might be an accident. It might be caused by negligence. It is only premeditated murder if the person who killed the victim planned to do so in advance and deliberately and successfully carried out their plan. Lucy Letby is convicted of a large number of premeditated murders and murder attempts. The jury believed that she had motive and opportunity and deliberately tried in some cases numerous times to kill the same infant.

As the trial of Lucy Letby proceeded, various independent observers with a scientific background started studying the case and commenting on it on various internet sites. There was my own blog, gill1109.com. There was Peter Elston’s “Chimpinvestor” blog, chimpinvestor.com. There was Scott McLachlan’s Law, Health and Technology “Substack”. There was Sarrita Adams elaborate and dedicated website rexvlucyletby2023.com, later morphed into the even more elaborate ScienceOnTrial.com. Numerous individuals of course also tweeted on the case, several FaceBook groups started up, several SubReddits were founded. Cheshire Constabulary kept a close eye on social media and dedicated websites and became more and more active in trying to suppress any support of the defence of Lucy Letby, though all those Twitter users calling for the return of hanging and for Lucy to be assassinated as soon as possible in the most horrific way, were presumably encouraged by Cheshire Constabulary.

Around May, while the trial still had a few months to run, the police apparently started to become nervous. Threatening emails were sent to myself, Peter Elston, and to Sarrita Adams, telling us that our websites must be taken down and links to those sites on social media should be removed. We know that the police also attempted to find out who was behind the Law, Health and Technology substack, but did not succeed so easily.

Of course, they found me, easily. But how did they discover the identity of the anonymous owner of rexvlucyletby2023.com, Sarrita Adams, who tried very hard indeed, for very sound personal reasons, to remain anonymous? The answer is simple: at some point Sarrita and I emailed to the court trying to alert the judge that the trial was unfair, and that important scientific evidence was hidden from the jury and the public. We did this through emails to the clerks of the court, asking them to bring our messages to the attention of the judge. However, this is not what they did. They gave the messages to police inspectors from Cheshire Constabulary, who were in court every day, hobnobbing with both the barristers, the judge, and with top NHS lawyers.

They also divulged the identity of Sarrita Adams to their internet trolls who rapidly managed to dig up a lot of dirt about Sarrita and dox her on Twitter.

The email letters which Peter, Sarrita and I were sent, are very interesting. They say that our internet activities were discovered by the police and that the police had discussed with the defence team, the defendant, and the judge, and that the judge said that what we were doing appeared to be contempt of court. We should remove our websites and remove all links to them on social media. According to the police, Sarrita and I were “associates” though we were in no way associated at all except in our common belief that the trial was unfair and the scientific evidence incorrectly interpreted. Yes, we had communicated with one another. The judge did point out that this was just his initial reaction and he couldn’t state that it was contempt of court without hearing our motivation from us. This shows again that he never received our emails to the court. Our stated motivation was to prevent a possible miscarriage of justice, not to cause a miscarriage of justice by subversion of the jury. We were attempting to contact all relevant authorities, not the jury at all. Indeed, since later the jury found Lucy guilty of the most heinous crimes, it is clear that we did not influence the jury at all.

I replied to the police by email that I would do what they asked. I did not remove my blog posts on the case but I did diligently delete links to Sarrita’s site and all tweets by myself with links to my blog or Sarrita’s website. I did not get a reply, though I asked who was emailing me and said that I wanted to talk to them, by telephone or Zoom. The letters had no phone number and no first name of whoever wrote them. I called Cheshire Constabulary by phone but they couldn’t help me because I did not know the initials or first name of whoever had emailed me.

About three weeks later, the jury was now deliberating in private. One Friday evening very late I was shocked by a knock at the door. (Actually, I had already gone to bed, but my son was visiting and woke me up. Thankfully, my wife slept through the whole thing). Local Dutch police wanted to deliver two letters to me, on paper, in person. They had been instructed to verify my identity and naturally, I did show them my Dutch passport. The letters were almost identical to the email letters which I had received earlier, and had already and immediately replied to. They did not have wet signatures, they were clearly printooouts of pdfs. Similar, but not identical to what I had already received.

So now Cheshire Constabulary had legal proof, with the help of their Dutch colleagues. that I had indeed received their letters! The letters threatened arrest next time I tried to enter the UK, and noted that contempt of court carries a two year prison sentence and a huge fine – namely, the costs of rerunning the whole trial with a fresh jury. It was pointed out that as a UK citizen I was still subject to UK law even though I lived in another country. The same thing was said to Sarrita, who lives in California, but is also a British citizen.

This was clearly intended to intimidate, and indeed it was very intimidating. I will now reproduce the original email letters and the later, paper, version. The wording is fascinating, the intention was to intimidate, but UK police cannot charge me with contempt of court without an order from a magistrate, and as Judge Goss remarked, he would need to know my actual motives before he could say that I had indeed likely committed the crime of contempt of court.