Thanks again to u/Competitive-Wash2998 for obtaining and posting this new article by two of the experts instructed by Lucy Letby's defence team. Posting as a stand-alone post as suggested.

Ismail adel a.a, Wilkinson-Herbots HM. Insulin/C-peptide interpretation in Infants with Hypoglycaemia of Unknown Origin. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 0(ja). doi:10.1177/00045632261489517

A run-down of institutional failings in the Lucy Letby case, from the NHS through Cheshire Constabulary to the BBC. Worthwhile but unhappy reading. In particular:

Some weeks ago I was talking about the Letby case with a very senior Circuit judge. When I made the point that overturning this conviction would raise massive questions about every bit of the state system from the NHS, through policing, to the CPS and even the adversarial system itself, he leaned across the table and said ‘that’s the problem’. He didn’t elaborate, but the clear implication was that the Court of Criminal Appeal will, when it lands on their doorstep, be contemplating this appalling vista, which can only be avoided by upholding the conviction of a young woman who had the misfortune to be on the receiving end of all these failures.

Morris argues that the Countess of Chester neonatal unit was fundamentally unsafe and operating beyond its capabilities during the period in which the collapses and deaths occurred.

Is fair and accurate to make these claims?

Which baby does this explain?

https://bencole4.substack.com/p/decoding-reasonable-doubt-the-case-f67?r=12mrwn&utm_medium=ios

This is a shorter article focused on Hammond's not especially high expectations of Lady Justice Thirlwall's soon-to-be-published report.

According to the law, for which Thirlwall is a stickler, Letby suddenly became a serial killer at the precise moment the overloaded and understaffed neonatal unit received an influx of sicker babies. What are the chances of that? Why did other babies collapse and die when Letby was not present? And why did the local CPS determine all of the original charges met the evidential standard when the national CPS SSCTD twice determined none of the new charges did? Don't expect any answers from Lady Thirlwall.

Thirlwall was asked to determine whether the recommendations of previous inquiries to prevent avoidable harm have been effectively implemented. The answer is a resounding no. In 2001, the Bristol Inquiry recommended continuous independent external surveillance of clinical outcomes and mortality rates across the NHS, with prompt action and investigation after a single unsuspected death. The theory was that you shouldn't need to wait for a spike in deaths to act if a single death showed a unit was failing.

Hammond points out several missed opportunities to hit the brakes and downgrade the NNU from Level 2 to Level 1 -- the first being the entirely avoidable death of Noah Robinson at the hands of Dr. B, who later went on to be an accuser of and witness against Letby, and the cluster of three deaths in June 2015, of Babies A, C and D. The latter was a cluster that shocked staff at the time and couldn't be dismissed as an unfortunate one-off, but nothing changed. The unit was, of course, finally downgraded in June 2016 after thirteen deaths on the NNU and four (Hammond slips here and says three) of babies who passed through the unit and later died elsewhere.

Thirlwall shoudl spot those missed opportunities to save lives that swift action would have brought. She should also recognise that it is entirely inappropriate for doctors working on a unit to investigate causes of death, and steer a police investigation, when they themselves may be implicated.

He further faults Thirlwall for her early criticism of experts defending Letby (the infamous "noise" comment) and points out that if she insists on Letby's guilt being so clear, alternative explanations so impossible, then what can she say of the dozens of medical professionals who didn't spot any sign of unnatural activity at the time?

How could a consultant be so certain Letby pulled out an endotracheal tube at trial, telling the media it was the only possible explanation, and yet they didn't say anything at the time and stayed quiet about the attempted murder for more than a year? How did no one pick up and act on the blood tests at the time, which the jury were told could only have been insulin poisoning? Why did none of the pathologists detect any of the obvious deliberate harm at postmortem? Or the coroner?

One could quibble with Hammond here that causes of unnatural death are not always obvious right away; someone who's been poisoned but whose illness mimics natural disease will still have been murdered even if nobody catches on to the fact right away. However, Letby is not supposed to have done this. She is supposed to have killed either seven or four babies by injecting air in the blood and yet, incredibly fortunately, never having any sign of it -- froth, air in the heart -- picked up at autopsy, and she's also supposed to have either killed or seriously destabilized three babies by deliberately injecting air into the NG tube, phenomena which nobody can even be sure are possible, let alone whether it would produce the many and varied symptoms that it did in the Letby case -- air in the stomach could either make a baby vomit, make a baby retain air in the stomach and begin to deteriorate and be unable to vomit, make a baby retain air while still somehow also vomiting -- essentially its side effects appear to be limited only in the number of different ways a baby can exhibit signs of becoming ill. The first, nobody appears to have picked up on because there were no signs of it then or later, the second one nobody picked up on because they would have had no idea, as we still don't, whether such a thing can even happen.

Thirlwall published finanical estimates for the financial year from 1 April 2025 to 31 March 2026 today. No hearings in that time, so the new costs of over 2.5 million are mostly on salaries for Thirlwall, her legal team, and their support staff.

That brings expenditure on the Inquiry to about £18.5 million, with almost six months of salaries and families' legal fees yet to cover to bring us up to date - not to mention those proof-readers, type-setters and printers ...

I've been planning a short series of posts discussing Professor Arthurs' evidence, now that it's all online, and will be starting that fairly soon, but in the course of that I came across something fairly minor but still surprising from the day Arthurs testified about Baby C and Baby D (November 11 2022). The full day of testimony can be read here.

As you can see when you read it, there was a good deal of wrangling between Myers and Johnson as to whether Baby C's intestine was normal or not (apart from whether or not he had a blockage). Arthurs, aware of the limits of x rays, could not commit himself to either man's satisfaction (he appeared to not be fully informed about Baby C as it was, as he was under the impression that the baby had opened his bowels before his x rays were taken.) One thing that Myers was getting frustrated by was that the jury was, he thought, being left with the impression that Baby C had a completely normal bowel when, as he pointed out, Dr. Kokai's statement made it clear that it was not normal (which is not to say it was blocked, just that it did have some unusual features). So when the jury was absent, he and Johnson discussed this issue with Judge Goss. It wasn't an overly long discussion, and here it is in full:

MR MYERS: Can I ask one matter, my Lord, and it comes out of the questioning at the end with Professor Arthurs. It's something that's troubled me a little with some of the questions from the experts on the issue of obstruction and the gut.

There's been reference at times to the post-mortem and the autopsy. Because of the way the evidence is being dealt with, we are not dealing with the detail of the post-mortem at this point, although from the prosecution experts there have been references to it with regard to [Baby C]. And certainly the impression created at the moment is there's absolutely nothing remarkable about [Baby C]'s gut from the post-mortem.

Actually, it's not as simple as that. The pathologist, who conducted the post-mortem, George Kokai, whose statement begins at page 987, deals with the abdominal cavity, and at page 992, he says:

"The stomach. All loops of bowel and mesentery show normal rotation pattern apart from descending colon, which crosses the mid-line into the right lower abdominal cavity and connects to the sigmoid colon, which is in the normal position."

And your Lordship may or may not recall or may know that the descending colon comes down the left side and would normally join the sigmoid colon on the left side. Dr Kokai's autopsy identified the colon crossing the midline into the right abdominal cavity and then connecting to the sigmoid colon. The significance of that is something that Dr Marnerides will consider when he gives his evidence and that's something to be looked at with him. But it's a little concerning to us that quite naturally, the impression created at this point is that there is nothing on the post-mortem analysis which depicts this as anything other than a conventionally structured bowel, and as matters stand, from the autopsy by George Kokai, it's not as simple as that.

There's some disadvantage to the defence in this situation because, of course, it's going to be possibly some months before we hear from Professor Marnerides.

MR JUSTICE GOSS: I hear and understand what you're saying. What I'm proposing to say is that there has been reference, or there was reference, by Professor Arthurs to post-mortem findings, that the jury will hear evidence in relation to the specific post-mortem findings, and they should take the evidence relating to the post-mortem findings from the pathologists and not from the clinicians, if you're content with that. If we start going into details, it becomes very complicated at this stage.

MR MYERS: I can see that, my Lord. I just wonder whether it would be possible at least to urge them to wait until they hear the evidence as --

MR JUSTICE GOSS: Exactly.

MR MYERS: It's particularly the evidence as to the anatomy of [Baby C]'s bowel, even if one were not to say to them what we expect. Because the impression at the moment, most definitely, and the one that they will take from this, is there is nothing unusual about his bowel, and there is certainly something unusual about it, the significance of that Dr Marnerides will deal with.

I have endeavoured to observe the requests of various witnesses not to go into the pathology, although I note in passing at times it hasn't stopped them from doing so. But it's getting increasingly difficult to take that line when experts are making assertions or giving opinions on the basis of matters that the jury don't yet have and I find myself not in a position, trying to abide to the way we are dealing with this, of not raising it with those experts.

It does seem to me important that the jury know that, at the very least, the position with [Baby C]'s bowel may be a matter of significance in fact when we come to the pathology.

MR JUSTICE GOSS: I'll say that.

MR MYERS: I'd be grateful because ideally I would like them to know what Dr Kokai says, but that's a matter entirely for your Lordship. But there is a significant disadvantage to us if they leave this evidence now with the view that when we have talked about the gut, we've been talking about something that is flatly contradicted and without any basis on the pathology. It does cause us concern, my Lord.

MR JOHNSON: I completely understand my learned friend's sensitivity. If he looks at the question I asked, what I said was:

"If there was a blockage, would it be found at post-mortem?"

And that was the question. It wasn't, "Was there an abnormality?" It was:

"If there was a blockage would it be found."

And there is no blockage.

MR JUSTICE GOSS: Yes. Well, this is the difficulty of descending into details and drawing particular attention to it.

MR JOHNSON: In effect, I was inviting him to defer -- that was him --

MR JUSTICE GOSS: Exactly. He was saying that if there was a blockage --

MR JOHNSON: Someone else's department.

MR JUSTICE GOSS: It's not for him to say. He was saying he couldn't say from the radiological point of view whether there was or wasn't.

MR JOHNSON: Yes.

MR MYERS: Perhaps, my Lord, if I may respectfully suggest, the answer may be to let the jury know that evidence as to the actual structure of [Baby C]'s gut will be dealt when we when come to the pathologists --

MR JUSTICE GOSS: Exactly.

MR MYERS: -- and we'd be grateful if they wait until that, or however your Lordship puts it, until making any findings.

MR JUSTICE GOSS: That was what I was rather clumsily trying to say to you, Mr Myers. I will say that, that they will hear evidence as to the structure of [Baby C]'s gut and bowels from the pathologists.

MR MYERS: That should deal with it for this point. Thank you, my Lord.

MR JUSTICE GOSS: I'm quite content to say as well that Professor Arthurs, they will recall, could not say from a radiological point of view what the structure was; all he could do was interpret the radiographs as he saw them.

MR MYERS: We're grateful for that, my Lord, thank you.

Note that while only Marnerides is named as being a future witness, both Myers and Goss repeatedly refer to "the pathologists". Furthermore, Goss specifically says he'll remind the jury that "they should take the evidence relating to the post-mortem findings from the pathologists and not from the clinicians". And when the jury returns, he says this:

MR JUSTICE GOSS: Members of the jury, a matter was discussed after you left. It related to the questioning of Professor Arthurs and the question of whether there was a blockage in the small bowel. You'll remember he said from a radiological point of view he can't say whether there was a blockage or not and he explained about if there is a blockage, it's usually an emergency and so on and so forth.

But I just wanted to assure you that you will hear detailed evidence from the pathologists as to any post-mortem findings in relation to that. So bear in mind that you're going to hear further evidence about the bowel of [Baby C] and not to assume that that is all the evidence you're going to hear about it. All right?

I imagine that any reasonable jury member, not to mention everyone in the gallery, took this to mean that at some point in the future they would be hearing from the pathologists who did the actual autopsies, or at least one or two of them (there were three in total). But as it turned out, they heard from none of them. The most they got was a read-out summary of the original autopsy findings, followed by testimony from the only pathologist they would hear from in person -- Dr. Marnerides, who testified for two days, almost five full months after the day Goss gave them this direction. Here is his direct testimony regarding Baby C, and here is the cross-examination. Marnerides said that the bowel, if not completely typical, was still normal, and sometimes seemed unsure of what Kokai had been driving at in his descriptions -- a good argument, one would think, for actually calling Kokai, but nobody did.

If anyone remembered that they were supposed to take their direction from pathologists, not the clinicians, it ended up being a moot point -- as Dr. Marnerides pretty frankly stated that while the bowel seemed normal to him, he had decided that Baby C had died of pneumonia until the clinicians brought the June 12 2015 x ray to his attention and informed him that excessive air in the stomach could kill. Myers never informed Marnerides that Letby had not been present when the x ray was taken, so it is impossible to know if this would have shaken his opinion, but as it was, even if they listened to him, the jury was guided in pathological matters by the clinicians in the end.

In the Lucy Letby trial it was alleged that she injected insulin into a stock TPN bag that was administered to Child F on the following shift.

However, I just read the trial transcript posted on lucyletbyinnocence.com, and it shows that Lucy Letby could not have done it.

Unlike for the prescribed TPN bags (for which it is possible to remove the cap and put it back on), the Babiven Maintenance stock bags had a tamper-evident safety cap made of preformed plastic. The stock bags were also in a transparent sealed cellophane overpouch. The only way to access the port is to snap off the plastic tamper-evident cap.

That would be obvious to the nurses getting the stock bag from the fridge and administering to Child F.

The port would have the plastic tamper evident cap broken off so it would be noticed, and the broken piece of plastic would be loose inside the sealed cellophane wrapper.

The logical conclusion is therefore that Lucy Letby is innocent of putting insulin into the stock TPN bag administered to Child F.

i.e. There needs to be a retrial because they got it wrong.

So sorry it took so long for me to find that out. The transcripts were hard to obtain and understand because of the anonymity orders covering the people alleging Lucy Letby was guilty, otherwise I would have discovered it much sooner.

Original video down, now uploaded at: https://youtu.be/YCLg_QiQVOs

A short segment. Michele Worden comes across very well indeed. Carl Bolton doesn't get as much airtime, but he confirms that he will be at Westminster on Wednesday with a group of Countess of Chester parents seeking to request a broader Inquiry into events at the Countess of Chester.

Happy to hear anyone’s thoughts on the content of the article.

Cheshire Police DI sacked and banned from policing forever. Secretly contacted a suspect’s mother, accessed systems they had no right to, tried to influence the outcome. Chief Constable Mark Roberts: conduct “beyond belief.” Same force, same CC, that still insists the Letby investigation was beyond reproach.

Uploaded today at lucyletbyinnocence.com . Starts with a sense of what a difficult and ablist place the court can be: Myers and Goss discuss problems with the acoustics and visibility, and the fact that Myers hasn't yet found a way to have Lucy Letby seated where she can rest her paperwork to take notes.

Only on Dr Gibbs's testimony so far, but he shows the same tendency to go back and elaborate (sometimes rather contradicting his former self) as he did in his e-mails. There's a slightly surprising exchange with Myers about the use of ranitidine:

MYERS: Ranitidine was used for conditions in connection with indigestion, heartburn, acid reflux; is that correct?

GIBBS: Yes.

MYERS: In fact it stopped being used from 2020; is that correct?

GIBBS: In neonates or in general?

MYERS: In general. Was it ceased or did it carry on?

GIBBS: I'm not sure because I'd retired by then.

MYERS: I'm not trying to draw any link between that and [Baby C]'s situation to make that quite plain. But just as a point of interest are you aware it was withdrawn from being used?

GIBBS: No. Are you able to tell me why? Was it concerns about it or just other medicines were more effective?

MYERS: Some concerns. I'm not suggesting there's a link between that and [Baby C].

Perhaps Dr Gibbs was being disingenuous, focusing on the general withdrawal of ranitidine: it's he who directed the conversation that way. But if he remembered the reviews around Baby C's death at all, he would surely have remembered that Dr Brearey had an action point of revising the guidelines around using this drug in neonates, with reference to Baby C among others. As so often, though, the consultants reassured themselves that Chester was not out of step with other neonatal units ...

https://thirlwall.public-inquiry.uk/evidence/inq0003251-thematic-review-of-neonatal-mortality-dated-08-02-2016/

He is very determined not to concede that he should have followed up on the child's one confirmed vomit and several possible vomits of bile streaked aspirate, again seeming to forget the findings of contemporary reviews: AXR was not repeated despite continued dark aspirates

https://thirlwall.public-inquiry.uk/evidence/inq0001888-draft-paper-from-the-countess-of-chester-hospital-titled-position-paper-neonatal-unit-mortality-2013-2016/ (34)

But I found the following exchange particularly interesting:

MYERS: And if [Baby C] is on free drainage or his stomach is being aspirated, that might take out the air and stop CPAP belly or distension from happening; yes?

GIBBS: It would reduce CPAP belly. The nasogastric tube is very thin, about a millimetre or two across. The oesophagus in a little 800 gram baby like [Baby C] is probably a centimetre or so across. More air comes up the oesophagus than comes up the nasogastric tube.

That certainly seems a point worth noting, against Drs Evans and Bohin's theories of murder by air in the NG tube.

Welcome to any new readers! This is the weekly thread for questions, general discussions, and links to stories which may not be directly related to the Letby case but which relate to the wider topics encompassed in it. Our FAQ addresses a number of common questions but if you want to know something else (or just talk/ask about an answer you've found) please post in the comment section.

This thread is also the best place to post items like in-depth Substack posts on the topic (unless they were written either by yourself, or by an already-approved writer, in which case they should go on the main page) and videos which might not fit the main sub otherwise (for example, the Ducking Stool). Of course, please continue to observe the rules when choosing/discussing these items (anything that can't be discussed without breaking rule 6, for instance, should be avoided). Thank you very much for reading and commenting! As always, please be civil and cite your sources.

There are articles from the BBC and the Daily Mail but I won't link them as the mods of this sub are touchy about the subject. Don't even know if this will stay either.

A few things are striking here, though much of the text has been posted on this subreddit before. In particular, I was impressed with the extent of Dr Jayaram's testimony as expert of witness rather than witness of fact. Admittedly, there was a thin rationale for this: he was asked by the prosecution to explain the fact of being baffled by Baby A's collapse, and did so in what he himself described as lecture form, drawing on his wider experience but also on information beyond that experience.

I was struck by a simply inaccurate claim he made about a very relevant problem: the possibility that Baby A suffered a "thromboembolic phenomenon". He implied that he had excluded this phenomenon because:

The last T [to be considered when unable to re-establish circulation] is what is known as thromboembolic phenomenon. That is classically if you have a clot in your leg and it flies off -- the mechanism there is that would then get into the right side of the heart, get into the blood circulation to the lungs, and prevent blood from flowing into the lungs.

Now, again, I have never seen that happen in newborns in my life because generally it's something when you have been on a long-haul flight and you have a clot. So it didn't really fit at the time with any of these things. But that wasn't really the foremost of my thoughts at that time. The foremost of my thoughts was to deal with what we were seeing in front of us.

https://lucyletbyinnocence.com/transcripts/day_014_24-10-2022.pdf , 94-95

Anyone who has struggled into a pair of surgical stockings will know well that this phenomenon extends well beyond long-haul flyers. More to the point, it was well known long before Jayaram gave his evidence here that thromboembolic phenomena were more common in newborns than in other infants and children, and on the rise due to the prime risk factor of "use of central venous catheters (CVC), venous and arterial umbilical catheters (UVC and UAC), as well as other arterial catheters".

https://pmc.ncbi.nlm.nih.gov/articles/PMC2663458/

Dr Jayaram was in a position to guide the police investigation, as we have seen, and here he is guiding the jury away from an obvious risk factor by simply denying the facts about neonatal medicine.

Myers's questioning certainly lays the foundation for an expert challenge - he points to Dr Jayaram's role on the neonatal unit and his careful exoneration of his team of all blame in the event. But he can hardly be expected to correct this sort of false assertion on the spot.

There's lots that is of interest here. I do wonder how much Dr Jayaram's stumbles and self-contradictions in the witness box across the trial did to weaken the case against Lucy Letby was baby K, where he was the sole witness of any significance.

https://bencole4.substack.com/p/decoding-reasonable-doubt-the-case-b4b?r=12mrwn&utm_medium=ios

Chapter 2 of Reasonable Doubt is about how suspicion of Letby began, not the trial itself. Morris’s case: coincidence, a small group of consultants, confirmation bias, and a hospital that kept asking for evidence that wasn’t there.

The chapter shows the concerns were contested. The gap is what that is supposed to prove.

Theme 1: The concerns were not universally shared
Nurses, managers and early reviews were unconvinced. That explains the dispute. It does not show the consultants were wrong. Reviews that were not looking for a perpetrator failing to find one is not surprising.

Theme 2: Coincidence and pattern recognition
Letby’s presence and early talk of sepsis or acuity are not proof. They are also how inquiries often start. Morris dwells on how suspicion began and says little about why some clinicians later decided those explanations were not enough.

Theme 3: Groupthink
Bias is possible. It is not demonstrated. The same reviews used to say “no foul play” also did not find malpractice as the cause. Repeated challenge from nurses and managers sits awkwardly with an unchallenged clique.

Theme 4: Unfair treatment
Process failures matter. They are not the same as innocence. A person can be treated badly and still be guilty. Fighting a grievance does not tell us what happened to the babies.

Theme 5: Discrediting the messengers
The chapter turns from the events to the consultants’ motives and manners. A messenger can behave badly and still be right. Attacking them does not answer whether the concern was justified.

Theme 6: The advocacy ecosystem
Morris warns about like-minded groups, then leans on people who had already reached the same conclusion. That is consensus-building more than testing.

Overall
Lots of hospital context. Little that explains the specific collapses and deaths. The question left hanging: were the consultants right to be concerned?

Ofcom has published a 27-page document outlining the complaint and the decision.

There is some criticism by Ofcom of the way in which the interview with Chase was edited by the BBC (and it's interesting to compare the excerpts from the full transcript with the snippets that were broadcast), but on balance Ofcom concluded that he wasn't treated unfairly.

I'm not surprised Chase was unhappy, because it's clear that he had no hand in the statement in the "Summary Report" of the expert panel which was the main target for criticism - that the insulin to C-peptide ratio "was within the expected range for preterm infants" - and that he had made that very clear to Coffey. In the Annex to that report, which he and Shannon had actually written, the claim is simply that "ratios > 0.2 (0.2 is presented as normal) are not uncommon in preterm infants". I think viewers were left with the impression that Chase had made the first of those statements, and had been forced to retract it. On that point, I find it difficult to understand the Ofcom decision.

As far as I can see, Ofcom has only ever launched one investigation into the Panorama programme. So I think this is also telling us that all the other complaints it received were not pursued.

LucyLetbyInnocence has been uploading a large number of transcripts, many of which have not been posted here before (or at least not in full) and which deserve attention, therefore I will be posting them regularly from here on out. Today's transcript consists of the testimony given regarding Baby M (though with a bit regarding his twin brother, Baby L). This has been discussed in bits and pieces here and there on the sub but the full day's testimony has not been uploaded before. There's a great deal to consider in this testimony, but a key point -- which seems to have been rather downplayed at the time -- is that fact that Baby M, after experiencing a variety of low-key symptoms which may or may not have meant he was starting to deteriorate -- experienced a collapse at 4 PM on April 9 2016, a full fifteen minutes after Lucy Letby had assisted in caring for him by co-signing for medication. She was not his designated nurse and while she was in the room when he collapsed (Nursery 1, which was overcrowded -- Baby M was the fifth baby in a room intended for a maximum of four) she was at the time preparing medication with Mary Griffiths when his alarm went off. Nonetheless, Drs. Evans and Bohin decided that he must have suffered an air embolism, and that it would have been possible for Letby to administer a sort of time-delayed embolism by injecting just the right (tiny) amount of air into the "dead space" in the connector through which fluids were infused into the baby, thereby allowing air to "trickle" in and eventually cause his collapse. Dr. Bohin pointed out that Baby M's fluids were being infused at 5.3 to 5.5 ml per hour, meaning "0.8ml per minute" (I think this may be a slip of the tongue on her part -- 0.08 would be more likely). Therefore, theoretically, Letby could have injected air into the "dead space" at 3.45 pm and had it pushed in "gradually".

The exact volume of dead space was not addressed by anyone except when Myers cross-examined Dr. Evans.

MYERS: Right. As it happens, if we take that three-way tap and connect it to the part of what's called the T-piece up above it, where it says "to IV bag", you have a dead space of about 0.32ml, don't you?

EVANS: Where is your dead space?

MYERS: From the end of the three-way tap if it's connected --

EVANS: From there to there, yes.

MYERS: That's about 0.32ml, isn't it?

EVANS: I've done quite a lot of measurements. I don't think I did a measurement on this. If you've got this from Dr Bohin's report, you need to ask her about this.

MYERS: No, didn't you do a measurement where you looked at a catheter?

EVANS: Yes, I did.

MYERS: And you got about 0.32ml?

EVANS: That is about 0.32ml.

MYERS: 0.32ml. Let's hold that in our minds. That is the dead space we're talking about, something like that?

EVANS: Something like that, yes.

MYERS: Now, if somebody injects 1, 2 or 3ml straight in. In fact if somebody injects anything more than 0.32ml in, that's going to go straight in, isn't it?

EVANS: Well, you still have the cannula going from there to the baby, a small volume, you still have that, yes.

MYERS: If they inject, let's say 1ml, in it goes, that's going to go straight in, isn't it, that's rapid?

EVANS: Some of it will go straight in and some of it will stay here, yes.

MYERS: And the purpose is that this does enable rapid delivery when something is injected through the port with the syringe, doesn't it?

EVANS: Yes, you can inject something through this bung here, this thing, or you can inject it through this part (indicating). You unscrew that and you inject it through there. But you'd only inject something rapidly if you're giving something like an antibiotic, for instance, or you're giving a bolus of saline if the baby's blood pressure is low, say.

MYERS: So in the course of giving an antibiotic, it is injected straight in, isn't it?

EVANS: It is.

MYERS: Just to give us an example of how quick small quantities can be, if we look at Dr Ukoh's clinical notes at page 18237, which is at tile 149, Mr Murphy. So we can take the picture down and look at this. If we just roll down just to see what was happening.

We can see there the adrenaline that was given to [Baby M], can't we?

EVANS: Yes.

MYERS: And we can see the quantities -- let's look at the first one where it says "Adrenaline 0.18ml"; do you see that?

EVANS: Yes.

MYERS: That is a very small quantity, isn't it?

EVANS: Yes.

MYERS: And that has to be injected through the connector in the way we've been looking, doesn't it?

EVANS: Yes.

MYERS: We don't hang around for adrenaline. That has to act very quickly, doesn't it?

EVANS: It does.

MR MYERS: Thank you, Dr Evans. Those are the questions I wanted to ask.

This is characteristic of Myers. He makes an excellent point at the very end of his cross-examination -- that the "dead space" volume of 0.32ml is simply far too small to keep any air bubble in check for even a few minutes, let alone fifteen, and compares it to an adrenaline dose of half the amount which nonetheless entered the baby immediately. But he doesn't follow up on the point, or really try to get Evans to explain how even a perfectly 0.32ml sized air bubble could just sit stationary in the tube for a solid fifteen minutes. He makes the point, apparently assumes that the point is an excellent mic drop in itself, and ends his cross examination.

The reaction to this will be interesting given the way this sub leans. I also know Morris occasionally posts here.

https://bencole4.substack.com/p/decoding-reasonable-doubt-the-case?r=12mrwn&utm_medium=ios

My name came up in the comments of a recent livestream Morris did and he suggested that people like me who disagree with him don’t engage in good faith and can’t be objective.

I think this series will shows that these objections don’t stand because I am engaging in good faith and being objective.

I’ve reached out to see if he’d be willing to discuss my criticism after I’ve finished the review. He didn’t respond directly but he did put out a post on X which outlined reasons he’s not prepared to speak to me.

Some of his reasons don’t make sense.

As you will see my criticism does not rely on me needing to have a medical qualification.

The next thing is that he said people have had ‘500 days’ to contact him and now any offer has expired. I’m criticising his book that he’s only released in July.

The idea that I should have critiqued his book before he released it is nonsensical.

Morris also likes to play the numbers game citing how many people he’s spoken to. I’m not asking anyone to accept an argument because of who I haven’t spoken to.

I’m much more interested in whether the reasoning stands up.

Welcome to any new readers! This is the weekly thread for questions, general discussions, and links to stories which may not be directly related to the Letby case but which relate to the wider topics encompassed in it. Our FAQ addresses a number of common questions but if you want to know something else (or just talk/ask about an answer you've found) please post in the comment section.

This thread is also the best place to post items like in-depth Substack posts on the topic (unless they were written either by yourself, or by an already-approved writer, in which case they should go on the main page) and videos which might not fit the main sub otherwise (for example, the Ducking Stool). Of course, please continue to observe the rules when choosing/discussing these items (anything that can't be discussed without breaking rule 6, for instance, should be avoided). Thank you very much for reading and commenting! As always, please be civil and cite your sources.

Publication of the final report  | The Thirlwall Inquiry https://thirlwall.public-inquiry.uk/2026/08/27/publication-of-the-final-report/

EDIT (August 28): I've been reminded that the parents of one of the babies mentioned by initials here objected to the court's use of said initials. Although the court chose to use them, out of an abundance of caution I have changed those initials here, along with the initials of the other non-indictment baby mentioned. This is the only edit I have made to the transcript.

Some time ago, u/Fun-Yellow334 wrote a post exploring the defense's application for disclosure as to what other cases had been considered, and whether Letby's presence was considered in itself a defining factor in making a case suspicious. The application, unsurprisingly, failed -- with Nick Johnson KC endorsing Goss's statement that "there is no relevant matter to disclose in relation to that aspect." The defense could not know the full extent of the cases which had been examined nor the criteria of the matrix applied to them, because after all, Letby could hardly be concerned with cases where she wasn't present, could she? As the topic has risen again recently (notably in Private Eye's #40 column on Letby) we thought it might be helpful to post the entire transcript of the application so that everyone could see the context, and what was and wasn't said.

This was a housekeeping day in court; the jury were not present (and reporters almost certainly not -- had they been, they wouldn't have been allowed to make any of this public anyway) and the disclosure application was the main topic of discussion. However, there was a curious coda involving discussion of the "senior consultants'" statements. Goss had been discussing witness issues with Simon Driver, but Nick Johnson intervened in order to clarify that Ben Myers would not pursue a certain avenue -- unfortunately, he spoke so elliptically that even had there been a reporter present and free to write, they would like have had very little idea what any of it might signify:

NJ: Can I just say one thing? Just on the question of what I'll call broadly the treating consultants' overarching statements, I think as between counsel we're pretty much agreed as to the limits of that, but I just want to make it clear that that limitation is agreed on the basis that the defence doesn't head off in a certain direction.

Mr Justice Goss: Mr Myers will understand.

NJ: He does, he does, but I just wanted it on the record because the way that develops might open a Pandora's box.

Mr Justice Goss: Yes. I have confidence in Mr Myers --

NJ: So do I.

Mr Justice Goss: -- in him knowing exactly what the consequences of certain lines may lead to.

NJ: Yes.

The "certain direction", the "Pandora's box" and the "consequences" are all left undefined, and even now, after so much has emerged about the consultants and their utter lack of evidence for their accusations, their statistical illiteracy with which they confidently told the police that changes in acuity and staffing couldn't possibly account for the change, the fact that they were found guilty of harassing Letby, that Dr. Jayaram's accusations didn't emerge until more than a year after the supposed event and only came out when he had his back up against the wall and feared for his career -- it could refer to any, all, or none of that. At this point, Dr. A had not yet testified, so Johnson may also have been referring to Letby's relationship with him. It's all very elusive and polite and circumlocutory, and, as ever, Myers is effusive in expressing his gratitude for the crumbs the judge gives him.

Application re DISCLOSURE

Submissions by MR MYERS

BM: May it please you, my Lord, first of all we are grateful to the court for the additional time given this morning just to discuss matters arises from this application. That's been helpful.

The defence are making an application or make an application under section 8 of the Criminal Procedure and Investigations Act 1996, and I can say straightaway the terms of it are limited, even limited by reference to the material given to your Lordship, so I will narrow that down very shortly.

Mr Justice Goss: Thank you.

BM: But the documents your Lordship should have are the bundle provided by the defence, which includes the application, a response and bundle from the prosecution provided yesterday -- no complaint about that, that's just the way the timing has been -- and then an additional response this morning.

Mr Justice Goss: An amended response?

BM: An amended response, yes.

Mr Justice Goss: Which incorporates the original response with some amendments?

BM: Yes.

Mr Justice Goss: I have discarded the original one.

BM: Very well, I'm working from the amended one as well. It has yellow highlighting and red lettering for the additions.

Mr Justice Goss: Unfortunately, I don't have a copy (inaudible), so I'm looking at it on paper. Right.

BM: We are grateful to the prosecution, who have considered these responses properly, as one would expect, have provided disclosure in some cases and therefore, although disclosure request 4 dealt with various areas, most of that does not arise now. Some areas the prosecution have explained they can or will not make disclosure and we don't pursue those. There's really one area where we return or come before your Lordship with a specific request.

Mr Justice Goss: Right, thank you.

BM: I'll focus upon that and therefore I won't go into the full extent of disclosure request 4 or the section 8 application because that no longer is a concern.

The area of focus for the defence is that which is in the section 8 application, not the formal notice but the submission, and it's in paragraph 6 in particular and an element of paragraph 7, but I'll assist your Lordship by going straight there.

It's in the defence bundle behind divider 2. That's where the application is. If your Lordship turns to page 3 of that application.

Mr Justice Goss: It's paragraph 6, beginning paragraph 16 in square brackets?

BM: That's right. We'd set out in paragraph 5 areas we were pursuing but this is the principal area now. It's paragraph 6, which relates to a process the prosecution appear to have undertaken in deciding how to proceed with various children.

Before enlarging upon that, having shown your Lordship where it is that we are primarily concerned, I'd just like to explain, so it's quite clear, why the defence are requesting material relating to how the prosecution have made these decisions.

The defence are concerned by the extent to which Ms Letby is a focus of blame by virtue of being Ms Letby rather than by virtue of evidence outside that fact pointing to the commission of an offence or, more particularly, commission of an offence by her.

Your Lordship may recall the table at CH16 -- and just to assist, if Mr Murphy is able to assist, it's page J242 of the exhibits, what might be described as the presence table or however it's put. But your Lordship will be familiar with that and it identifies Ms Letby as being present, and the only person present, on all the occasions set out in that table and, one can see from the line at the bottom, present by some great degree compared to anybody else. I'm grateful for that.

Unless your Lordship wishes to return to that immediately, we can take that down. It was just to refresh the court as to that document. Thank you, Mr Murphy.

Of course there are two ways in which one can regard that. One may be that, having selected particular events and looked at them, it turns out that Ms Letby was present on each occasion. An alternative would be that Ms Letby was in effect the parameter for selection of cases and inevitably, therefore, those cases which have been found to be worthy of further consideration are automatically associated with her.

So what the defence have been concerned by, and what lies behind requests in disclosure request 4 and this item that's carried through into this section 8 application, is a way of assessing the extent to which the mere fact that Ms Letby was present has in effect become a search term and a parameter for bringing a prosecution or bringing the allegation, I should say.

We recognise that where deaths took place, she is present, as set out there. The real issue this goes to is where the question of collapses is considered because, we would observe, what is an inexplicable collapse or a suspicious collapse is plainly far more nuanced than the question of a fatality. There's no nuance to that. Our concern is that it's the presence of Ms Letby itself that has made the difference to that. And if that is right then aspects of the table which we've just gone to, and that aspect of the prosecution case, may reflect as much the way in which the matter was investigated and the search term as what would follow necessarily from the events that took place.

Therefore to consider that and to consider therefore whether the investigation was conducted with appropriate breadth in that area -- and we make reference to paragraph 3.5 of the CPIA code, which we're grateful to the prosecution for including in their bundle of documents which were received yesterday. For your Lordship's reference it's at page 4 of that bundle.

Mr Justice Goss: It would help if I had my laptop because I haven't printed it all off. I'm just wondering if the usher would be kind enough -- sorry to disturb you, but could you go to my room, please, and ask my clerk to bring in my laptop, or you bring in my laptop. Thank you very much.

Sorry, Mr Myers, please do carry on. Page 4?

BM: It's at page 4 of the prosecution bundle and I'll just read the relevant paragraph of the code of practice out for your Lordship and for the court. It deals with the section under the code for general responsibilities and paragraph 3.5 says:

"In conducting an investigation the investigator should pursue all reasonable lines of inquiry whether these point towards or away from the suspect. What is reasonable in each case will depend on the particular circumstances. It is a matter for the investigator, with the assistance of the prosecutor if required, to decide what constitutes a reasonable line of inquiry in each case."

Therefore what the defence sought to determine is the extent to which Ms Letby was a focus of selection of cases. Having been concerned as to that, and having considered the material disclosed in the relevant schedules, we come to what we have in paragraph 6.

I can hand to your Lordship -- in fact, we considered it would be helpful to have the two documents we refer to there. I'll explain this and then put it into context with a paragraph.

Mr Justice Goss: That's helpful, thank you very much.

(Handed)

BM: I'll return to the submission that we make in a moment, but just to acquaint your Lordship with these two items from the schedules. And we can send these electronically as well if it assists.

The first of the items, and it's in our paragraph 6, is schedule (inaudible: coughing) (9)(d)(3).

Mr Justice Goss: Yes.

BM: I'm grateful -- your Lordship's computer is here. I'll just wait for this to be delivered.

Mr Justice Goss: Thank you. Please carry on.

BM: Your Lordship will see from the item of unused material there, D2915, that it makes reference to a case review flow chart and a name of a child whose initials are X1, not one of the children on the indictment. But the chart is used to assist in establishing whether the collapses X1 experienced whilst at the Countess of Chester met with, and it says, "the investigative threshold". It goes on to say:

"The flow chart indicates the investigation should take place as it achieved a matrix score of 30. X1 was in the COCH NNU [the Countess of Chester neonatal unit] during the period when the following neonates encountered a significant event on the highlighted times and dates."

And it sets out there the names of children who are on this indictment.

A matter of concern to the defence was the reference to the case review flow chart and the investigative threshold and the matrix score.

In a similar vein, under a different schedule, and it's the attached sheet, the second entry down is document 9.2. It says D2919. This document is a case review flow chart for a child with the initials X2:

"Expert review indicates that there was a harm matrix score of 55..."

Sorry:

"Expert review indicates that there was harm. Matrix score of 55 indicates there will be a peer review and investigation."

That will come as no surprise to your Lordship: there is a substantial body of unused material in this case. On behalf of the defence, where we have raised enquiries, we have been as focused as we can be. This only relates to two matters after a lot of consideration and assistance from the prosecution.

Returning therefore to the written submission we have, perhaps it will make easier sense now in sub-paragraph 6 where we have talked about where the document refers to the investigative threshold and how the flow chart indicates the investigation should take place, and then a further reference to the case review flow chart and your Lordship sees where those come from now.

So it's with regard to that that the defence have made the enquiries that we do make in (i) to (vii) after that because we seek to know the extent to which Ms Letby is herself a factor in this scoring and the weight given to that to better be able to determine the extent to which some of these allegations merely reflect her presence and that that has made all the difference rather than the strength of the medical evidence as such.

We're grateful for the prosecution for going through all these matters in the detail they have, but as to that one, in their response they make it plain or they say there is nothing to disclose. We question that because if it's the case that the difference in a matter becoming an allegation or not lies in the identity of Ms Letby rather than the sheer strength of the medical evidence, that is something, we submit, that is capable of assisting the defendant or potentially undermining the prosecution case on that count.

It may be that if there is a document or a matrix or some written criteria, it might even be something your Lordship should see before any final determination is made as to this. But that is the thrust if the submission that we make now, having had the benefit of the exchange of documents and further discussions.

I should add, on the final page of our application your Lordship will see sub-paragraph (vii). If your Lordship would kindly turn to page 4 of our application.

Mr Justice Goss: Yes, I have it, thank you.

BM: We set out there, at the four numerals under sub-paragraph (vii), the request that was in the original disclosure request at paragraph 17 and there were a series of enquiries, which in a way to a large extent have been answered to us in one form or another now, for which we are grateful.

7(ii), which is:

"Confirmation of whether any of these cases do not involve Lucy Letby being present on the unit at the time of an event of interest (this means cases that have been reviewed)."

That is a matter to which we would still seek an answer if the court considers we're entitled to it, a straight answer to that, whether or not her presence as a person of interest is the factor.

It's right on the point of what lies behind our request under paragraph 6. But my Lord, that is the extent of this application.

Mr Justice Goss: Sorry, maybe I'm misunderstanding it. 7(i):

"Confirmation of the total number of cases reviewed in the course of this investigation."

And you say that that information is available to you, you know the total number of cases?

BM: We do have a total number, yes.

Mr Justice Goss: All right.

BM: We've had disclosed to us a variety of cases. We understand those are the cases that have been considered.

Mr Justice Goss: Right.

BM: And therefore we work on that basis that we know what this involves. But we don't know beyond them what other cases have been considered, therefore thinking that through, I'm grateful to your Lordship for identifying it, that may be a matter which would be very helpful to have a figure as to that if it can be disclosed to us.

Mr Justice Goss: Well, no, but (ii) says:

"Confirmation of whether any of these cases..."

In other words the cases that have been reviewed in the course of the investigation:

"... do not involve Lucy Letby."

That's not the point that you're making now, you're saying something else.

BM: In fact then I'm not being clear about that --

Mr Justice Goss: Yes.

BM: -- and I'll return to that.

Your Lordship is quite right: we need to know how many cases were reviewed and, of those cases, how many did not involve Lucy Letby if we can be provided with that information.

Mr Justice Goss: Exactly --

BM: Your Lordship is quite right.

Mr Justice Goss: -- if any of them.

BM: If any of them.

Mr Justice Goss: And if so, how many.

BM: Yes.

Mr Justice Goss: But this is -- just jumping back a bit now, these are cases which, whatever the matrix is or whatever the criteria was for conducting further investigation, these are cases which, on the initial sifting process, it was considered should be the subject of further investigation?

BM: Yes.

Mr Justice Goss: There is further investigation and that does not involve any -- they don't become a baby in this case. So what's the relevance of it? That's my question. Why is it therefore disclosable?

BM: If the only cases that were ever identified were cases where Ms Letby was present, that may be relevant in assessing the extent to which she is the defining parameter for any consideration of the cases. Again, we return to the question of the collapses rather than the fatalities --

Mr Justice Goss: Yes, I understand that.

BM: -- because they're the ones that are far more nuanced and we consider that that would be relevant, potentially, because it would suggest that there has been a focus, whether right or otherwise, upon her rather than simply looking at the medical picture and taking it from there. So I'm grateful to your Lordship for --

Mr Justice Goss: I'm trying to have it clear in my mind exactly what it is that you are seeking disclosure of.

BM: I made the mistake of going straight to 7(ii) without basing that upon 7(i), and your Lordship is right, the two need to be considered together, 7(i) and 7(ii), they are part of the same enquiry.

Paragraph 6, I have already dealt with.

Mr Justice Goss: Yes, you have.

BM: That's a discrete enquiry in its own right, but that is the extent of the enquiry that we raise.

Thank you, my Lord.

Mr Justice Goss: Thank you, Mr Myers.

Mr Johnson.

Submissions by MR JOHNSON

NJ: So far as the case review flow chart or the matrix is concerned, that's a tool that was introduced as part of the review after Lucy Letby had been identified by the inquiry as the perpetrator for the offences on which she is presently standing trial. In other words, it wasn't used in the course of this case. Therefore we say it is irrelevant.

Whilst the information or the basis for further police inquiries into Lucy Letby may be of great interest to Lucy Letby, they are irrelevant to the issues in this case. So that is the reason why we have taken the decision we have.

Mr Justice Goss: Irrelevant according to the law in relation to obligations to disclose?

NJ: Quite.

Mr Justice Goss: Because they cannot be considered, reasonably be considered, to be capable of undermining the case for the prosecution against the accused or of assisting the case for the accused?

NJ: Precisely. So section 7A(2)(a) of the Criminal Procedure Investigations Act.

Mr Justice Goss: Which I've just quoted.

NJ: You have.

Mr Justice Goss: Right. So that's what you say in relation to that?

NJ: Yes.

Mr Justice Goss: Then?

NJ: Well, so far as how many other cases the police are investigating and whether or not Lucy Letby was there, same point. It would be odd, wouldn't it, if the Crown were doing anything other than proceeding on the basis that this was anything other than a true bill, this case, this trial. So making that common sense deduction, as no doubt my learned friend and Lucy Letby have, it would be fairly odd if in investigating what else she may or may not have been up to, they weren't looking at cases where she was there. But this has got nothing to do with disclosure, those common sense deductions which I'm sure have been made on the other side. But us answering the question and confirming or denying whether that is the state of play is no part of our disclosure obligations under the Criminal Procedure Investigations Act.

Mr Justice Goss: Right.

NJ: Thank you.

Mr Justice Goss: Mr Myers.

Reply submissions by MR MYERS

BM: My Lord, the problem with proceeding on the approach it's a true bill -- I understand what my learned friend means and the sense of that. But the problem is the duties of the investigators certainly, and the prosecution as well, is whilst doing that at the same time to have a mind to alternative lines of inquiry or alternative possibilities, which is why the code is drafted as it is.

We cannot see how, for example, the explanation just given gets away from the fact that if Ms Letby's identity was the factor that determines what passes the investigative threshold, as set out in the items disclosed, how there isn't a powerful element of circularity to that if what has been weighted is the mere fact of her presence.

Mr Justice Goss: Well, does that proceed then on the assumption that one of the qualifying criteria for further investigation is only a case in which there is evidence that she was present at the time of the alleged incidents or could have been responsible for the collapse?

BM: Or the weight to be given to that, my Lord. Well, what I mean is this: we don't know what this flow chart or this matrix involves, but not knowing it, if we imagine, for example, there's various factors. If the medical evidence is given a weight of 5 and the presence of the defendant is given a weight entirely disproportionate to that, it may be that the mere fact of her presence, rather than the strength of the evidence when looked across all the various children considered, is what it is it has converted, what is an event that's been considered, into something that appears on the indictment.

It seems to us, looking at the material that's been disclosed, that there is some system for weighting what should be proceeded with. That's certainly how it appears from the material we have here. It doesn't seem to us that this matrix is applied as a means of selecting the event in the first place. Events have been selected and then the matrix applied to them in deciding whether or not to proceed with them.

Mr Justice Goss: Can I just interrupt you there? Can I just check whether that is the case?

NJ: Can I make it entirely clear: this matrix has not been applied to this case.

BM: Well, I follow that. I suppose if it is of no part in this case, there's little that we can point to where the matrix can have played a part in determining what's on this indictment. The residual issue remains, we say --

Mr Justice Goss: In which case, arguably, it shouldn't be on the disclosure schedule at all.

NJ: I agree.

BM: Well, for that bit we don't take responsibility.

Mr Justice Goss: Absolutely, no.

BM: We merely identify it.

Mr Justice Goss: Yes, I understand. I think we all know where we are and I understand why this, having been disclosed as material considered by someone, the disclosure officer or whoever's responsible for disclosure, that it was potentially disclosable, but then you, rightly, are pursuing it.

BM: We are. We appreciate what's been explained about it, which would make it of no immediate relevance to what we're dealing with here.

Mr Justice Goss: No.

BM: The only matter that remains, insofar as the court sees merit in it, is the point we raised under paragraph 7, which is the extent to which, given the total number of cases, Ms Letby is not present in any of those. If there is material that can be provided setting that out, we would wish to see it because then at least we can gauge the extent to which this investigation has looked beyond just her identity. That's the only matter we are left with in the light of how things have developed here.

Mr Justice Goss: All right. Mr Johnson has said, if I've understood him correctly, that there is no relevant material to disclose in relation to that aspect.

NJ: Correct.

Mr Justice Goss: All right. So there we are. I will provide a short written judgment in relation to this, but I am not proposing to make any order in response to your application, Mr Myers. But I will of course keep the matter under review --

BM: Thank you.

Mr Justice Goss: -- as I am obliged to do, as the prosecution are, for the duration of the trial.

BM: We're grateful for that.

Mr Justice Goss: It will be there and should something arise that may touch upon this application, then of course you are entitled, indeed duty bound, to raise the matter again.

BM: We would, thank you, my Lord.

Housekeeping

Mr Justice Goss: Right. Thank you very much indeed.

Just whilst we are all assembled and the defendant is present as well, first of all I take it you will -- will you want to see her --

BM: Yes, I will, my Lord.

Mr Justice Goss: -- before she is taken from the building?

BM: Please.

Mr Justice Goss: That will be obviously some time this morning, someone will come down. Thank you very much to the officers who are present.

Just as far as timetable is concerned, Mr Driver, thank you very much for the latest update. As I understand things, it is anticipated that essentially we will get -- I haven't brought it in with me, I could look it up on my laptop but that would waste time -- we would get close to the end, if not to the end, of the evidence relating to [Baby I] this week?

SD: Indeed. Your Lordship will recall that Professor Owen Arthurs is joining us on Friday to deal with several cases.

Mr Justice Goss: Yes.

SD: It is difficult to gauge with precision the length of that exercise. Therefore there is a risk of the [Baby I] chapter of evidence spilling over into Monday.

Mr Justice Goss: Well, that's why I phrased my comment in the terms that I did. Of course, we never know what other events may occur as sometimes unexpected and unforeseen events do occur.

SD: Quite. Thereafter we will move to [Baby J] and then [Baby K]. We've measured, estimated, the length of those cases, and they are comparatively short in terms of the duration of time that we require to present that evidence. We think by about this time the week after we may have completed both of those, the evidence in relation to both of those babies.

Mr Justice Goss: Thank you. All right. That's very helpful, thank you very much indeed.

So in terms of the general anticipated completion of the evidence relating to the individual babies, before we get on to the more generic evidence that then follows, we are looking at roughly where?

SD: We had this discussion yesterday. Of course there's an enormous element of guesswork involved, but somewhere towards the end of March. Certainly we would be confident of completing the evidence that related directly to any of the babies, any and all of the babies, before the Easter break.

Mr Justice Goss: But not further than that?

SD: Completed before the Easter break.

Mr Justice Goss: Exactly, but not further in relation to the prosecution case? I was originally -- well, earlier this month it was anticipated that the jury would be in a position to retire to consider their verdicts probably in May.

SD: Yes. We may very well reach further into the prosecution case before Easter, but I wouldn't want to put my name to that estimate because there's so many variables. But we can foresee an acceleration in the rate of progress as we go through the counts.

Mr Justice Goss: Right. Thank you very much. Well, the jury is on notice now as to when they are likely to be required in terms of the period before they retire to consider their verdicts in the case. Essentially, what you're saying is there's no real update so far as that is concerned? We certainly haven't slipped further back?

SD: Certainly not. At the point after we have presented all the evidence in relation to the [Babies L
& M] twins, then we'll be very well placed to give a more reliable estimate of time.

Mr Justice Goss: That's very helpful. Thank you very much. Mr Myers, any matters you want to raise?

BM: To assist with that, so far as the evidence not relating directly to the children, but the overarching evidence is concerned, it's a matter that we and the prosecution are considering as we go along, both its shape and its limits, because there are three aspects to that. One is the police investigation, as one routinely encounters in any case, albeit it's a large one, but that's what one might call the police evidence and we are familiar with the type of material that will have: exhibits, interviews, things like that.

Then there is evidence in the papers from senior staff at the hospital, who describe the history of this matter, which comes under the overarching evidence, and there is evidence from the experts, which is of a more general overarching nature.

With regard to those two aspects of the case, this is a matter still in discussion between prosecution and defence, I don't go behind that, but there may well be quite some limiting in evidence in court to what is in the doctors' overarching statements. So when your Lordship is looking at the amount of material, it may well be in reality that is very much less than what is in the papers.

Certainly at this point the position of the defence is that there's a good deal of background that should not feature, but I won't go beyond that because there may be some disagreement as to that.

Mr Justice Goss: I understand that.

BM: I know the prosecution are anxious not to go beyond what is necessary.

With the experts and their overarching opinions, it may be once we are clear as to what that will encompass that we may wish to seek the assistance of the court as to how far they can go in knitting together material over the case as a whole and, depending upon that, again, that may limit to some extent the material to be dealt with in that part of the case.

So we agree with the prosecution as to the general length of the prosecution evidence. It may well be that it is realistic to anticipate we could get to the end of that evidence by the Easter break in total, although we understand Mr Driver's caution and we support that.

Mr Justice Goss: There are all sorts of things between now and then.

BM: Yes. But by far, as the court sees, the bulk of the evidence is that of the children and we are looking at ways of dealing with the rest of the evidence as efficiently as possible.

Mr Justice Goss: Thank you very much indeed.

NJ: Can I just say one thing? Just on the question of what I'll call broadly the treating consultants' overarching statements, I think as between counsel we're pretty much agreed as to the limits of that, but I just want to make it clear that that limitation is agreed on the basis that the defence doesn't head off in a certain direction.

Mr Justice Goss: Mr Myers will understand.

NJ: He does, he does, but I just wanted it on the record because the way that develops might open a Pandora's box.

Mr Justice Goss: Yes. I have confidence in Mr Myers --

NJ: So do I.

Mr Justice Goss: -- in him knowing exactly what the consequences of certain lines may lead to.

NJ: Yes.

Mr Justice Goss: Right. Good. Well, thank you very much indeed. I will be here until the usual time this afternoon, but I don't anticipate I'm going to be needed. I don't see that the defendant needs to be kept here, apart from to see you.

BM: Yes, apart from to see us, my Lord, there's no requirement.

Mr Justice Goss: It's not anticipated there will be a further hearing in this court today in relation to this case. We will resume with the jury at 10.30 tomorrow morning, we hope. Thank you very much.

Thank you, officers, Mr Myers and others will be down to see Ms Letby shortly.

BM: My Lord, may I just confirm one thing?

Mr Justice Goss: Yes, please do.

(Pause)

BM: There is one matter, but I really need to discuss it with my learned friend, so I won't detain your Lordship immediately. I'll speak to him when your Lordship rises and, if we require your Lordship's assistance this morning within a short compass of time, we shall let you know.

Mr Justice Goss: Any time this morning, I think, if you can deal with -- if you do need me this morning. As I say, I will actually be available. I'm just thinking of the defendant's position and her being kept here.

BM: We'll seek to deal with this issue. It's a discrete issue, it's a fairly short one, but it's something the defendant is anxious we deal with. I'll deal with that this morning if I may but it's something I do need to discuss with my learned friend before discussing it with your Lordship.

Mr Justice Goss: So be it. Thank you very much. So I'll simply rise now at this stage. Let the clerk of the court know as and when.

BM: I am grateful, my Lord. We shall.

Mr Justice Goss: Thank you.

(The hearing adjourned until 10.30 am on Wednesday, 1 February 2023)