Erica Witherington
Reporting from the inquiry

More now on the meeting with the hospital board in January 2017.

Harvey advised that Lucy Letby should be supported in her return to the unit, which the lawyer says is "completely unacceptable".

Harvey says "in retrospect, yes" and again says he regrets not telling the police in summer 2015.

"It was irresponsible and dangerous to return Lucy Letby to the unit as you could not be confident she would not harm a child again?" the lawyer asks.

"I accept in retrospect it was a risk," Harvey says.

He is asked again if this should have been allowed.

"Looking at this, no," he says.

After a short break, the inquiry has resumed, and Peter Skelton KC begins his questioning of Ian Harvey on behalf of some of the babies' families.

The inquiry is on a break. When it resumes, at 16:10, Ian Harvey will be asked questions by Peter Skelton KC, on behalf of some of the babies' families.

Ian Harvey is asked to look at a press release which the hospital put out on 7 July 2016 explaining that the neonatal unit was being downgraded to only care for less premature babies.

The press release says the reason was there had been an increase in mortality amongst “some of our most poorly babies”.

Rachel Langdale KC asks Ian Harvey: “Was that a fair description of the babies that had died?”

He answers: “At that time I believed that that was a reasonable description.”

Langdale says that's what the neonatal unit manager had said, but not doctors.

"Did you take her word, rather than the experienced consultants?" Langdale asks.

Harvey says: "I believe in terms of the communications, that was the understanding at the time. That's all I could say."

The inquiry is shown handwritten notes from a meeting held between the consultants and executives on 30 June 2016.

Dr Ravi Jayaram is noted as having mentioned "air embolism" (one of the methods of murder which Letby was later convicted of).

He also mentioned difficulties with resuscitating babies.

Rachel Langdale KC puts it to Ian Harvey: “He’s saying it constantly isn’t he? This is the concern?”

Harvey replies, “I’m not sure that the notes capture the way things were discussed in the meeting."

Judith Moritz
Special correspondent, reporting from the inquiry

Rachel Langdale KC is now taking the inquiry through a series of emails, external which pass between senior managers in the days after babies O and P had died on consecutive days at the end of June 2016.

She points out that whilst these emails are being sent back and forth about the subject, Lucy Letby is still being allowed to keep working in the unit.

It starts with an email from a consultant, Dr Saladi, to his colleagues. He says they are "all under suspicion and the only agency who can investigate all of us I believe is the police”.

Another consultant, Dr Ravi Jayaram replies to say that he and Dr Steve Brearey were “trying to meet with the execs ASAP to discuss exactly this” but “they do not seem to see the same degree of urgency as we do”.

Ian Harvey then replies to all the doctors on the email chain to say: "This is absolutely being treated with the same degree of urgency… all emails cease forthwith."

Judith Moritz
Special correspondent, reporting from the inquiry

Counsel for the inquiry Rachel Langdale KC now moves forward in time, and asks Ian Harvey about the period at the end of June 2016 after two triplet brothers, babies O and P, died on consecutive days.

Letby has since been convicted of their murders.

Dr Brearey asked Harvey to join a meeting with the paediatricians after the two deaths.

He did not go. Langdale asks why not. “Why didn’t you attend that meeting? Two babies have just died on consecutive days. It’s hard to imagine anything more serious in the hospital."

Harvey says he can’t say, and doesn’t know what other commitments he had at the time. He was aware that there was a separate prearranged meeting for a hospital fundraising drive, and took that opportunity to meet instead.

Judith Moritz
Special correspondent, reporting from the inquiry

Image source, Thirlwall Inquiry

Dr Brearey previously told the inquiry that - at this same meeting on 11 May 2016 - the neonatal unit manager Eirian Powell countered his concerns “quite forcefully and with great emotion, saying there were no issues with Lucy Letby".

Ian Harvey is asked about his recollection of this.

He says: “I think Dr Brearey is overstating it by saying ‘with great emotion’.

"I believe that Eirian was factual. She was obviously passionate about her unit, but I don’t think that she was excessively - as is implied - passionate with regard to defence of Lucy Letby.

"I think that has been overstated."

Judith Moritz
Special correspondent, reporting from the inquiry

Rachel Langdale KC shows the inquiry an email to the director of nursing, Alison Kelly, which Dr Brearey sent in May 2016.

The email says, external that there's a nurse on the unit who has "been present for quite a few of the deaths and other arrests".

Ian Harvey replies to Kelly, who has forwarded him the Brearey email, and suggests Brearey may have raised this point in his email because he was "concerned" for the nurse involved.

The inquiry has previously heard evidence from Brearey about a meeting on 11 May 2016 in which he went through the detail of the ‘thematic review’, highlighting things like the unusual number and pattern of deaths which happened in the early hours of the morning.

Harvey now says he does not agree with Brearey’s recollection of that meeting.

"I don’t recall Dr Brearey being that detailed or that assertive”.

Judith Moritz
Special correspondent, reporting from the inquiry

Rachel Langdale KC puts it to Harvey that in August 2016, when the coroner was preparing for the inquest of Baby A, hospital staff had "been talking in various meetings about whether Letby is killing babies”.

She asks him: “Do you think the coroner was adequately informed about the suspicions and concerns you had about Lucy Letby killing babies, and whether or not she was looking after this baby?”

Ian Harvey says he doesn’t know.

He is asked about one of the “themes” a thematic review carried out in February 2016 identified, which was that 6 out of 9 babies whose deaths were reviewed had had cardiac arrests in the early hours of the morning.

It’s pointed out to him that in the case of serial killer Harold Shipman, a local GP spotted a pattern in the deaths of his patients (many of whom Shipman had killed in the afternoon during home visits).

He’s asked whether the fact that Dr Brearey identified a pattern of the timing of the baby deaths in Chester should have stood out to him as unusual.

Harvey says no - because he was made aware that there were still further investigations being carried out.