
Dr John Gibbs, a consultant paediatrician who worked at the Countess of Chester Hospital during the period when Lucy Letby murdered seven babies and attempted to murder seven more on the neonatal unit, has reflected on the findings of the Thirlwall Inquiry. The final report, published on Tuesday, comprised 822 pages and was initiated following Letby’s conviction in 2023. Lady Justice Thirlwall characterized the events as “a complete failure to protect babies on the neonatal unit.”
Gibbs acknowledged that consultants bear “collective” responsibility for some of the failings detailed in the inquiry. He expressed regret that medical staff were not braver in escalating their suspicions to police at an earlier stage, and accepted personal accountability for not having done so independently when colleagues did not. The consultant, who began working in Chester in 1994 and is now retired, stated he felt consultants failed the babies and apologized to families affected. He agreed with the report’s assessment that hospital executives had multiple opportunities to intervene while deaths were occurring and potentially could have saved lives.
Gibbs described the period following Letby’s removal from the unit until police involvement as particularly difficult, with management determined to convince staff that Letby had been wrongly suspected. He also referenced team failures, including a missed opportunity when blood test results suggesting insulin poisoning in August 2015 were not properly reviewed by multiple staff members covering the unit. The inquiry found that hospital managers should have notified police earlier than they did and had repeatedly dismissed consultants’ concerns.
The Thirlwall Inquiry has recommended urgent reforms to neonatal units, including CCTV for all cots and incubators and restricted access to insulin. Health Secretary Yvette Cooper announced officials will “urgently develop plans” to introduce live-streaming cameras on England’s baby wards. Letby, who maintains her innocence and is serving 15 whole-life terms, has been denied permission to appeal twice, though the Criminal Cases Review Commission is currently examining her convictions.
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