For reference as it’s been at least a 100 years this is the defence opening.
Defence opening statement
Mr Myers: "It is difficult to think of allegations that may be harder to stand back and look fairly and look at the actual evidence.
"The sympathy of everyone will rightly be with families of the children...involved in this case. We all share the same feelings and experiences."
"It is natural to sympathise - we all do it. We recognise the sadness, distress and anger that come with allegations like these.
"We acknolwedge the great loss suffered by all families.
"Nothing I can say in this trial is intended to diminish that in any way.
"It is obvious...where we have such terrible allegations, it would be terribly easy for emotion to overcome reason, and convict without hearing a word of evidence."
"There is a real danger people will simply accept the prosecution 'theory' of guilt.
"It is a theory built 'firmly' on coincidence."
"What we are left with is coincidence.
"In the events that happened. Sometimes what happened was the result of deterioration in a baby.
"Sometimes, no-one can say what caused a deterioration.
"Sometimes, things have gone wrong, or the necessary standards of care have not been met, irrespective of anything to do with Lucy Letby. For that, she should not get the blame."The assumption is "The worse it sounds, the more guilty she must be."Mr Myers outlines the 'key issues' for the defence, in what he says will assist the jury and will place everything into context.
He said his speech, at this stage, will take about a couple of hours, and will break down the defence into three general areas: Letby and the general area of her defence, coincidence, and the medical evidence.
He tells the court the medical evidence is a key area, and there are 'key issues' for each count.Letby was a "dedicated nurse" "who did her best" to care for infants and did not intentionally cause "any harm" to any baby, My Myers said.
"She loved her job...and cared for the babies' families.""You won't get your answers [to what Letby is like] through seeing her in thed dock.
"This is what she is like six years after the allegations started. That, as you can imagine, is gruelling for anyone.
"You may want to keep that in mind as we go through the evidence in this case.""A young woman who trained hard to be a nurse...and looked after many vulnerable babies for years.
"A young woman who loved what she did, and found she was being blamed for the deaths of the babies she cared for.
"We are dealing with a real person dealing with...a litany of allegations...not one of which has been proved."Mr Myers refers back to the note shown to the court just before the break.
He said it is a note written in anguish and despair.
She was "going through a grievance procedure" with the NHS at the time, the court hears, and knew what was being said about her before her arrest.
The allegations were "destructive", the court hears.
The note is headed 'not good enough'. The defence notes it does not say 'guilty'.
The note adds: "I will never have children or marry".
Another part of the note says "I haven't done anything wrong".
Mr Myers: "We say people can pour feelings on to paper.
"This [paper] represents the anguished state of mind Letby felt when accused of killing children she had cared for.
"We say this paper represents 'anguish' and not 'guilt'.
There was further paperwork the police took from Letby's address at the time of her arrest.
The defence say the paperwork was "nothing more extraordinary" that Letby being someone who scribbles a lot of work down, and keeps hold of it.
The defence say the prosecution case is "driven by the assumption of someone doing deliberate harm combined by the coincidence of Letby's presence."That is, Mr Myers said, combined with Letby "not doing" what is alleged against her.
"You will find, from what we have heard, no evidence of her actually doing harm to a child.
"These allegations are of attacks. You will have heard words of poisoning, sabotage - words likely to have had an emotional impact on you.
"You will have to refer to whether Letby is engaged in any of the attacks alleged.
"Using syringes to inject air? No. Tampering with bags of fluid - or poisoning them? No. Physically assaulting children? Smothering them?
"We are dealing with 24 events and we say there is nothing [to suggest that].""The time of Letby's presence has itself become an explanation for the deterioration."The list on nursing staff on duty for all the fatal and non-fatal collapses, with Letby on duty for all events, is shown again to the court.
"This table exists because the prosecution created it, and was put together for the purpose of the prosecution."It was to show what were declared to be key events.
"This is a self-serving document. What we have here is because the prosecution have chosen to present it this way."
The defence says it does not show the 'individual health of the children concerned, or any problems they had from birth, or the risks, or the course of treatment and/or problems encountered by said treatment'.
The chart does not show 'other collapses or desaturations' for the children when Letby is not present.The table does not show 'shortcomnigs in care' which 'could have impacted the health of the baby', or 'how busy the unit was', or 'what Letby was actually doing at the time of the event', My Myers tells the court.It doesn't show 'whether Lucy Letby was anywhere near to a child at the time of the event' or if there was 'a problem which could be traced before Letby's arrival'.Regarding the explanations for what happened, My Myers said: "This is something which is quite a difficult question, even for experts to look at.""What the case will come down to is the medical evidence, on what can be safely proved and what it can't."Regarding the medical evidence, Mr Myers said: "The cause of the deteriorations, or deaths, is not clear and have a number of possibilities.
"Generally, we are dealing with babies who are fragile, and their condition can change and deteriorate very rapidly."
Mr Myers adds the premature and vulnerable babies can come with developmental conditions that require extra treatment, and are prone to infections.
"It is crucial to consider the starting point in these cases.
"There is a question to whether this hospital should have been caring for this number of children."Mr Myers: "We suggest whether an event that clearly fits an ongoing and difficult condition has been covnerted into an event of deep suspicion that harm is being done."For a nurse standing in the neonatal unit next to an infant is "unremarkable", without a "suspicion of guilt", Mr Myers tells the court.
"When we come to the experts, you will need to consider their evidence and how strong it is."The defence say there are five 'important' considerations for the evidence:
The birth condition of the infant.
If there were any problems in the care leading up to the event - events 'can come up from nowhere'
Whether the prosecution expert evidence concludes there was deliberate harm done
Whether Lucy Letby was present at the relevant time, and what she was doing
Whether there were failings in care by other people or the neonatal unit as a wholeThe birth condition of the infant
Mr Myers tells the court: "We are dealing with some of the most medically fragile babies under the most intense medical care.
"All of them, bar one, are premature to varying degrees. Some had considerable problems.
"These babies are already at risk of deterioration and this can happen unexpectedly and it can be rapid."The matters leading up up to the event
Mr Myers refers to the medical situation and condition of the children involved.
Sometimes that includes 'the ability of doctors and nurses to spot' signs of problems in the build-up to the event.Sometimes that would be a problem if the unit was "understaffed and overstretched," Mr Myers saidThe defence say in relation to the evidence, "we have to be careful of the assumption or theory of guilt," and the "dangers of opinion" in relation to the conclusions of "deliberate harm".
"We say that if an expert sets out within expectation a suspicion of harm being done, that may make it more likely they will reach conclusions which are harm based...rather than innocent explanations.
"When there is no explanation, there is a danger of the expert filling the absence of an explanation with one...by the prosecution.""If someone looks for something, and has something in mind, they will look for that."
"Confirmation bias," added Mr Myers"There is plenty of disagreement" between the prosecution expert evidence and the defence.Medical evidence
Mr Myers tells the court that sometimes deteriorations are unexplained, and if Lucy Letby cannot provide an explanation, that does not make her responsible.
For every count, Letby is "adamant" she has "done nothing wrong" to cause any deliberate harm to any of the babies in the case, Mr Myers adds.
Regarding the point of air embolus cases The defence "accept it is a theoretical possibility", but that "does not establish very much".
"You will hear in this case, that the air present after death does not indicate an air embolus."
Mr Myers said air present in the abdomen "can happen post-mortem".
the opening statement then goes on to discuss each baby in more detail - see the baby A-Q sections below
Mr Myers added there are two further areas to consider.
"It is important not to guess, or proceed on a presumption of guilt."
"Even when we have timings...some will be more precise than others."
There were many occasions when "Lucy Letby was simply not there" when harm was being alleged.
"Lucy Letby was a young nurse with no family commitment, who had built her life around the neonatal unit.
"She was often called in to help babies with severe health issues...she was more likely to be there to cover for clinically difficult babies."
The defence say Letby's lack of recollecting details in police interviews should be put into context, like other witnesses, who may not be able to recall anything beyond the notes they made at the time.
"Goodness knows how many babies she will have cared for over the years," Mr Myers said.
Other staff
Mr Myers said this is important - it would be "unbalanced and unfair" if the focus was on Lucy Letby without focusing on problems with other staff, or how the unit was run.
"We do not suggest for one moment the doctors and nurses did anything other than the best they could.
"What they do is admirable and crucial."
"We say there were problems with the way the unit performed which had nothing to do with Lucy Letby."
Examples of sub-optimal care for babies previously mentioned and conceded by the prosecution are relayed to the jury.
"There are many other examples of sub-optimal care of babies in this unit," Mr Myers.
The defence say the prosecution have referred how babies improved rapidly when moved to a tertiary unit - "when moved away from Lucy Letby"
The defence says the improvement could be because they had been "moved away from the Countess of Chester Hospital".
It is evidence that the unit "did not always deliver the level of care that it should have provided" and to blame Letby "is unfair and inaccurate".
Mr Myers explains the neonatal unit is a level 2 unit, with level 3 offering the highest specialist care for new-borns, such as in Arrowe Park.
Either 'through lack of technical level of skill among the staff, or because it was too busy and could not deliver with the level of staff it had available.'
The Countess of Chester Hospital neonatal unit was subsequently 'resdesignated' as a level 1 unit after Letby was redeployed in July 2016, Mr Myers said.
"You can imagine in a situation like that, there is bound to be concern."
The defence also refer to Dr Ravi Jayaram, and his 'concern' about Letby's behaviour as detailed by the prosecution in the opening.
"You may wonder what on earth that is all about.
"If Dr Jayaram had these suspicions, when did that start?
"You may think that if consultants had suspicions, then why did Letby continue?
"You may wonder if there was any basis for suspicion at all.
"You may think that suspicions by one or more consultants like that, if Letby is to blame, then that is fertile self-serving territory for an assumption of guilt to take hold."
Mr Myers said Letby became a "target" for blame.
"It would be very unfair to judge Lucy Letby by standards or expectations different to other staff in the unit," Mr Myers said.
The defence say if it can be interpreted the unit is understaffed, treatment is "hurried," "mistakes made" and records "not kept". Mistakes may "not be immediate".
Mr Myers: If the unit has "failed" in its care which has led to this "uncharateristic spike in deaths", you can imagine "pressures" which call for an explanation, 'distancing the blame from those running the hospital' through "confirmation bias".
"The blame is far too great for just one person," Mr Myers added.
"In that dock is a woman who says this is not her fault."
They have to work with this.
