Few can have followed the Lucy Letby reporting without jaw-dropping amazement. That a nurse can cold-bloodedly murder and harm some of the most vulnerable in our society is astonishing. That her senior management rejected calls from senior clinicians to investigate her defies belief.

This whole, tragic, episode raises all sorts of questions. I don’t have the answers to them all, but I have a lot of concerns.

The first is the accountability of NHS managers. Here at the Worcestershire Acute Hospitals Trust, I have seen 5 or 6 managers since becoming Wyre Forest’s MP in 2010. That’s roughly one every two or three years. Just as they get their feet properly under their desks, and start to understand the organisation they run, they move on. Importantly, they are not here long enough to be accountable for their period in office. So, with an NHS-wide cycle of unaccountability of managers, how can we be sure the NHS is being run properly? Conversely, the head of Hereford and Worcestershire Health and Care Trust has been in office (across some changes) since 2010, so there are exceptions.

The second is whether we have too idealistic a view of those who work in the NHS. It is unquestioningly the case that the vast majority of those in the NHS are highly dedicated to their work. But we know there are bad people. In 2022 there were nearly 700 murders in England and Wales. Assuming each one was a victim of a different murderer, then that implies one in every 85,000 of us is a murderer. With 1.3 million people working in the English and Welsh NHS, that statistically implies the NHS has 15 people who might be murderers in just one year alone. Of course, I’m not for a moment suggesting that the NHS is full of murderers, but if the system demonstrated by Lucy Letby’s employers is widespread, then the apparent default position of those in control is to believe junior people over clinical experts. Something is appallingly wrong.

Finally, I have been searching my memory and notes to see if there has ever been anything like this highlighted to me, with regard our local NHS services. I can’t find anything that has given me cause for concern over my past 13 years. That’s not to say there isn’t always room for improvement, but I can say with confidence that here in Worcestershire, I have never seen anything like the Lucy Letby case.