The Thirlwall Inquiry Failed by Assuming Letby's Guilt Instead of Examining Whether Murders Actually Occurred
Source: Rachel Aviv. "The New Lucy Letby Report Misses the Point | The New Yorker." September 18, 2026. www.newyorker.com
The Gist
Rachel Aviv argues that a massive, expensive government inquiry into how a hospital failed to stop nurse Lucy Letby from murdering babies completely missed the real problem: nobody has adequately investigated whether Letby actually murdered anyone in the first place. She points to a major medical review that found no evidence of murder, a reversal by a top government official, and internal hospital records showing nurses had good reason to doubt the accusations—yet the inquiry treated Letby's guilt as a given and dismissed the nurses' skepticism as mere loyalty or tribal bias.
Conclusion
The Thirlwall Inquiry, despite its cost and scope, missed the central issue by proceeding on the unexamined assumption that Lucy Letby committed murder, rather than investigating whether the underlying convictions were actually sound.
Premises
- A panel of fourteen leading international neonatology experts, convened by Dr. Shoo Lee (whose own research was misused as key trial evidence), reviewed 35,000 pages of medical evidence and found no medical evidence that Letby harmed any of the fourteen babies in question, attributing deaths instead to natural causes or substandard medical care.
- The former Health Secretary at the time of the deaths, Jeremy Hunt, who once treated Letby's guilt as settled, publicly reversed his position after reviewing expert concerns, warning that if deaths were misattributed to murder rather than medical error, the wrong lessons would be drawn and more babies could die.
- Twenty-four clinicians and scientists, including a former forensic-science regulator, formally requested that the inquiry be postponed or its scope amended because proceeding on an assumption of guilt might obscure other causes of neonatal deaths and prevent correct systemic lessons for the NHS.
- The inquiry's chair explicitly stated it was not her role to explore alternative theories about the deaths, meaning the inquiry structurally excluded the question of Letby's actual guilt from its scope.
- Internal hospital records reveal that the accusations against Letby originated from doctors' subjective 'gut feelings' rather than concrete evidence, while nurses who worked directly alongside her repeatedly defended her competence and questioned the lack of evidence—yet the inquiry dismissed the nurses' views as 'unthinking loyalty' and 'tribalism' rather than treating them as legitimate countervailing testimony.
- Two independent clinical reviews (by the Royal College of Paediatrics and Child Health and an outside neonatologist) conducted at the time found no signs of deliberate harm, yet these findings were overridden by the doctors' persistent suspicions.
- The inquiry's recommendations (e.g., cameras in neonatal units, mandatory escalation of suspicions) presuppose that the failure was one of not stopping a murderer sooner, foreclosing the possibility that the deaths were never murders at all.
Assumptions
- An official inquiry that operates only within the frame of settled guilt cannot produce reliable or complete lessons if that underlying premise is actually false or contested.
- Expert medical review (Lee's panel) constitutes credible, weighty evidence capable of overturning or seriously challenging a criminal conviction reached through a legal trial process.
- The hierarchical dynamic between doctors and nurses in the hospital biased whose testimony and instincts were credited as reliable evidence of wrongdoing.
- Institutional and governmental incentives favored treating Letby's guilt as settled (to justify the inquiry's framing, cost, and the earlier conviction) rather than reopening uncomfortable questions.
- The truth of what happened to the infants is knowable and separable from the narrative that emerged through the trial and inquiry process.