Dr Ravi Jayaram, who is a consultant paediatrician at the Countess of Chester Hospital, told ITV News he repeatedly raised concerns about his former colleague
The doctor who helped catch child-killer Lucy Letby has told ITV News that babies' lives could have been saved if hospital bosses had contacted police sooner.
Dr Ravi Jayaram, who is a consultant paediatrician at the Countess of Chester Hospital, said he repeatedly raised concerns about his former colleague months before police were alerted.
In an exclusive interview, he has detailed to ITV News how executives at the top of the organisation at the time told him to “draw a line” under his suspicions and to apologise to Lucy Letby for his accusations.
It was almost two years after the first babies died before police were eventually contacted by the trust.
“I do genuinely believe that there are four or five babies who could be going to school now who aren't," Dr Jayaram told us.
He said consultants first began raising concerns after three babies died in June 2015.
As more babies collapsed and died, consultants held several meetings with hospital executives to raise their concerns about Letby.
However, in the minutes of one meeting seen by ITV News, the doctors are told to “draw a line under the 'Lucy issue'” and to apologise to her for alleged 'victimisation'.
Dr Jayaram claims that the then-Chief Executive Tony Chambers told consultants at the meeting in January 2017: “I'm drawing a line under this, you will draw a line under this, and if you cross that line, there will be consequences for you.”
When doctors suggested going to the police with their concerns, hospital executives are alleged to have warned them that it would result in “blue and white tape” all over the ward, damaging the reputation of the trust.
Detective Superintendent Paul Hughes explains how meeting Dr Jayaram and his colleague, Dr Breary, lead to the police catching Lucy Letby
Dr Jayaram told ITV News that his suspicions about Lucy Letby were confirmed when he walked in on the nurse attending to a baby one evening.
“That is a night that is etched on my memory and will be in my nightmares forever”, he says.
“As I walked towards the incubator, I could see on the monitors that the oxygen saturations were dropping, and they'd dropped to a level that ordinarily the alarms would've been going off and the nurse would've called for help.”
“Lucy Letby was standing by the top of the incubator. She didn't have her hands in the incubator. She was just standing there.”
Dr Jayaram noticed the baby's breathing tube had become dislodged.
'You know what's happened before when Lucy's been on duty'
“Tubes do become dislodged, but this was a twenty-five week gestation baby, who wasn't kicking around, who wasn't vigorous. The only possibility was that that tube had to have been dislodged deliberately.”
The jury did not reach a verdict in relation to this infant, known at trial as Baby K, who did survive.
As more infants collapsed and died, consultants held several meetings with hospital executives to raise their concerns about her.
The hospital did eventually move Letby off the unit, leading her to take out a grievance against the trust.
It concluded that the doctors had made “unsubstantiated comments” and executives advised them to apologise to Letby to avoid facing a possible referral to the General Medical Council.
In a letter to Letby seen by ITV News, the consultants felt pressured to write: "Dear Lucy, we would like to apologise for any inappropriate comments that may have been made during this difficult period. We are very sorry for the stress and upset that you have experienced in the last year. Please be reassured that patient safety has been our absolute priority during this difficult time."
As doctors continued to raise their suspicions, Medical Director Ian Harvey insisted to them via email that there was “no smoking gun” and they were informed that Letby would be returning to the ward.
In order to aide her return, Dr Jayaram was asked to attend a mediation session with the nurse whom he still suspected.
“It was bizarre," he told ITV News.
"To listen to her saying, ‘I'm coming back next week, will you work with me?’ And of course I was having to say, ‘Well, if the trust have deemed that you are coming back to work, I will work with you, yes’ - because I wasn't happy.”
Eventually, in April 2017 the trust allowed doctors to meet with a police officer who took their suspicions seriously.
"The police, after listening to us for less than 10 minutes, realised that this is something that they had to be involved with. I could have punched the air," Dr Jayaram said.
Shortly afterwards, an investigation was launched and Letby was eventually arrested.
Detective Superintendent Paul Hughes at Cheshire Constabulary told ITV News that Dr Jayaram and his colleague Dr Stephen Brearey had been instrumental in catching the killer.
“I think the doctors have been incredibly brave in coming forward when they have and certainly their actions have prevented more deaths,” he said.
“I went to have a meeting with Dr Brearey and Dr Jayaram at Countess of Chester Hospital and asked them to tell me why it should be investigated. It was their explanation on a very simple level that meant I was actually able to get some criteria to look at it."
The father of two babies (known as Baby L and Baby M), who Letby attempted to murder, praised Dr Jayaram's actions.
"Dr Jayaram is my hero. He saved our son and without his expertise and professionalism, I don't know where I would be today," he said.
Dr Jayaram now wants a public inquiry into whether the hospital took too long to raise concerns with police.
He is also calling for the establishment of a new watchdog to hold NHS managers to account if they are accused of misconduct.
“I won't rest and consider any closure for me until they have been put in a position where they can be held to account,” Dr Jayaram said.
Tony Chambers, former Chief Executive of the Countess of Chester Hospital NHS Foundation Trust said: “All my thoughts are with the children at the heart of this case and their families and loved ones at this incredibly difficult time. I am truly sorry for what all the families have gone through.
“The crimes that have been committed are appalling and I am deeply saddened by what has come to light.
“The trial, and the lengthy police investigation, have shown the complex nature of the issues raised. I will co-operate fully and openly with any post-trial inquiry.”
Mr Chambers denies telling consultants they should "draw a line" under their suspicions of Lucy Letby.
He also said: "The consultants were completely free to call the police and share their concerns at any time. Like the consultants, we were absolutely focused on trying to get to the bottom of what happened at the neo-natal unit."
Mr Chambers said the hospital's insistence that consultants apologise to Lucy Letby "was a recommendation from the grievance panel".
Responding to Dr Jayaram's account that the doctors' suspicions of Lucy Letby were "convenient" for them, Mr Chambers said: "This is a one-sided account of the meeting where what I said has been taken out of context.
"The implication, if any, was that a significant number of factors needed to be considered, including demand, acuity, clinical care, staffing and environment."
Ian Harvey, former Medical Director, at the Countess of Chester Hospital said: “At this time, my thoughts are with the babies whose treatment has been the focus of the trial and with their parents and relatives who have been through something unimaginable and I am sorry for all their suffering.
“As Medical Director, I was determined to keep the baby unit safe and support our staff. I wanted the reviews and investigations carried out, so that we could tell the parents what had happened to their children.
“I believe there should be an inquiry that looks at all events leading up to this trial and I will help it in whatever way I can."
Mr Harvey also said: "Throughout this whole process, the consultants were completely free to contact the police at any time.
"We never had hard evidence, but we had reached a point where we had explored every other cause. However, the consultant paediatricians didn’t feel there was any further work or investigation - short of a police investigation - that could be done that would satisfy them that some of the deaths weren’t due to natural causes."
The Countess of Chester Hospital NHS Foundation Trust’s Executive Medical Director, Dr Nigel Scawn said: "I speak for the whole Trust when I say how deeply saddened and appalled we are at Lucy Letby’s crimes. We are extremely sorry that these crimes were committed at our hospital and our thoughts continue to be with all the families and loved ones of the babies who came to harm or died. We cannot begin to understand what they have been through.
"This case has had a profound impact on our patients and our local community and also our staff - who come to work every day determined to provide safe and high-quality care for our patients.
"Our staff are devastated by what happened and we are committed to ensuring lessons continue to be learnt. We are grateful for the cooperation of our staff, especially those who have maintained the utmost professionalism whilst giving evidence in the trial, sometimes on multiple occasions. We will continue to support them and other staff to ensure they receive the care and support they need.
"We would like to extend our thanks to Cheshire Police for their extensive investigation and the work they did to bring this case to trial. We’d also like to thank them for the comprehensive support they have provided to all of the families.
"Since Lucy Letby worked at our hospital, we have made significant changes to our services. I want to provide reassurance that every patient who accesses our services can have confidence in the care they will receive.
"And, most importantly, our thoughts are with all the families and loved ones at this very difficult time."
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