We must learn from criminal tragedies in the NHS

When I heard about the appalling crimes of Lucy Letby convicted of killing babies in a hospital specialist baby unit my reaction was “oh no, not again”. The parallels with the mass murdering GP Harold Shipman are clear.
Shipman was a popular and competent GP. He never had a complaint. When he was arrested, his patients set up a petition to have him released. They are probably a bit embarrassed now but the idea that their popular GP could be a mass murderer was bizarre.
Lucy Letby was a popular nurse, going on holiday to Ibiza with colleagues. She was also capable.
The first indication that Shipman was not all he appeared came from basic statistics. A local funeral director was concerned about the number of deaths in his single-handed practice.
She contacted another local GP who spent the weekend looking through all the figures. There was an anomaly. The GP contacted the coroner who spoke to Shipman and dismissed the concerns. Shipman continued to murder patients.
The consultant paediatricians in Lucy Letby’s department were concerned about the number of unexplained deaths of babies in the department. They spent time going through the figures. The only common feature in all the deaths was that Letby was on duty at the time.
They reported their concerns which were not only dismissed but they were forced to write a letter of apology to Letby for “bullying”.
There will be an enquiry into the Letby case, which is now going to be statutory, judge led. There was a long enquiry into Shipman that produced many proposals, many of which were good but would not have stopped Shipman.
All GPs now must have regular appraisals. I supported this idea and became an appraiser myself, but it would not have picked up Shipman. He was a competent GP. The important statistics, which might have rung alarm bells, were not available to appraisers.
Now all GPs have to send out questionnaires to see whether the patients are happy with the service. Shipman would have scored well.
The proposal, which was not implemented, was an idea that there should be two coroners, one legal and one medical, who would review every death. Not only is this completely impractical, it would have cost a fortune. My only disappointment when this idea was shelved was that I rather liked the idea of applying to be the medical coroner.
But will the figures for any health professional show that another mass murderer in the NHS?
I do not believe that there are lies, damned lies and statistics. Analysed carefully by a qualified statistician, they can be a useful basis for discussion if there are outliers.
There may be a valid reason. A doctor who specialized in end-of-life care will have more deaths. Also, a young practice will have more referrals to the ear, nose and throat department, or to the paediatricians. But there could be other outliers with other explanations.
Both the coroner in the Shipman case and the manager of the Letby case were not qualified doctors. The manager who sided with Letby, forcing the consultant paediatricians to apologise, was a qualified nurse who was “anti-doctor” according to a new manager who was brought in later.
The medical director was an orthopaedic surgeon not a paediatrician. He told the grievance panel that he wanted to protect Letby from these allegations. Senior doctors were even threatened with being reported to the General Medical Council for “misconduct”.
The doctors wanted the police involved but the Trust refused. The chief executive told Letby’s parents that the troublesome doctors would be “dealt with accordingly”.
I do not suggest that we go back to the “Doctor in the House” days of Sir Lancelot Spratt, the terrifying all-powerful consultant, even though they were still around in my hospital days.
However, in any organisation, if expert professionals flag up a concern, they need to be taken seriously, especially by managers who do not have the same qualifications and experience.
Surely it is time we learnt from these tragedies.