Sharing Isle of Man school review cost 'not in public interest'
Publishing the costs of a contract with an education review provider could reduce the government's ability to get "best value for money" in future, the education minister has said.Daphne Caine has defended her department's decision not to release the amount paid to external validators Etio in response to a Tynwald question for written answer.She told the House of Keys that as her department was in the second of a three year contract with the firm it was "not in the public interest" to release the information.But MHK Lawrie Hooper said the costs were "routinely made available by the UK in relation to the exact company and the services they provide".
Hooper said the rationale was "nonsense", and said based on figures released by the UK government indicated the Manx services would "probably cost between £150,000 and £250,000".Cain suggested she could share the figure confidentially with the Public Accounts Committee.
During Tuesday's sitting, Kate Lord-Brennan called for the minister to provide a cost range for the report, arguing releasing the information was about "education delivery, standards, and public money, not about Etio".Chris Thomas MHK said it was "unusual" not to share the costs even when a contract was live, and noted that Treasury had published the terms of contracts in the past. Concerns were also raised by Julie Edge MHK, who said she did not understand why there was "so much resistance when it is such an important piece of work for our schools".Tim Glover MHK questioned how released the figure confidentially would restore and maintain public confidence.Caine said it was not in the public interest if it "breached" commercial confidentiality, and the competitiveness of future bids was "compromised".She said the department would "likely" go out for tender in the next six months, and sharing the cost could limit the "commercial competitiveness so that all bids come in within a ball park".That was "not serving the best interest of the Isle of Man community", she said.
Read more stories from the Isle of Man on the BBC, watch BBC North West Tonight on BBC iPlayer and follow BBC Isle of Man on Facebook and X.
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"I'm very confident that we're going to get back to the Court of Appeal." Asked how Letby "is doing", he said: "I don't talk about Lucy herself as a person but to say this: She's read all the reports, she's seen the reports, we have a new hope now. "A new hope that, in fact, the truth will come out. So yes, she has a new hope." Last month, lawyers for the families of Letby's victims rubbished the international panel's findings as "full of analytical holes" and "a rehash" of the defence case heard at trial. Mr McDonald also gave the CCRC a separate report on the insulin cases of Child F and Child L from seven experts including two consultant neonatalogists, a retired professor in forensic toxicology and a paediatric endocrinologist. Their report summary concluded the jury was misled in a number of "important areas" including medical and evidential facts, and that key information on the insulin testing procedure was not submitted. It added that the biomechanical test used in both cases "can give rise to falsely high insulin results" due to the presence of antibodies which can interfere with the outcome. On Thursday, Mr McDonald released the independent panel's case summaries of all 17 babies that were said by trial prosecutors to have been deliberately harmed on the Countess of Chester Hospital's neonatal unit. The 14-strong panel concluded that no criminal offences had been committed at the Countess of Chester Hospital in 2015 and 2016 and instead provided alternative causes of deterioration. Among the findings of the panel, working pro bono for Letby's defence team, was that baby boy Child C died following ineffective resuscitation from a collapse after an "acute small bowel obstruction" that went unrecognised, rather than from a deliberate administration of air. Child P, a triplet boy, was also found by the jury to have been fatally injected with air but the panel ruled he died from a collapsed lung that was "suboptimally managed". Letby's experts said there was no evidence of air embolism - in which bubbles form and block the blood supply - in Child E, a twin boy, and that bleeding was not caused by inflicted trauma but from either a lack of oxygen pre-birth or a congenital blood vessel condition. The panel said insulin-related levels for Child E's brother, Child F, insulin were within the norm for preterm infants and it did not prove that synthetic insulin was administered. The same conclusion was reached for Child L, another twin boy that Letby was convicted of attempting to murder by insulin poisoning, and both cases were said to have involved sub-standard medical management of hypoglycaemia. BOMBSHELL EMAIL Meanwhile, an explosive email has also been found which appears to cast more doubt on the prosecution claims that Letby was caught "red-handed". A new email - sent on May 4 2017 to colleagues at the Countess of Chester Hospital - suggests there could be discrepancies over the chronology of events. The memo, revealed in April, is a significant boost to Letby's legal fight to overturn her convictions. Dr Ravi Jayaram is the only hospital staff member to have claimed to see Letby act suspiciously and link her behaviour directly to babies' deaths. Medical experts provided case summaries on all 17 babies from the Letby trial An international panel of medical experts has provided case summaries on all 17 babies who featured in the 10-month trial of Lucy Letby. The 14-strong panel concluded that no criminal offences had been committed at the Countess of Chester Hospital in 2015 and 2016 and instead provided alternative causes of deterioration: - Baby 1 (known as Child A in the trial): The prosecution said the boy was murdered by an injection of air into the bloodstream which caused an air embolism where bubbles form and block the blood supply. The panel found no evidence of air embolism and said the child had died from thrombosis, where a blood clot forms in a vessel. - Baby 2 (Child B): The prosecution said Letby attempted to murder Child A's twin sister by also injecting air into her bloodstream. The panel found no evidence of air embolism and said the child had collapsed from thrombosis. - Baby 3 (Child C): The prosecution said the boy was murdered with air forced down his feeding tube and into his stomach. The panel said the child died following ineffective resuscitation from a collapse after an "acute small bowel obstruction" that went unrecognised. - Baby 4 (Child D): The prosecution said the girl was murdered by an injection of air into the bloodstream. The panel found no evidence of air embolism and ruled the child died of systemic sepsis, pneumonia and disseminated intravascular coagulation (blood clotting). Issues with failures to give relevant antibiotics were also identified. - Baby 5 (Child E): The Crown said Letby murdered the twin boy with an injection of air into the bloodstream and she also deliberately caused bleeding to the infant. The panel said there was no evidence of air embolism and bleeding was caused either by a lack of oxygen pre-birth or a congenital blood vessel condition. - Baby 6 (Child F): The prosecution said Letby attempted to murder Child E's twin brother by administering insulin. The panel ruled that the child's insulin levels and insulin/C-peptide ratio did not prove that exogenous insulin was used and were within the norm for pre-term infants. It added that there was poor medical management of the child's prolonged hypoglycaemia. - Baby 7 (Child G): The prosecution said Letby attempted to murder the girl by overfeeding her with milk and forcing air down her feeding tube. The panel said there was no evidence to support air injection into the stomach or overfeeding. The infant's vomiting and clinical deterioration was due to infection, it found. - Baby 8 (Child H): Jurors cleared Letby of one count of attempted murder and failed to reach a verdict on a second count. Prosecutors said the nurse sabotaged the girl's care in some way which led to two profound oxygen desaturations. The panel said the deteriorations were due to medical mismanagement of a tension pneumothorax where air is trapped between the lung and chest wall. - Baby 9 (Child I): The prosecution said Letby murdered the infant by injecting air into her bloodstream and stomach. The panel said it found no evidence of air injections and that the baby died of breathing complications caused by respiratory distress syndrome and chronic lung disease. - Baby 10 (Child J): Jurors could not reach a verdict on an allegation of attempted murder. No specific form of harm was identified by the prosecution but they said Letby did something to cause the collapse of the girl. The panel said the deterioration was caused by sepsis and there was no evidence to support malicious airway obstruction. - Baby 11 (Child K): The prosecution said Letby attempted to murder the girl by deliberately dislodging her breathing tube. Among its findings the panel said there was no evidence to support a dislodged endotracheal tube (ETT) and the clinical deterioration was caused by use of an undersized ETT. - Baby 12 (Child L): The Crown said the nurse poisoned the boy with insulin. The panel said the infant's insulin-related levels were within the norm for pre-term infants and there was no evidence of deliberate administration. - Baby 13 (Child M): Prosecutors said Letby attempted to murder Child L's twin brother by injecting air into his bloodstream. The panel said there was no evidence of air embolism and his collapse was caused by sepsis or a heart problem. - Baby 14 (Child N): The Crown said the boy was the victim of attempted murder by inflicted trauma in his throat and an air injection into his bloodstream. The panel said there was no air embolism and it was likely his blood oxygen levels dropped due to his haemophilia condition or routine cares, which was "exacerbated" by repeated attempts to insert a breathing tube. - Baby 15 (Child O): The prosecution said Letby murdered the triplet boy by injecting air into his bloodstream and inflicting trauma to his liver. The panel said he died from liver damage caused by traumatic delivery, resulting in bleeding in the abdomen and profound shock. - Baby 16 (Child P): Prosecutors said Letby murdered Child O's brother by injecting him with air. The panel said there was no evidence to support that mechanism and that he died from a collapsed lung that was "suboptimally managed". - Baby 17 (Child Q): Jurors could not reach a verdict on an allegation of attempted murder. The Crown said Letby attempted to murder the boy by injecting liquid, and possibly air, down his feeding tube. The panel said there was no evidence to support air injection into the stomach and the child deteriorated because he had early symptoms of a serious gastrointestinal problem, or sepsis. He testified that the nurse was seen standing over Baby K's cot as the infant's condition deteriorated. Taking the stand, the doctor said Letby failed to call for help as the newborn's condition declined, insisting the nurse had virtually been caught "red handed". But prior to the start of the police investigation, Dr Jayaram wrote in an email to colleagues: "At time of deterioration ... Staff nurse Letby at incubator and called Dr Jayaram to inform of low saturations." The revelatory memo appears to contradict previous testimony, with the evidence not making it into documents handed to cops before the start of the investigation. In the newly released email, Dr Jayaram also suggested Baby K's fragile premature condition was instead the cause of death, saying: "Baby subsequently deteriorated and eventually died, but events around this would fit with explainable events associated with extreme prematurity." The note sees him suggest that the baby's death was explained by issues associated with extreme prematurity. Appearing at the 2024 trial, the doctor framed her behaviour as suspicious, telling the court: "Lucy Letby was stood next to the incubator. "She wasn't looking at me. She didn't have her hands in the incubator." Asked by prosecutor Nick Johnson KC whether he had "any call for help from Lucy Letby?", he replied: "No, not at all. "I was surprised that the alarm was not going off, although my priority was (Baby K) and I didn't question it at the time.'In retrospect, I was surprised that help was not called, given (Baby K) was a 25-week gestation baby and her saturations were dropping." However, at the recent Thirlwall Inquiry, the doctor expressed regret at not raising the alarm over the nurse's behaviour sooner He explained: "I lie awake thinking about this ... I should have been braver." 6 6
