Context
Ian Harvey was Medical Director at the Countess of Chester from 2010 to 2018. His Thirlwall Inquiry evidence addresses his clinical-leadership decisions around Letby’s continued presence on the unit, the decision to commission the RCPCH review as a service-level review rather than an individual-case investigation, and the framing of the consultants’ concerns for much of 2016 as a dysfunctional-team matter.
Key passages
Failing to call the police. Asked directly whether he had failed to have Letby investigated earlier by the police and removed from the unit, Mr Harvey, the Trust’s Medical Director, said: “I am aware, from all the documentation, that in June/July 2016 I had expressed an opinion that we should approach the police and I sincerely regret that we didn’t at that time.” He added that “on reflection, I’m not comfortable seeing that and thinking that we didn’t”, while noting he was “not convinced…that they would have necessarily acted at that point”.
“All emails cease forthwith.” Shown an email he had sent during the Consultants’ exchanges about going to the police in June 2016, telling Dr Jayaram “this is absolutely being treated with the same degree of urgency — it has already been discussed and action is being taken. All emails cease forthwith. We will share with you what action we are taking”, Mr Harvey said he had been trying to stop a tendency for emails to become “more and more extreme”. He accepted: “I fully accept that I — I got that completely wrong, that email doesn’t read as it should have done.”
The original view. Discussing mortality-rate data the Trust had compiled, Mr Harvey said one graph was “really a reflection of the figures that we were already aware of that had actually sparked the need for the investigation” rather than something that could explain the individual deaths. Reflecting on the events of 2015 to 2017, he told the Inquiry: “regret that I didn’t stick with my original view that we should have gone to the police.”
Missed opportunities. Discussing why deliberate harm by staff can be hard to detect, Mr Harvey interjected that “we had three opportunities that were missed where there was clear evidence of harm, that we weren’t fortunate enough to have been informed about”, naming the cases as “Child F, Child K and Child L”. Asked whether a Casenote Review might have found the insulin results for two of those children, he said that would not merely have been a possibility: “that would have been a definite”.
The Royal College review. Mr Harvey accepted that the Terms of Reference he set for the Royal College of Paediatrics and Child Health review were flawed, telling the Inquiry: “I got the Terms of Reference or the Terms of Reference were incomplete and I — I got that wrong. It should have been specific with regard to a Casenote Review.” Asked whether the resulting report could be relied on to exclude the possibility that the children had been harmed, he answered: “No.” He gave the same answer, “No”, when asked whether the later reviews by Dr Hawdon and Dr McPartland had excluded the possibility that Letby had harmed the children.
What to read alongside this
See our profile of Ian Harvey and the evidence of Dr Brearey and Tony Chambers.