A supporter’ s placard outside Parliament in

London, UK, May 2025.

evidence, expert witnesses, statistical

nurses could kill patients, and that she also

statistical spike in deaths that is explicable

Rachel Carter Chief of staff at Australian Doctor.

probabilities and juries asked to cast judgement within an adversarial justice system.

Australian Doctor spoke to Melbourne barrister Professor Ian Freckelton KC, a

had notes on her phone suggesting that she regarded herself as evil and didn’ t deserve to live.

However, the circumstantial evidence

in terms other than homicidal conduct.

That has resulted in a major statutory inquiry in the UK, the Thirlwall Inquiry, looking at all of the circumstances of the

The neonatal nurse is serving 15 whole-life prison terms, but medical experts say she may be innocent.

professor of law, psychiatry and forensic medicine.

Australian Doctor: Beyond the shocking nature of what was alleged, why is this case significant?

Professor Ian Freckelton: There are multiple reasons.

was buttressed by a large amount of expert evidence, including: paediatric endocrinology evidence, forensic pathology evidence, paediatric evidence, statistical evidence, and forensic psychology evidence in relation to a controversial phenomenon, said to be‘ healthcare serial killing’, and also Munchausen by proxy conduct.

The major issue is whether there are

deaths in the hospital.

The CCRC is also revisiting the case and examining whether the matter ought to be referred to the Court of Appeal.

To be clear, the Court of Appeal has previously refused leave to appeal the convictions on two occasions, in January and April of last year.

Notably, leave to appeal against

As is quite common, the evi-

alternative plausible theories for the

her later conviction of one count of

dence against the accused was largely circumstantial.

It rested on a number of pillars, including a divergence from statistically

deaths, which are consistent with innocence, and whether inappropriate inferences may have been drawn by the jury in relation to the expert evidence.

attempted murder in June 2024 was also refused in October.

So, the situation is in abeyance so far as the criminal justice system is concerned,

one of the worst in UK legal history.

The claim still comes as a shock. At the time the sentences were handed down for killing seven babies under her care, the condemnation seemed almost universal, the only questions being speculation as to her motivations.

“ She has thrown open the door to hell and the stench of evil overwhelms us all,” a columnist in the Daily Mail wrote with typical tabloid frenzy.

But this year, 14 leading paediatric and neonatal specialists collated a 700-

‘ There are many difficult features to the case.’

expected mortality rates among newborns

, and a pattern identified by the prosecution that was consistent with purposeful suffocation, air embolism and insulin poisoning.

AD: The prosecution’ s evidence has been challenged by the report from Canadian neonatologist Professor Shoo Lee and other experts.

Ms Letby in a number of cases was accused of using insulin to kill the babies.

But the version of the report published earlier this year goes through the clinical basis of all the deaths, suggesting alternative reasons— including poor care.

pending the further scrutiny being given to the case by the CCRC, which will report later this year.

It will take account of the Professor Lee analysis and the potential for additional evidence to be adduced.

AD: Was there other evidence at risk of being wrongly interpreted by the original jury which convicted Ms Letby?

Professor Freckelton: This was an exceptionally complex case in which

page report arguing there was no clini-

There was also the fact that Ms Letby

expert evidence featured prominently …

cal evidence of deliberate harm to any of the babies— the deaths were the result of

was present on each occasion; the fact that she sought information about the families

Professor Freckelton: The report argues that there is no medical evidence of inten-

and there are many difficult and worrying features to the case, which are prob-

poor medical care and missed diagnoses.

of the deceased infants, which was said to

tional harm inflicted by Ms Letby.

ably going to start to clarify when the

As the Criminal Cases Review Com-

be indicative of morbid curiosity.

The assertion has been made that

CCRC delivers its analysis.

mission( CCRC) considers the report, the

And with that there was her strange

the causes of the deaths may well have

But what it has raised is the issue

debate begins again.

online history of looking up issues about

been systemic failings during the rele-

about bias in expert evidence in terms of

How best to deal with complex clinical

infant resuscitation failure and whether

vant 18-month period, which generated a

assumptions made by expert witnesses