frenzy . They included the declaration

, “ I will never have children

or marry ,” along with , “ Why

should this mother be able to

enjoy this baby when I can ’ t ?”

Were the deaths of those poor

babies under her care revenge

murders ?

The prosecution lawyers generally

left the dark psychological

question of her motivation

untouched during her trial .

She is now imprisoned for life .

And those dark psychological

questions may never find satisfactory

answers given the nature

of what she did .

But has justice been done ?

People who received warnings

about her from the medical staff remain in positions of responsibility or have shuffled off to the comforts of a pensioned retire-

Lucy Letby and whistleblower paediatrician Dr Stephen Brearey ( right ).

ment . They include the senior

hospital bosses who staff said should have acted sooner when the flags were being raised .

It has taken a little time , but last month , the police

entity ’ s duty of care .

• In all the circumstances , the breach was gross .

• The gross breach caused or made a significant contribution

published by the BBC , she said the association was “ unfortunate ” and that the incidents had nothing in common .

Six months later came another

was finally reassigned . It was at this point , according to the BBC , that the suspicious deaths and collapses stopped .

Rather than go to the police as

announced they were investigating the Countess of Chester Hospital , where Ms Letby worked , for possible corporate manslaughter .

The investigation , according to the media reports , will consider areas including “ senior leadership and decision-making to determine whether any criminality has taken place ”.

“ At this stage , we are not investigating any individuals in relation to gross negligence manslaughter ,” the police said .

Corporate manslaughter

I worked at the interface of medicine

and law for some 20 years , which included four years in the UK .

I arrived in the UK in 2009 , soon after the Corporate Manslaughter and Corporate Homicide Act 2007 was promulgated .

The general elements in establishing corporate manslaughter are as follows :

• The corporate entity has a relevant duty of care .

• Activities were managed or organised by senior management in a way which comprised a breach of the corporate

to the death .

In the Letby case , the broad elements needed to bring a corporate manslaughter charge apply .

There was an employer , the Countess of Chester Hospital , which is part of an NHS trust , a public benefit corporation .

There were employees of that corporate entity — namely , the clinical and administrative staff .

And there were patients — in this case , the babies who were killed — to which the trust had a duty of care , separate from the duty of care owed by the doctors .

The facts may be a little more complicated .

The hospital ’ s management did respond to the expressed concerns of the doctors in the neonatal unit by ordering various reviews .

But you cannot help thinking the response met the definition of something close to gross negligence .

When in the middle of 2015 , three babies died in the space of a couple of weeks while Ms Letby was on shift , Dr Stephen Brearey , lead consultant of the unit , contacted the unit manager about his concerns .

According to a detailed account

unexpected death .

This time a consultant had seen Ms Letby standing and watching the baby — subsequently known as Baby K — when it stopped breathing .

The medical director was contacted , but again , little was done to address the concerns raised .

Three months later , two more

babies almost died on the unit and then in June 2016 , two triplet siblings died . The BBC describes this as the tipping point for the doctors .

A senior manager initially refused Dr Brearey ’ s demand to take Ms Letby off duty .

He challenged her that she was making the decision against the wishes of seven paediatricians — and asked her if she would still take responsibility for it . She apparently told him yes . But the following day another baby almost died and Ms Letby

the doctors suggested , the hospital management , allegedly alarmed by the public relations implications , asked the Royal College of Paediatrics and Child Health to review the level of service in the unit .

While it found no evidence of anything obviously malign , the college still recommended a

People who received warnings about her from the medical staff remain in positions of responsibility .

“ thorough external independent review of each unexpected neonatal death ”.

That recommendation was never taken up .

A premature baby specialist was also asked by management to review the babies ’ case notes . She also came to the conclusion that four baby deaths needed to be forensically investigated .

But records of a subsequent board meeting where these findings were discussed in depth , apparently show that the hospital

CEO concluded the problems in the unit were down to issues with leadership and timely intervention .

Two doctors at the unit were reportedly told to attend mediation sessions with Ms Letby .

There was also that letter of apology they were told to sign . It read as follows : “ Dear Lucy , “ The increased mortality in the neonatal unit and subsequent reviews and re-designation of the neonatal unit has been a very stressful time for all staff and patients .

“ We understand it has been an exceptionally stressful time for you .

“ We would like to apologise for any inappropriate comments that may have been made during this difficult time . As you are aware , emotions have run high .

“ We are very sorry for the stress and upset that you have experienced in the last year …”

Australian criminal code

In Australia , corporate manslaughter

is defined in Division 12 of Australia ’ s federal Criminal Code Act 1995 .