Perhaps the greatest tragedy behind the crimes of Lucy Letby is that doctors, paedotricians and fellow medical professionals who saw what was happening and knew enough to raise the alarm were over-ruled by managers.
https://www.theguardian.com/uk-news/202 ... aby-deaths
Doctors were actually forced to apologise to her for raising the alarm.
Consultants were threatened with being struck off if they continued to voice their concerns.
The people who saw the data and knew how to read it were doing their best to get Letby away from the unit but people who seemed to agree with the politicians off the time - that 'we've all had enough of experts' - ignored the experts and the deaths continued for years afterwards affecting many more families.
A non-judicial enquiry has been set up but I don't think that's enough. A non-judicial enquiry has no power to compel co-operation, no power to demand access to records and documents, and no power to sanction those who withhold information that is material and relevant to the enquiry.
Only a full, independent judicial enquiry will do, and when it reports it must have power to sanction, and if necessary bring action against, the politically appointed hospital managers who let down the families.
Lucy Letby is wholely responsible for her own crimes and should never be released from prison, but the system that placed the reputation of the healthcare trust above the well-being of patients must also bare its share of the blame for creating an environment in which science, statistical data and expert advice were ignored.