I use this rule, Bayes’ rule, repeatedly, each time taking account of another part of the evidence. It is named for Thomas Bayes, a presbyterian minister and mathematician, who was interested in using it to find a mathematical proof of the existence of God. https://en.wikipedia.org/wiki/Thomas_Bayes
The likelihood ratio for the question at hand, based on some part of the evidence, is the ratio of the probabilities of that part of the evidence under the two competing hypotheses. More precisely, one uses the conditional probabilities of that fact given previously incorporated evidence. We have to start somewhere and we start by describing two alternative hypotheses and our probabilities or degrees of belief or personal betting odds for those two hypotheses, before further evidence is taken into account.
Let’s start with the news reports of a police investigation of a possible killer nurse at a neonatology unit in the UK; the investigation being triggered by a disturbing spike in the death rate on that unit.
I think that in the last fifty years there simply hasn’t been been a case in the UK of a killer nurse on a neonatal ward, except possibly the case of Beverley Allitt. One might argue that there do exist doubts as to the safety of her conviction, or one might argue that there can have been serial killer nurses who completely evaded detection. Did Alittit work in an intensive care unit? I also think that in recent years, every year has seen a scandalous calamity in a UK neonatal ward, leading to avoidable deaths of quite a few babies. So a priori: the relative chances of a killer nurse being responsible for the spike, or simply poor care, is in my estimation 50:1 in favour of poor care in a failing hospital unit rather than activity of a killer. If you disagree, give me your arguments for both those rates and hence their ratio. If you would like to take a different starting point, try that. Eg, what is the chance a random nurse is a serial killer? At some point one will have to use the information that this was a neonatal unit and one will have to take account of the “normal” rate of deaths on the unit. I think my choice is reasonably specific. One could argue that the prior odds should be 10 to 1, or 100 to 1, instead of 50 to 1. I expect that most people will at least agree that killer nurses on neonatal units are very rare, disastrously poor care on a neonatal unit in the UK is not rare at all.
So we are back in 2017 and hear the news and rightly we should be sceptical that there really is a case here. But clearly there are grounds to investigate what is the cause of that spike, and maybe there is more information which the police already have.
Then, many years go by. A particular nurse is detained for questioning in two successive years; and finally arrested in a third year. Two more years go by (Corona). At last, a trial begins. It turns out that roughly seven years of police investigation has uncovered no direct evidence at all (neither medical evidence, toxicological evidence, witness testimony or CCTV recordings, finger prints or DNA) of unlawful action by the nurse who has been under intensive investigation all that time. And not just no evidence against that nurse – no direct strong evidence of malevolent activity by anyone.
One might want to argue that the insulin evidence is strong toxicological evidence. We could argue about that for a long time. Even if one or two babies were given unauthorised doses of insulin there is no direct proof that Lucy Letby did that herself. There is the possibility of accidental administration (twins in adjacent cots). The argument that Lucy did administer insulin seems to have been that we know at some point she carried out other murderous attacks and it is unlikely that there were two murderous nurses working in the unit. But why do we believe there are murderous nurses working on the unit? This argument can only be made after hearing all the other evidence in the case.
So we have to estimate the probability of a 7 year police hunt for evidence of murder by a particular nurse finding no direct evidence of any malevolent activity at all by anyone, if Lucy Letby actually was innocent, and if she truly was a serial killer. In my opinion ,what we actually observed is much more likely under the innocence hypothesis than under the guilty hypothesis. If she truly is innocent the chance of finding powerful directly incriminating evidence must be rather small; if she truly is a serial killer then it must be unlikely that that no baby can be definitely proven to have been murdered or attacked. I guess the two probabilities of no hard evidence to be 95% and 5% respectively. These are probabilities of 19/20 and 1/20 respectively, so a likelihood ratio of 19. I’ll be a bit more cautious and call it 10.
We already had odds of 50:1 in favour of innocence. We have a likelihood ratio of 10:1 in favour of innocence, having learnt that police investigation uncovered no strong and direct proof of malevolent harm to any baby. The odds on Lucy being innocent are therefore now 50 times 10, or 500 to 1.
Let’s now bring in the evidence from psychology. Are there reasons to believe Lucy is a psychopath? Which surely she must be, if she is a serial killer of babies in her care. It seems there is no reason at all to suspect she is a psychopath. I think that there very likely would be strong independent signs of psychopathy in her life history if she really is a serial killer, but obviously not so likely if she is completely innocent. [Clearly she could be both a psychopath but did not actually harm or try to harm any baby. I don’t think this is an interesting hypothesis to explore. I will also not pay attention to the Munchhausen by proxy idea, that she was trying to attract the attention of an older male doctor. All the evidence says that he was more romantically interested in her, than vice versa.]
Put the likelihood ratio at 2, ie twice as likely to see no evidence for psychopathy if innocent, than if a serial killer. Actually I think it should be closer to 10. We should ask some psychologists. Lucy Letby did not sadistically kill little animals when she was a child. By all accounts, she was a dedicated nurse and cared deeply for her work.
We were at 500 to 1 for innocence. Factor in a likelihood ratio of 2 for psychological evidence. Now it’s 1000 to 1. But we are not done yet.
Next, I would like to take account of the statistical evidence that the spike in deaths is quite adequately explained by the acuity of the patients being treated in those 18 months. I would say that this is exactly what we would expect if Lucy is innocent but very unlikely if she’s a serial killer. I think this hypothesis is very adequately supported by published MBRRACE-UK statistics, and what we know about the acuity of the babies in the case. We know why acuity went up in around 2014 and we know why it went down midway in 2017. The spike seems to have been caused by hospital policy which was being made and implemented by the consultants on that unit. They should have expected it.
Say a likelihood ratio of 10. That brings us to 10,000 to 1 she’s innocent; a posterior probability of 99.99%. I haven’t yet brought in the facts of an investigation driven by tunnel vision and coached by doctors who, as we now know, were making quite a few deadly mistakes themselves. I haven’t brought in yet the innocent explanation of the post-it note. In my opinion, the post-it note is powerful evidence for innocence; it makes absolutely no sense under the hypothesis of guilt. The irrelevance of the handover notes and the notations in her diary. Facebook searches? Her alleged lies (about what she was wearing when she was arrested). Anything else?
Anyway, I am now well above 99.99% sure that Lucy is innocent and since the press conference and the report of Shoo Lee and his colleagues, we can all be even more sure that that is the case.
This LinkedIn conversation started with me asking Dewi Evans to connect to me. I was amazed that he accepted. I guess my request contained a brief message too, but this is not recorded in my LinkedIn account. I suppose Dewi has it in an email sent to him from LinkedIn. It would be nice to see it.
Dewi – are you there, reading this?
Feb 3, 2024
Dewi Evans sent the following message at 11:46 AM
11:46 AM Dear Richard. I’ve read your comments re the importance of statistics in court cases. I can’t comment on specific cases currently because of reporting restrictions. I would welcome discussing this with you, as it’s a matter that is worth exploring.
Richard Gill sent the following messages at 12:30 PM
12:30 PM I agree! I am looking forward to the reporting restrictions being lifted. Hope to talk to you within a year from now…
12:32 PM Do take a look at the case of Lucia de Berk. The case is horrifically similar to that of Lucy Letby. I helped get her out of jail. Also an Italian nurse, Daniela Poggiali. I acted as expert on the applications to the CCRC of Ben Geen. I am sure he is innocent but UK criminal justice is nowadays badly tilted in favour of the prosecution.
Dewi Evans sent the following message at 12:36 PM
12:36 PM With a bit of luck reporting restrictions will be lifted after the end of the retrial due in June.
Richard Gill sent the following messages at 12:44 PM
7:03 AM I’m visiting Liverpool to give a lecture next week, dept of statistics. Will probably also check out Chester. Would you like to meet? I’m not interested in reporting restrictions. They are unfair and immoral. Science must not be stopped. Chester police sent Dutch police to my door in the night to intimidate me. This only made me speak out more loudly.
7:21 AM Do you have an email address? I’d like to send you some links and materials
8:11 AM By the way, reporting restrictions means reporters cannot write in newspapers about evidence supporting Lucy’s innocence. However, it allows the Daily Mail to publish week by week horrible stories about how evil she is, her cushy life in jail, her friendship with another killer … You and I are not reporters. There is no law against us exchanging information. You can tell me about medicine, I can tell you about forensic science. I’m sorry for you that you live in a police state. In the Netherlands there are also disturbing developments. The state is eroding civil rights. In the UK the process has got much further.
8:12 AM Fortunately, many investigative reporters are working on the case and many scientists are working on the case. The dam is starting to crack and it won’t be long before it crashes down.
Dewi Evans sent the following message at 9:37 AM
9:37 AM No problem having a private discussion. But reporting restrictions are reporting restrictions and all that. I’ve no wish to contaminate due process. I’ve no idea re Daily Mail articles. Never read it (apart from the one where they covered the Letby story after speaking to me. My easy access email is xxxx@xxxxx.xxx
Richard Gill sent the following message at 10:48 AM
10:48 AM Thanks for the email address! I do not wish to contaminate due process either. I wish to ensure due process. I can promise in advance of any discussion with you total confidentiality.
Dewi Evans sent the following message at 10:48 AM
10:48 AM Thanks Richard
Richard Gill sent the following messages at 11:37 AM
6:56 PM You asked for all the deaths and all the collapses in the period January 2015 to July 2016. They gave you all the deaths but only collapses when Lucy was there. There must have been at least 50 collapses when she wasn’t on duty, given the acuity of those infants. You were lied to, you were used.
Feb 23, 2024
Dewi Evans sent the following message at 10:31 AM
10:31 AM That is incorrect. I received information re numerous collapses. I separated them into those that were explained by the common causes- infection, haemorrhage etc and those that were not explained, ie suspicious. The name Lucy Letby was not known to me at the time. As for “at least 50 collapses” I don’t know where you got that figure from.
Richard Gill sent the following message at 10:54 AM
10:54 AM Interesting. Your story does not match the story one gets from other sources (for instance, the police themselves). I got my figure from several neonatologists and a similar figure from nurses with experience in neonatal intensive care. Secondly, “not explained” is not synonymous with “suspicious”. This confusion of words in the minds of on experts was exactly what led to the conviction of Lucia de Berk. I recommend you study it carefully!
Dewi Evans sent the following message at 11:17 AM
11:17 AM Away this weekend. Back Tuesday. Content to engage post the appeal and retrial. Information from the police was all disclosed to the Defence presumably. Those are the rules. No idea which other neonatologists involved. 2 gave reports for the Defence. They were not called. That’s a Defence issue. Read the Lucia de Berk story via Wikipedia weeks ago.
Richard Gill sent the following messages at 11:35 AM
11:35 AM I know, the defence was useless. Scandalous. The newspapers were appalling. Social media too. This was not a fair trial.
11:37 AM Lucy Letby was a whistleblower and got crushed by the NHS. Much better to put the blame on a killer nurse than on lax consultants and poor management. Focussed on cost cutting at the expense of patient care.
11:51 AM Have a. nice weekend! I just had a great visit to Liverpool and to Chester. Wonderful to see Welsh mountains in the distance from the city walls of Chester.
Feb 24, 2024
7:31 AM All deaths in the period when Lucy was fully qualified and full time (with very much overtime) at CoCH, and 15 non-fatal collapses *selected by the gang of four* and exclusively at times when Lucy was on duty. How much of the time do you suppose she was in the ward? “Since the start of our enquiries and, as the information gathering process has continued, the scope of the investigation has now widened. We are now currently investigating the deaths of 17 babies and 15 non-fatal collapses between the period of March 2015 and July 2016” https://www.chesterstandard.co.uk/news/16329278.healthcare-worker-countess-chester-hospital-arrested-suspicion-murdering-eight-babies/
9:25 AM Hi Dewi, maybe it’s time we had a chat? I don’t want to blame you. I blame NHS underfunding. Really bad police work, “experts” who don’t follow the rules (and apparently don’t know the relevant science either). The jury system, the contempt of court rules, a biased judge, a weak defence. The farce of her appeal being rejected but the CPS appeal accepted. The CCRC is utterly unfit for purpose and the next stage is going to take five to ten years. This certainly is the biggest miscarriage of justice since those big famous ones which led to the setting up of the CCRC. Of course in public you will presumably, for a while, go on saying you believe Lucy is guilty. I know all about obstinacy! Anyway: my suggestion is we do a Zoom chat, not recorded, Chatham house rules for just us two. Clear the air. I’ll tell you some things you don’t know yet, and vice versa. Win win.
Jul 8, 2024
Dewi Evans sent the following message at 10:42 AM
10:42 AM Currently getting over Covid, so back to normal next week. Afraid I don’t agree with you re the verdict. Letby was as guilty as they come. And to date, I’ve not seen a single comment from a suitably qualified person or institution that offers a reasoned defence. As for social media – best to give it a big ignoral. CCRC? As a witness of course one has to work within the system, but recognise its limitations. As for other cases, I expect that the police are investigating them. They involve displacement of breathing tubes for no apparent reason. And of course Lucy Letby was the nurse looking after the baby at the time. I’m not in touch with the police or the investigation any longer, so it will be interesting to find the outcome. My hunch is that there are quite a lot of other cases out there. [Interesting that since she was suspended in July 2016 (and I knew nothing about that before the trial) there have been few deaths at Chester apparently, and no ‘suspicious’ events.]
Jul 25, 2024
Richard Gill sent the following message at 7:27 PM
7:27 PM You would say that, wouldn’t you. Sorry, you are going to end up on the wrong side of history. “No apparent reason” does not equal “murder”. There are plenty of reasons breathing tubes get displaced. A person who gives expert evidence must be completely neutral and mention alternative explanations and margins of error. They must be fully qualified too. I’m sorry, but you are going to be in deep trouble.
Dewi Evans sent the following message at 8:07 PM
8:07 PM Richard. Just asking. Have you seen the clinical records of the babies? Have you seen / read the statements of the local medics and nurses? Have you read the statements of the parents? Were you at the trial? Does your medical experience extend beyond knowing which side of the bandaid you put on the wound? Cheshire Police are reviewing the notes of all babies at Chester, with the aid of an experienced neonatologist – I’m not involved and unaware of the findings. Don’t know if they are employing a statistician. So, Richard. Stick to your opinion. I’m still waiting for your evidence. But, for the record. None of my reports was based on “statistics”. It was based on Evidence. Look up its meaning. Her arrest, her charging, her guilty verdict had nothing to do with “statistics”. It was based on the Evidence of 6 independent experienced doctors, and the evidence of numerous local nurses and doctors. Evidence dear boy, Evidence! As for the Defence. It was their decision not to call evidence from independent clinicians and pathologists. Why do you think that was? Apart from the local plumber of course. Does one therefore assume that they consider your opinion less useful than that of a local plumber. Finally. Please do NOT make accusations about my evidence, or alleging that my evidence is not impartial. Half of my reports in criminal cases are at the request of the Defence. My most recent report for the Defence, just a few weeks ago, led to the Prosecution withdrawing the allegations within 2 hours of the opening of the trial. As for breathing tubes getting displaced for a number of reasons. For once you are correct. If you had listened to my evidence you would have known that I did not allege deliberate displacement of a breathing tube in any of the cases where I gave evidence. So, I’ll stick with the facts. Endorsed so far by judge and jury, Appeal Judge and 3 Appeal Court Judges. Not too bad I suppose. I look forward to your answers to my questions. I’m sorry if the facts (that word Evidence once more) get in the way of your opinion. But there you are. That’s a problem for you to address. Don’t see much point in engaging in a continuing dialogue. But thought that I should respond once.
Jul 26, 2024
Richard Gill sent the following messages at 11:08 AM
11:08 AM Thanks. I hope you will keep your mind open to new evidence as it comes to light, like a real scientist always does. I hope you will also bear in mind the growing criticism against our judges and courts. UK criminal justice is just as broken as the NHS. I too stick to the facts. The fact is that Brearey and Jayaram ran to the police when they realised that they were in deep shit due to the RCPCH findings. The fact is that you violated the duty of a scientific expert, but of course, as you said, you are not really. a scientist.
11:11 AM PS thanks for keeping the line of contact open! I still think that you have a fantastic opportunity to display wisdom and integrity. Do not let yourself be led by pride and vanity. Read the RSS report with great care. I talk to enough doctors who are better qualified than you to interpret those clinical notes, and many of them have access to those notes now. The arguments of appeal judges just show what big fools those people are. Also puffed up with vanity.
Dewi Evans sent the following message at 2:31 PM
2:31 PM Not seen the RSS report! You are welcome to send it, or send me the link. But as I said, my evidence had nothing to do with statistics.
Richard Gill sent the following messages at 4:07 PM
4:13 PM The defence didn’t understand medicine, didn’t understand science, didn’t understand statistics. Yeah – lawyers. Defence scored an own-goal by not disputing the interpretation of the immunoassay results. I just talked to a prominent UK professor of paediatrics. I asked him what he thought about the insulin? He basically said it was just bollocks and he explained why. This means that the evidence of Hindmarsh, Milan and Wark was just bollocks too. It may take 10 years, knowing UK criminal justice, but Lucy is going to walk free, you mark my words. Cheshire Constabulary have made enormous fools of themselves, costing the UK taxpayer millions, and by digging themselves in they are only making the debacle for themselves worse.
Dewi Evans sent the following messages at 4:54 PM
4:54 PM Who’s this professor of paediatrics Richard?
4:55 PM I’ll read the 64 page report over the weekend.
Jul 27, 2024
Richard Gill sent the following messages at 6:18 AM
6:18 AM I can’t tell you that professor’s name, sorry. Enjoy your weekend! Let me know if you have any questions about the report. It went pre-trial to defence, to prosecution, and in fact to all concerned parties. The man from the CPS said to me (at a pre-publication try out at the Newton Institute in Cambridge) “we are not using any statistics in the Letby case. They only makes people confused”. The defence too just did not understand the statistical issues, which are issues of scientific research methodology. And of forensic scientific investigation methodology. They got comprehensive advice from a very competent statistician but did not understand a word of it.
6:23 AM Sarrita Adams and I sent her medical analyses to the court during the trial, as an amicus brief. It was intercepted by Cheshire Police who sent Dutch police to my door in the night to deliver an intimidating letter. It threatened arrest next time I visited UK, two years in jail, and the cost of re-running the whole trial. The witch-burning mob doxed by mother’s address in a care home in Marlow, Bucks, and planned a demonstration outside. My Mother was 97. They also disrupted a lecture I gave at Liverpool University. The Mirror wrote that I was a sick and deluded conspiracy theorist and that I was attempting to corrupt the youth of England at the university, so the university authorities were evil too. Yep. All in a day’s work when you stand up against a witch hunt. Just so you know you are not the only guy getting publicly attacked in the media.
5:47 PM A friend – professor of mathematics – recently asked me: “I can’t understand why medical experts seem to often be so dishonest”. Here is my answer: “They are not scientists. They are trained to be rapid judges and executioners. That’s one thing. The other thing is the medical hierarchy, and clan forming. The paediatricians are more concerned with the paediatricians than with their patients. The youngest and least paid always have to get the blame to protect the reputation and earning power of the older and most highly paid.” These are unfortunately easily verifiable true facts! Think of all those who kept on supporting Prof Sir Roy Meadow. Maybe he was a good children’s doctor. He was however a lousy statistician and a lousy psychologist and this caused enormous disasters. No doubt he was a charming and amicable man. I always invoke Hanlon’s razor. Stupidity is a more likely cause of despicable behaviour than malice.
9:12 AM Here’s a name for you. Dr Svilena Dimitrova, NHS consultant neonatologist. Neonatologists against the paediatricians? CoCH had no neonatologist. Your friend well-known bully Dr Stephen Brearey “had an interest in neonatology” but was not a neonatologist. RCPCH (paediatricians!) told CoCH to recruit a neonatologist immediately.
9:14 AM I’m not saying it’s all your fault. Police lie and cheat. This has been proven again and again. Cheshire Constabulary have an especially bad reputation in this respect. I think you should cut all links with the bad guys and change sides as fast as possible, if only to save your own skin.
9:16 AM The momentum is growing. The Lucy Letby case is the biggest miscarriage of justice in the UK since the Guildford 4 and the Liverpool 6 (or were they 7 or were the numbers the other way round?). Just like the Lucia de Berk case in the Netherlands. The two cases are carbon copies of one another, but things panned out much worse in every respect in the UK. Utterly failed NHS, utterly failed CJS. Appalling gutter press. You should give an interview to a quality newspaper for a change.
Sep 13, 2024
7:07 PM Intelligent life outside the M25: what do you think of me then?
7:11 PM Babies do just suddenly drop dead. The Lucia de Berk case made that clear.
7:17 PM Unexplained and unexpected actually does happen all the time.
7:24 PM How did you exclude infection?
7:38 PM There is not one unrecordable explanation of a low C-peptide level. One of the explanations is that it is too high!!!!
9:37 AM Hi Dewi, yet again, I want to suggest you change sides! Become a hero. I know you do have the guts to do it, you are not a scared little man. I hope you’ve now studied Marks and Wark (2013) https://pubmed.ncbi.nlm.nih.gov/23751444/. It has a great summary of recommendations at the end. You see, Lucy Letby is innocent, 100% (ie, 99.99% certain, at least). Shall I show you the calculation? Science thrives on the clash of theories. As Niels Bohr once said “now we have a contradiction, at last we can make progress”. I honestly wish you well and know you are a good guy at heart. Forensic aspects of insulin – PubMedpubmed.ncbi.nlm.nih.gov
11:28 PM So you made a nice start, changing your expert medical opinion on three cases! But you are still convinced Lucy Letby was responsible. Surely that can only be by a statistical argument? But where are your statistical calculations and statistical qualifications? As far as I know neither police nor prosecution used testimony from a statistician. Lucy was often present at unpleasant events, but she worked the most hours of any nurse on that unit, and eagerly took the hardest shifts. Lucy’s defence team let her down badly, the judge was disgustingly biased. The whole disaster was not your fault. NHS managers and lawyers have a lot to answer for. Many reforms are needed. But they can only come if the system admits its failings.
11:32 PM I offered my services to defence, prosecution, and to the court. But no one wanted to know. Cheshire constabulary threatened me and sent Dutch police to my door in the night, to deliver a letter in person which I’d already received by email. Very intimidating. They needed legal proof I’d received their warning.
I just recently became aware of a deep connection between Countess of Chester hospital and radical restructuring of the NHS in the early 90’s, which brought in new layers of bureaucracy and internal competition. Don’t coordinate and distribute. Instead, let hospitals compete, survival of the fittest, dynamic leadership,and innovation! We’ll end up with better health care for less money.
The connection is Sir Duncan Nichol, former chairman of the Countess of Chester hospital trust. That’s a higher management level than the hospital executive board. Side effect of the innovations was more managers with even bigger top salaries. But Nichol is not just any manager. He’s a former NHS chief-executive, “part tycoon, part mandarin”. Read all about Sir Duncan’s innovations here: https://www.managementtoday.co.uk/uk-profile-sir-duncan-nichol-nhs-chief-executive/article/409550
Here are some more quotes from Management Today, emphasis added by myself.
“Nichol helped oversee the greatest shake-up in the health service since the war. Out went the old-style consensus management where low-grade administrators charged round trying to keep high-grade doctors happy; in came a whole raft of modern business nostrums: greater pressure on cost-efficiency and customer satisfaction, the introduction of ‘internal markets’, the separation of key functions like purchasing and service provision, and, of course, the increasing use of snappy titles like chief executive and general manager.”
“Some, still seething at the enforced changes, argue that you cannot apply market doctrines to the basic tenets of caring and curing. Others, especially those working in conventional businesses, remain unconvinced that any amount of fancy tinkering will change the nature of the beast. The last few years, they note, have still been dotted with high profile examples of cash squandering on a massive scale.”
I would recommend everyone interested in the Lucy Letby case to carefully study the 58 page appeal judgement – a board of three judges refused Lucy’s application to appeal. It is only 58 pages, it is well written and carefully argued… It is just built on heaps of false assumptions. What it says about the insulin evidence is particularly significant.
Three points specifically concern the insulin babies, babies F and L: points 14, 30 and 104 [and another on the evidence of Prof Hindmarsh, which I won’t go into right now.] Here they are in italics; my underlining.
14. A proposed ground 4 (that the jury were wrongly directed on evidence relating to the persistence of insulin in the bloodstream) was withdrawn following the refusal of leave to appeal by the single judge.
30. At trial, the integrity of the blood samples and reliability of the biochemical testing was challenged by Mr Myers. However, in her evidence at trial, the applicant [Lucy Letby!] admitted that both babies had been poisoned by insulin, but denied that she was the poisoner. The prosecution relied upon the unlikelihood of there being two poisoners at work on the unit. As the judge expressed it shortly before the jury retired to consider their verdicts: “If you are sure that two of the babies…had Actrapid, manufactured insulin, inserted into the infusion bag that were set up for them 8 months apart in August 2015 and April 2016 respectively, and you are sure that that was done deliberately, you then have to consider whether that may have been a coincidence, two different people independently acting in that way or were they the acts of the one person and, if so, who.”
104. The prosecution made some general points to rebut the allegations of bias and unreliability, including that almost every opinion given by Dr Evans was corroborated by another expert. In addition, it was pointed out that Dr Evans was the person who had identified that two of the babies had been poisoned by insulin (Baby F and Baby L). This was a matter which had eluded the treating medics and went to prove that someone was committing serious offences against babies in the unit; and it was particularly important independent evidence, bolstering Dr Evans’ credibility and reliability. Further, when Dr Evans reached his conclusions, he did so without knowing about other circumstantial evidence relied on by the prosecution in establishing guilt, including the applicant’s Facebook searches, the shift pattern evidence, and the “confession” in the note recovered from the applicant’s home on 3 July 2018
Richard’s comment on point 30: the applicant was told during the trial that it had been proven that two babies had been poisoned. Her reply was not that she admitted this fact, it was more like “well if you say it is proven it must be true. But I didn’t do it”. Notice that for the prosecution, six experts all say that this was true: Evans, Bohin, Hindmarsh, Milan, Wark; the hospital doctors had concurred (Gibbs, in particular). The defence had apparently not even looked for an expert on the insulin matter. They had raised problems about the reliability of the tests but these are ignored because Lucy herself agrees that the babies were poisoned with hospital insulin.
How can a young nurse agree or disagree with a deduction made by half a dozen senior medics that the immunoassay results proved deliberate insulin poisoning? All doctors and nurses have been taught in doctors’ or nurses’ school something about insulin metabolism and know that the ratio of insulin to C-peptide (after someone has been fasting for three hours) should be about 1 to 6. They are not taught anything about the forensic determination of deliberate insulin poisoning, which tells us that an anomalous ratio is a warning sign for something that might have been happened but it should be followed up with completely different tests which exclude a numerous sets of artefacts which can each also cause an anomalous ratio of immunoassays’ numbers. The test result comes back from the lab with a warning note printed in red with exactly this information. It was ignored by hospital doctors. The specialists weren’t called in and never told about it. The babies were nicely recovering from their hypoglycaemia and were rapidly transferred elsewhere.
Note that according to point 14 the defence had submitted and withdrawn a “ground for appeal” concerning the insulin. [I don’t know what it was, someone should find out!]. Note that the insulin is seen by all concerned as proof of presence of a murderer on the unit. The court of appeal sees it as ludicrous to suggest there are two murderers on the unit! They believe that the other evidence (air embolism etc etc) proves Lucy is a murderer. The insulin evidence shows someone tried to murder babies F and L. There can’t be two murderers. Therefore Lucy also tried to murder babies F and L.
The logic of the argument is impeccable. Just the premises of the argument are wrong.
These points do show the utter incompetence of the defence team.
One of the prosecution experts (Gwen Wark) has even published a paper Marks and Wark (2013) with a concluding list of recommendations which state that the immunoassay only suggests a possibility; in order to prove it other tests must be done. https://pubmed.ncbi.nlm.nih.gov/23751444/ They were not done. No sample was saved so they never can be done. Both babies F and L are alive and well to this day though one has cerebral palsy … linked to problems experienced during birth.
At the trial Dr. Wark confirmed the other experts’ claim that insulin poisoning had been proven. How could she? What had she written in any written testimony provided pre trial to police or CPS? Richard Thomas (Lucy’s solicitor) says that the defence team can’t say whether or not any documents exist and whether or not they saw them. The jury is not shown any such documents.
People say “the jury was given so much more, information…”. That is quite simply not true. The jury in a UK criminal trial hears what is said and it observes the body language. That’s all. It does not receive copies of written testimony of scientific experts. (This is a consequence of “open justice” with a trial by a jury of your peers).
What was the fifth ground in the original application for an appeal? The one which a single judge scrapped and the defence team then scrapped too?
Maybe some journalist should chase after that. I’m afraid the defence team is unlikely to tell us. They are not obliged to, and they can only do it if Lucy instructs them to do so. And nobody is able to talk to her.
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.
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 spreadsheet was shown on TV both yesterday (Friday August 18, the day of the verdicts) and at the start of the trial of Lucy Letby. Apparently, Cheshire Constabulary find this absolutely damning evidence against Lucy. And indeed, many journalists seem to agree.
The 25 events are almost all of the events at which LL was present during the periods investigated. They are suspicious because she was under suspicion when the police started their investigations. Not surprisingly, most nurses are not present at many of these events. And of course, many nurses probably work far fewer hours than LL. Many are often on administrative duties.
The doctors on the ward are of course missing. Doctors were never investigated as suspects but from the start of police investigations apparently always believed to speak gospel truth. During cross-examination, during the trial, some of them have changed various parts of their stories. Of course, unlike Lucy, they do not lie, since they could never (under oath in court, or earlier, when being interviewed as witnesses by police) be saying untruths in order to deceive.
Back to the spreadsheet. When drawing conclusions from any data it is important to know how it was gathered. It is important to know what data is missing, but would be needed draw even the most preliminary and tentative inferences.
There was an NHS investigation into the raised rates of deaths and collapses at Countess of Chester Hospital (CoCH) in summer 2015 and summer 2016. It was published in 2017 by the Royal College of Paediatrics and Child Health (RCPCH). The investigation blamed the consultants for the appalling low standard of care, and the terrible situation regarding hygiene. The RCPCH investigators actually wrote that nurse Lucy Letby could not be associated with the events, but that passage was redacted out of the published report for privacy reasons. We know that already, consultants had presented their fears to hospital management. One of them (successful TV doctor and FaceBook influencer dr Ravi Jayaram) was on TV yesterday proudly telling the world that he had been vindicated. Management was inclined not to believe them, and did not act on them, but they certainly came to the ears of the RCPCH. On publication of the report, four consultants had had enough, and went to the police with their suspicions that LL was a murderer.
Thanks to FOI requests and statistical analysis by independent scientists, we now know that the rate of events (deaths and collapses) is just as much raised when Lucy is not on the ward as it is when she is on the ward. A lot of medical information (as well as the state of the drains at CoCH) points to a seasonal virus epidemic.
The elevated rate went back to normal after the hospital was down-graded (no longer accepting high risk patients), and when the drains were rebuilt, and when the senior consultant retired, all of which happened soon after the police investigation started. Incidentally, the rate of still-births and miscarriages show exactly the same pattern.
Lucy must certainly have been a witch in order to kill babies in the womb and even when she is far from the hospital.
Those familiar with miscarriages of justice involving serial killer nurses will be familiar with this police and prosecution tactic. Is it evil or is it just stupid? (cf. Hanlon’s razor). I think it is quite simply “learnt”. Police and prosecution learn what convinces jurors over the years, and that is why the same “mistakes” are made again and again. They work!
Lucy Letby enjoys prosecco at a small new year party with friends and family at her home (?).Lucy Letby appearing via video link at court in Warrington, England, Thursday Nov. 12, 2020, charged with 8 murders and 10 murder attempts (Elizabeth Cook/PA via AP)Lucy Letby as featured on a campaign brochure in the fight to prevent closure of CoCH.
Newest Note: [14 May] And then Rachel Aviv’s splendid article in the New Yorker came out, here is the link: https://www.newyorker.com/magazine/2024/05/20/lucy-letby-was-found-guilty-of-killing-seven-babies-did-she-do-it. I think this really marks “the end of the beginning” to quote a famous British statesman. Amusingly, The New Yorker has kindly blocked people with UK based IP address from reading it online, in order to comply with current reporting restrictions. One must not interfere with UK criminal justice; the next trial of Lucy – for killing baby K – must not be influenced. Some links to internet archive copies of the article can be found here: https://mephitis.co/new-yorker-magazine-lucy-letby-bombshell/. Hopefully readers in the UK will be able to get over these hurdles and find out what a lot of people outside the UK have already known for a year.
New Note: [10 May 2024] By now this post is even more terribly incomplete. Fortunately, Lucy Letby has more supporters (and support is growing by the day, to judge by social media) and this has resulted in a two splendid websites each with many articles concerning many aspects of the case, and a podcast with a fantastic series of conversations about the trial, and a YouTube channel. Here are links to them:
https://www.lucyletby.press “Vaudeville: Junk science and the Trial of Lucy Letby” is a website run by a retired medical practitioner from Ireland calling himself James Egan. Its blog contains numerous articles. Today it seems to be offline, I hope it will be back soon … and two days later it is back with a different address: https://jameganx.notepin.co/. Clearly in the process of redesign of the website, as well as moving to a new URL.
https://mephitis.co is run by Peter Elston, whose “chimpinvestor” site was one of the first to criticise the prosecution case against Lucy Letby. Peter has moved articles about the Letby case on that site to this new one. “Mephitis mephitis” is the scientific name of the animal we all know as the skunk.
Finally I want to recommend Mark Mayes’ YouTube channel https://www.youtube.com/@ThePersecutionofLucyLetby (“The Persecution of Lucy Letby”). I also highly recommend Ceri Morrice’s videos, such as this one: https://www.youtube.com/watch?v=HFTSV_qh_Ik. And while I’m at it I’ll mention my own YouTube production (two hours, sorry): a scientific lecture focussing on the spreadsheet, the green post-it note, and the insulin evidence https://www.youtube.com/watch?v=RxmFLKTlim8 “A tale of two Lucy’s”. I need to update part of that talk since I have since realised that the police were given medical notes (selected by the consultant paediatricians) on 32 babies, not on 32 events. And I’ve also learnt a great deal more about insulin. I expect the next version will be a set of three one-hour lectures (or maybe four).
Note: [20 August 2023] This post is incomplete. It needs a prequel: the history of medical investigations into two “unexplained clusters” of deaths at the neonatal ward of the Countess of Chester Hospital. It needs many sequels: statistical evidence; how the cases were selected (the Texas sharpshooter paradox) and the origin of suspicions that a particular nurse might be a serial killer; the post-it note; the alleged insulin poisonings; the trouble with sewage backflow and the evidence of the plumber; the euthanasias. For the medical material, the site to visit is the magnificent https://rexvlucyletby2023.com/.
This is how the post originally started:
Lucy Letby, a young nurse, has been tried at Manchester Crown Court for 7 murders and 15 murder attempts on 17 newborn children in the neonatal ward at Countess of Chester Hospital, Chester, UK, in 2015 and 2016.
She was found:– Guilty of 7 counts of murder (against 7 babies) – Guilty of 7 counts of attempted murder (against 6 babies) – Not guilty on 2 counts of attempted murder (against 2 of the 6 babies she *was* found guilty of attempting to murder). No decision was reached on 6 counts of attempted murder against 6 different babies. However, 2 of those 6 she was also found guilty of a different count of attempted murder. [Thanks to the commenter who corrected my numbers.]
The prosecution dropped one further murder charge just before the trial started, on the instruction of the judge. Several groups of alleged murders and murder attempts concern the same child, or twin or triplet siblings. All but one child was born pre-term. Several of them, extremely pre-term.
I’m not saying that I know that Lucy Letby is innocent. As a scientist, I am saying that this case is a major miscarriage of justice. Lucy did not have a fair trial. The similarities with the famous case of Lucia de Berk in the Netherlands are deeply disturbing.
BTW [16 May 2024], I still don’t *know* that she is innocent but I am increasingly certain that she is.
The image below summarizes findings concerning the medical evidence. This was not my research. The graphic was given to me by a person who wishes to remain anonymous, in order to disseminate the research now fully documented on https://rexvlucyletby2023.com/, whose author and owner wishes to remain anonymous. Note that the defence has not called any expert witnesses at all (except for one person: the plumber). Possibly, they had not enough funds for this. Crowd-sourcing might be a smart way of getting the necessary work done for free, to be used at a subsequent appeal. That’s a dangerous tactic, and it seems to me that the defence has already taken a foolish step: they admitted that two babies received unauthorised doses of insulin, and their client was obliged to believe that too.
This blog post started in May 2023 as a first attempt by myself to blog about a case which I have been following for a long time. The information I report here was uncovered by others and is discussed on various internet fora. Links and sources are given below, some lead to yet more excellent sources. Everything here was communicated to the defence, but they declined to use it in court. Maybe they felt their hands were bound by pre-trial agreement between the trial parties as to what evidence would be brought to the attention of the jury, which witnesses, etc.
An extraordinary feature of UK criminal prosecution law is that if exculpatory evidence is in the possession of the defence, but not used in court, then it should not be used at a subsequent appeal, whether by the same defence team or a new one. This might explain why the defence team would not even inform their client of their knowledge of the existence of evidence which exonerated her. Even though, it is also against the law that they did not, as far as we know, disclose evidence which they had which was in her favour. The UK law on criminal court procedure is case law. New judges can always decide to depart from past judges’ rulings.
A very important issue is that the rules of use of expert evidence is that all expert evidence must be introduced before the trial starts. It is strictly forbidden to introduce new expert evidence once the trial is underway.
UK criminal trials are tightly scripted theatre. The jury is of course incommunicado, very close to its verdict, and I do not aim to influence the jury or their verdict. I aim to stimulate discussion of the case in advance of a likely appeal against a likely guilty verdict. I wish to support that small part of the UK population who are deeply concerned that this trial is going to end in an unjustified guilty verdict. Probably it will, but that will not be the end. So much information has come out in the 9 months of the trial so far, that a serious fight on behalf of Lucy Letby is now possible. Public opinion crystallised long ago against Lucy. It can be made fluid again, and maybe it can even be reversed, and this is what must happen if she is to get a fair re-trial.
As a concerned scientist who perceives a miscarriage of justice in the making, I attempted to communicate information not only to the defence but also to the prosecution, to the judge (via the clerk of the court), and to the Director of Public Prosecutions. That was a Kafkaesque experience which I will write about on another occasion. Personally, I tend to think that Lucy is innocent. That was however not my reason for attempting to contact the authorities. As a scientist, it was manifestly clear to me that she was not getting a fair trial. Science was being abused. I tried to communicate with the appropriate authorities. I failed to get any response. Therefore I had to “go public”.
Here is a short list of key medical/scientific issues, originally copied from an early version of the incredible and amazing website https://rexvlucyletby2023.com/, with occasional slight rephrasing and some small, hopefully correct, additions by myself. That site presents full scientific documentation and argumentation for all of the claims made there.
Air embolism cannot be determined by imaging, and can only be determined soon after death, and requires the extraction of air from the circulatory system, and analysis of the composition of the air using gas chromatography.
The coroner found a cause of death in 5 out of 7 of the alleged murder cases. Two of them appeared to be, in part, related to aggressive CPR, two appeared to be due to undiagnosed hypoxic-ischemic encephalopathy and myocarditis, one of the infants received no autopsy, and the other infant was determined to have died due to prematurity. It is highly unusual for the cause of death to be altered years after the fact and using methodology that is not supported by the coroner’s office.
The two claims of insulin poisoning are not supported by the testing conducted, and the infants (who are still alive and well) did not have dangerously low or dangerously high blood glucose levels for any period of time. There are many physiological reasons that could explain their low blood glucose during the whole period. In one of the two cases, assumptions are being made on the basis of one test taken at a single time point, clearly inconsistent with the other medical readings, and contravening the manufacturer’s own instructions for use (see image below). The report detailing the conclusions from that single test violates the code of practice of the forensic science regulator. Moreover, it appears that some numerical error has been made in the necessary calculation, resulting in an outcome which is physiologically impossible (or the person responsible did not know about the so-called “hook effect”). The mismatch between C-peptide and insulin concentration does not prove that the excess insulin found must have been synthetic insulin. There are many other biological explanations for a mismatch. No testing was done to determine the origin of the insulin. Similarly, there are many innocent explanations for the detection of some insulin in a feeding bag.
The air embolism hypothesis is confusing because it fails to explain why some children apparently perished and others did not, and it has not been supported by the minimal necessary measurements.
In at least one case, Lucy is blamed with causing white matter brain injury. This claim is utterly dishonest. The infant who experienced this brain injury was born at 23 weeks gestation, and white matter brain injury is associated with such early births. Further, there is sufficient evidence that demonstrates that enterovirus and parechovirus infection has been linked to white matter brain injury in neonates, resulting in cerebral palsy.
At the time of the collapses and deaths of the infants, enterovirus and parechovirus had been reported in other hospitals. There is a history of outbreaks of these viruses in neonatal wards in hospitals around the world. They especially harm preterm infants who do not yet have a functioning immune system. It is reported that many parents of the infants were concerned that their ward had a virus (as was Lucy) and that Dr Gibbs denied this was so. To date we have seen no evidence to show they did any viral testing, and if they did what the results were.
Then a fact pertaining to my own scientific competence.
Both prosecution and defence were warned long ago about the statistical issues in such cases. Both have responded that they are not going to use any statistics. They are also not using the services of any statistician. Seems the RSS report https://rss.org.uk/news-publication/news-publications/2022/section-group-reports/rss-publishes-report-on-dealing-with-uncertainty-i/ has had the opposite effect to that intended. Amusingly, the same thing happened in the case of Lucia de Berk. At the appeal the prosecution stopped using statistics. She was convicted solely on the grounds of “irrefutable medical scientific evidence”. (Here, I’m quoting from the words both spoken by the judges and written down on the first page of their > 100 page report of the reasons and reasoning which had led to their unshakable conviction that Lucia de Berk was guilty. The longest judge’s summing up in Dutch legal history). I was one of the five coauthors of the RSS report. We were a “task force”, formally commissioned by the “Statistics and the Law” section of the society. I consider it the most important scientific work of my career. It took us two years to put together. We started the work in 2020; we had seen the Lucy Letby trial on the horizon since 2017 when police investigations started and the suspect being investigated was already common knowledge.
The UK does not have anything like that because a jury of ordinary folk are the ones who (legally) determine guilt or innocence. This is a clever device which makes fighting a conviction very difficult; no one can know what arguments the jury had in their mind, no one knows what, if anything, was the key fact that convinced them of guilt. Ordinary people are convinced by what seems to be a smoking gun, they then see all the other evidence through a filter. This is called “confirmation bias”. In the Lucy Letby case, the smoking gun was probably the post-it note, and the insulin then seems to clinch the matter. The prosecution cross-examination convinces those who already believe Lucy is guilty that she moreover is constantly lying. More on all this in later posts, I hope.
Back to the insulin. Here are the instructions on the insulin testing kit used for the trial, taken from this website http://pathlabs.rlbuht.nhs.uk/ccfram.htm, the actual file is http://pathlabs.rlbuht.nhs.uk/insulin.pdf. Notice the warning printed in red. Yes, it was printed in red, that was not something I changed later. (All this is not my discovery; the person who uncovered these facts wishes to remain anonymous).
The toxicological evidence used in the trial violates the code of practice of the UK’s Forensic Science Regulator (see link below). It should have been deemed inadmissible. Instead, the defence has not disputed it, and thereby obliged their own client Lucy to agree that there must have been a killer on the ward. The jury are instructed to believe that two babies were given insulin without authorization, endangering their lives. (The two babies in question are still very much alive, to this day. Probably now at primary school.)
The defence stated to me that they cannot inform Lucy of the alternative analysis of the insulin question. It appears to me that this violates their own code of practice. Do they feel bound by the weird rules of UK’s criminal prosecution practice? Their client, Lucy Letby, is herself essentially merely a piece of evidence, seized by the police from what they believe is a scene of crime. No one may tamper with it during the duration of her own trial, which is lasting 10 months! I think this constitutes an appalling violation of basic human rights. The UK laws on contempt of court are meant to guarantee a fair trial. But in the case of a 10-month trial on 22 charges of murder and attempted murder, they are guaranteeing an unfair trial.
Lucy’s solicitor refused to pass on a friendly personal letter of support to Lucy or to her parents because she had not instructed him to do so. Should one laugh or cry about that excuse? I have the impression that he is not very bright and that he may have been convinced she is guilty. If so, I hope he is changing his mind. In the UK, the solicitor does all the legwork and communication between the client and the defence team. The barrister does the cross-examinations and the court theatrics, but probably never builds up a personal relationship with his client. Lucy has been all this time prison, in pre-trial detention, far from Manchester or Hereford. This might explain the extraordinarily weak defence which has been put up so far. But it might be deliberate.
One must take into account the fact that funding for legal support is meagre. The prosecution has been working on the case for 6 or so years, with unlimited resources. The defence has had a relatively very short time, with very limited resources. Probably the solicitor and the barrister already put in many more hours than they are paid for. There are no funds for expensive scientific witnesses. It is very possible that the defence team well understands that they cannot put up a serious defence during the 9 to 10 months of the trial, but that precisely this time period, with a huge number of revelations being made outside the trial, material for a serious defence during an appeal has been “crowd-sourced”. It seems to me that this mass of high-quality independent scientific work provides plenty of grounds for an appeal, in the case that the jury hands down a guilty verdict.
Do Statistics Prove Accused Nurse Lucy Letby Innocent? https://www.chimpinvestor.com/post/do-statistics-prove-accused-nurse-lucy-letby-innocent This splendid and comprehensive blog post also has a large list of links to reports and data sets. Yet more data analysis can and should be done. This site gives anyone who wants to a quick-start. And after that, two more outstanding posts…
At a pre-publication meeting of stake-holders held to gain feedback on our report, a senior West Midlands police inspector told me “we are not using statistics because they only make people confused”. Lucy’s sollicitor and barrister knew well in advance of our report, were even given names of excellent UK experts whom they could consult, but did not bother to contact one of them. No statistics in our courts please, we are British! Yet the UK has the best applied statisticians and epidemiologists in the world.
Article in “Science” about my work on serial killer nurses
https://www.bbc.co.uk/sounds/play/m001k7vt?partner=uk.co.bbc&origin=share-mobile “The UK’s forensic science used to be considered the gold standard, but no longer. The risk of miscarriages of justice is growing. And now a new Westminster Commission is trying to find out what went wrong. Joshua talks to its co-chair, leading forensic scientist Dr Angela Gallop CBE, and to criminal defence barrister Katy Thorne KC.”
Criminal Procedure Rules and Criminal Practice Directions
New expert evidence cannot be admitted once a trial is in progress
“The courts have indicated that they are prepared to refuse leave to the Defence to call expert evidence where they have failed to comply with CrimPR; for example by serving reports late in the proceedings, which raise new issues (Writtle v DPP [2009] EWHC 236). See also: R v Ensor [2010] 1 Cr. App. R.18 and Reed, Reed & Garmson[2009] EWCA Crim. 2698″. This quote comes from https://www.cps.gov.uk/legal-guidance/expert-evidence. Note, a judge is always allowed to break with precedence. The rule is not actually a permanent rule, it is merely a description of current practice. Current practice evolves when and if a new judge sees fit to break with precedence. Obviously, he would have to come up with good legal reasons why he believes he has to do that. It’s his prerogative, his free choice. That’s the essence of case law, aka common law.
Hierbij een eerste indruk. Er worden nu betrouwbaarheidsintervallen bepaald en men ziet meteen dat de statistische onzekerheid enorm is. Natuurlijk, worden deze berekeningen gebaseerd op statistische veronderstellingen, en die zijn altijd betwistbaar. Maar op zijn minst kunnen ze geinterpreteerd worden op een pure beschrijvend-data manier als een gevoeligheids analyse. Een brede interval laat zien dat als de data een klein beetje anders was, het antwoord totaal anders zou zijn geweest. We weten zo wie zo dat er allerlei foutbronnen zijn; we weten dat de gegevens in de data bestanden van rijksinstellingen heel ver kunnen afliggen van de ervaringen van de burgers; dat ze afhangen van allerlei definities en afspraken die hun oorsprong hebben in bureaucratische administraties.
Een belangrijke resultaat is het plaatje hieronder, waarbij statistische onzekerheidsmarges toegevoegd zijn aan een plaatje uit de eerste (en omstreden) CBS rapport. Figuur 6.1.1.
Ik heb de “kleine letters” en de “nog kleinere kleine letters” meegenomen, niet om te lezen, maar om te laten zien dat er een hele technisch verhaal bijhoort.
De eerste indruk is dat het lijntje in het midden ongeveer plat is. Dus: de nare ingreep (gedupeerd zijn) in jaar “nul” geen sterke effect heeft. Men ziet over meerdere jaren een lichte toename bij dezelfde 4000 gezinnen van maatregelen van jeugdbescherming wat, zo te zien, beste toevallig had kunnen zijn. De hypothese van “geen impact” kan niet verworpen worden op grond van deze cijfers.
Maar, dat is niet de enige mogelijke uitleg van het plaatje, en die is net zo min te verwerpen. Dat hobbeltje in de grafiek zou ook “echt” kunnen zijn, en bovendien veroorzaakt door de klap wat de belastingdienst in “jaar nul” uitdeelde. Het ziet eruit als een stijging van een half procent per jaar, over meerdere jaren. De meest aannemelijke schatting is dat 20 tot 30 (of zelfs meer) echte dubbele slachtoffers zijn; dubbele slachtoffers in de zin dat gedupeerd zijn door de uitkeringsschandaal werkelijk leidde tot een uithuisplaatsing wat anders niet zou zijn gebeurd.
Het echte effect is gedempt en uitgesmeerd door alle tekortkomingen van het onderzoek. De conclusie moet zijn: het zijn zeker tientallen en mogelijk zelfs honderd.
Overigens, zou ik graag een keer een extra cijfer willen hebben waardoor ik de statistische onzekerheid in het verschil in hoogte van deze twee waardes (blaue en groen) zou kunnen evalueren.
Er zijn ruwweg 4000 gedupeerden en die zijn gepaard één op één met vergelijkbare niet-gedupeerden. We hebben feitelijk te maken met rond de 4000 matched pairs. Het CBS weet van elk lid van elk paar of een jeugdbescherming actie plaatsvond. We hebben feitelijk 4000 waarnemingen van paren, elk waarvan een van de vier waardes kan aannemen (0, 0), (0, 1), (1, 0), (1, 1); noem deze twee gevallen (x, y). Een “1” betekent uit een huisplaatsing (of iets dergelijks), een “0” betekent geen uithuisplaatsing. We zijn geinteresseerd in de gemiddelde van de x‘en minus de gemiddelde van de y‘s. Dat is hetzelfde als de gemiddelde van alle (x – y) waarden; elk ervan is gelijk aan –1, 0, of +1. Ik zou graag het 2×2 tabel willen zien van aantallen van elk van de vier mogelijke gesamenlijke uitkomsten (x, y). Ik zou de standaard afwijking willen uitrekenen van de (x – y) waarden. Dit zou ons inzicht geven in de mate van success van de matching: als het goed is, zouden we een positieve correlatie zien tussen de uitkomsten van de twee groepen. Een correlatie van +1 zou impliceren dat de uitkomst volledig bepaald is door de matching variabelen, dat zou betekenen: gedupeerd zijn maakte werkelijk niks uit. Kom’ns op, CBS!
Professor Gill helped exonerate Lucia de B., and is now making mincemeat of the CBS report on benefits affair
Top statistician Richard Gill cracks down on the research conducted by Statistics Netherlands (CBS) into custodial placements of children of victims in the benefits affair. ‘CBS should never have come to the conclusion that this group of parents was not hit harder than other parents.’
Carla van der Wal 26-01-23, 06:00 Last update: 08:10
Emeritus professor Richard Gill would prefer to pick edible mushrooms in the woods and spend time with his grandchildren. Nevertheless, the top statistician in the Netherlands, who previously helped to exonerate the unjustly convicted Lucia de B, is now firmly committed to the benefits affair.
CBS should never have started the investigation into the custodial placement of children of victims in the benefits affair, says Gill. “And the conclusion that this group of parents has not been hit harder than other parents, CBS should never have drawn. It left many people thinking: only the tax authorities have failed, but fortunately there is nothing wrong with youth care. So all the fuss about ‘state kidnappings’ was unnecessary.”
After Statistics Netherlands calculated how many children of benefit parents were placed out of home (in the end it turned out to be 2090), it seemed that victims in the affair lost their children more often than similar parents who were not victims. The results were presented on November 1 last year, which Gill now denounces.
Gill is emeritus professor of mathematical statistics at Leiden University and in the past was an advisor to the methodology department of Statistics Netherlands. In the case of Lucia de B. he showed that calculations that would show that De B. had more deaths in her services were incorrect.
CBS abuses
There is a special reason that Gill is now getting stuck in the benefits affair – but more on that later. First about the CBS report. Gill states that Statistics Netherlands is not equipped for this type of research and points out that after two research methods were dropped, only one ‘not ideal, but only option’ remained. He also thinks, among other things, that the more severely affected victims in the benefits affair should be the focus of the investigation. He emphasizes that relatively mildly affected families most likely had to deal with much less drastic consequences. CBS itself also says that it likes to use information about the degree of duping, but that there was none.
CBS also acknowledges some criticisms. “CBS itself has mentioned a number of comments to the report. There seems to be a misunderstanding on one point,” said a spokesperson, who also said that CBS still fully supports the conclusions. CBS will soon be discussing the methodology used with Gill, but in any case CBS sees itself as the right party to carry out the study. “CBS has the task of providing insight into social issues with reliable statistical information and data and has the necessary expertise and techniques. In this case there was a clear social need for statistical insight.”
Gill thinks otherwise and thinks it’s important to raise this. Because he is awakened by injustice. That was also a reason to offer his help when questions arose about the conviction of Lucia de B., who can simply be called Lucia de Berk again since her acquittal. In 2003 she was sentenced to life imprisonment.
Out-of-home placement
With the acquittal in 2010, Gill became not only a top statistician, but also a beacon of hope for people who experienced injustice. And José Booij, a mother of a child placed in care, contacted him many years ago.
Somewhere in Gill’s house in Apeldoorn there is still a box with papers from José. It contains diaries, newspaper clippings and diplomas of hers. She was a little different from other people. A doctor who fell for women, fled the Randstad and settled in Drenthe. There she became pregnant and had a baby. And she had a neighbour with whom she had a disagreement. “That neighbour had made all kinds of reports about José to the local police, said that something terrible would happen to the child.” After six weeks, José’s daughter was removed from home.
State kidnapping
“What happened to José at the time, I also call that a state kidnapping, just as the custodial placements among victims of the benefits affair are now called.” The woman continued to fight to get her child back. But gradually that fight drove her insane. She lost her job, she lost her home. She fled abroad. “Despite a court ruling that the child had to be returned to José, that did not happen. José eventually derailed. I now know that she has left information with more people in the Netherlands to ensure that it is available to her daughter when she is ready. But I can’t find José anymore. I heard she was seen in the south of the Netherlands after escaping from a psychiatric clinic in England.”
And meanwhile he keeps that box. And Gill thinks of José, when he considers the investigation by the Central Bureau of Statistics into custodial placements of children of victims in the benefits affair. Gill makes mincemeat of it. “The only thing CBS can say is that the results suggest that the differences between the two groups that have been compared are quite small. There should be a lot more caution, and yet in the summary you see bold summaries, such as: ‘Being duped does not increase the likelihood of child protection measures’. I suspect that CBS was put under pressure to conduct this study, or wanted to justify its existence. Perhaps there is an urge to be of service.”
Time for justice
Now is the time to put that right, Gill thinks. Research needs to be done to find out what’s really going on. “I had actually hoped that younger colleagues would have stood up by now, who would take up such matters.” But as long as that doesn’t happen, he’ll do it himself. Maybe it’s in his genes. It was Gill’s mother – he was born in England – who helped crack the enigma code used by the Germans to communicate during World War II. Gill wasn’t surprised when he found out. He already suspected that his excellent mind was inherited not only from his father, but also from his mother.
Love
Yet in the end it was his wife – the love of whom led him settle in the Netherlands – who put him on this track. She pointed Gill to Lucia de Berk’s case and encouraged him to get to work. She may have regretted that. For example, when Gill threatened to burn his Dutch passport during a broadcast of The World Keeps on Turning Round (“De wereld draait door”) if the De Berk case was not reviewed. “She said, ‘You can’t say things like that!'”
In fact, he would like to enjoy his retirement with her now – he has been out of paid work for six years now. Then he would spend his days in the woods looking for edible mushrooms. And spend a lot of time with his grandchildren. But now his calculations also help exonerate other nurses. Last year, Daniela Poggiali was released in Italy after Gill interfered with the case together with an Italian colleague. There are still things waiting for him in England.
And so the benefits affair is here in the Netherlands, which, as far as Gill is concerned, needs more in-depth, thorough research to find out exactly what caused the custodial placements. “That is why I ended up with Pieter Omtzigt and Princess Laurentien, who are also involved in the benefits affair.” Among the people who express themselves diplomatically, he wants to be the bad cop, the man who shakes things up, as he did when he threatened to set his passport on fire. But at the same time, he also hopes that a young statistician will emerge who is prepared to take over the torch.
CBS provided this site with an extensive explanation in response to Gill’s criticism. It recognizes the complexity of this type of research, but sees itself as the appropriate body to carry out that research. An appointment to speak with Gill has already been scheduled. “CBS always tries to explain as clearly and transparently as possible in its reports what has been investigated, how it was done and what the results are.”
Statistics Netherlands also points to nuances in the text of the report, for example after the sentence above a piece of text: ‘Being duped does not increase the chance of child protection measures’. “On an individual level, there may be a relationship between duping and youth protection, which is stated in several places in the report.” Even if ‘on average no evidence is found for a relationship between duping and youth protection’, as Statistics Netherlands notes.
Statistics Netherlands fully supports the research and the conclusions as stated in the report. It is pointed out, however, that there are still opportunities for follow-up research, as has also been indicated by Statistics Netherlands.
