“I am a horrible evil person… I AM EVIL I DID THIS.” These were nurse Lucy Letby’s own words, written on a piece of notepaper found by police investigating the deaths of babies on her unit. “I don’t deserve to live. I killed them on purpose because I’m not good enough to care for them.”
Lucy Letby is a serial killer, the most prolific child murderer of modern times in the UK; her name now forever associated with the likes of other medical monsters such as GP Harold Shipman and nurse Beverley Allitt. She is also one of the most prolific female serial killers in British history, alongside the likes of Rose West and Moors murderer Myra Hindley.
In pictures taken at work and socially, Letby, 33, is smiling, carefree-looking, apparently happy. You might describe her as someone who looks “nice” or “kind” or “friendly” or like a million other young women, about as far-removed as you could get from the image of a serial killer that would spring to mind for most.
The motivation behind such an horrific killing spree, taking the lives of tiny babies who didn’t stand a chance, is unfathomable – even to some experts who have spent years profiling murderers.
Dr Sohom Das, a consultant forensic psychiatrist whose work takes him into prisons and secure hospitals such as Broadmoor, says Letby doesn’t fit any “typical” killer profiles. Having assessed several women who have killed babies – usually mothers – he also says most are usually driven by psychotic beliefs.
“I’ve seen at least two or three patients who have had delusional beliefs related to schizophrenia, for example, where they believe children are marked by the devil, that they’re somehow saving them from hell or damnation,” he tells Sky News. “Lucy Letby doesn’t fit into that category. I’ve also met serial killers and they tend to be antisocial, angry, they tend to have a long criminal history of violence. Again, Lucy Letby doesn’t fit that kind of motivation.”
Beverley Allitt: ‘Angel of Death’
Dr Das describes the case of Beverley Allitt – the nurse known as the “Angel of Death” who murdered four babies and attempted to kill others in Grantham, Lincolnshire, in 1991 – as “eerily similar” in terms of how the children were attacked. Letby injected air into babies’ bloodstreams and overdosed them with insulin, as did Allitt.
However, he does not believe the motivation to be the same. Allitt drew attention to the babies being ill, he says, and wanted attention herself, while Letby did the opposite.
“[Allitt] had Munchausen by proxy – when someone fakes illnesses in other people, usually their own kids, because they like to be connected to the process of ‘being victims’, they like the empathy and sympathy,” he says. “I don’t think Lucy Letby fits that pattern because she wasn’t trying to seek attention.”
One theory put forward by the prosecution during her trial was that Letby “sabotaged” the care of one baby boy – one of two triplets she murdered – to get the attention of a doctor she had a crush on.
But Beatrice Yorker, a professor emerita of nursing and criminal justice and criminalistics at California State University in Los Angeles, agrees it does not appear as if the nurse was seeking attention.
She highlights the case of Richard Angelo, a nurse who was convicted of killing four patients and suspected of causing more deaths in New York in 1987. “When they arrested him… he admitted it. He said, ‘I do it for the respect that I get from my nursing and doctor colleagues because I perform very well in a code’ (cardiac arrest)…
“I haven’t read anything about Lucy Letby that indicates she wanted to be the centre of attention, that she enjoyed resuscitation of the infants. She seemed much more clandestine and deceitful. Kind of sadistic, maybe.”
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7:12
‘They could have stopped her’
Professor Yorker, who has studied more than 130 cases globally of health professionals who kill, says one motive, if not attention, “seemed to be… an act of covert violence or sadism” as the perpetrators found themselves in a position of power.
“They realise that you don’t have to bludgeon somebody, you don’t have to shoot somebody. It is a very powerful way to kill somebody, just to give them a few extra drops of a substance that can make their heart stop. And you don’t even have to prick them with a needle, you inject it into their IV line. That’s a lot of power for people who might have a propensity to kill people or injure people or be violent in a very, very covert way.”
‘Dr Death’ Harold Shipman
Harold Shipman is one of the UK’s most notorious serial killers. A GP in Hyde, Greater Manchester, he was convicted in 2000 of murdering 15 people between 1995 and 1998, but is suspected to have potentially killed as many as 250 between 1975 and 1998.
He had a “God complex”, says Dr Das. “It was like he was deciding whether to let people live or die, almost like mercy killings.” But rather than having a God complex, he believes Letby suffers from low self-esteem and self-confidence, related to depression and anxiety.
“This kind of offence is so rare anyway, but of the times that it has occurred there are so many typical pigeonholes and criteria and oddly to me, Lucy Letby doesn’t fit into any of them,” Dr Das continued. “So to answer the question, what is the motivation? It’s really hard to actually know. When people do things like this and don’t fit into those categories, it’s usually out of some sort of jealousy or some sort of anger.”
One of the lines in the note by Letby found by police, which was shown to the court during her trial, said she had an “overwhelming fear… I’ll never have children or marry… I will never know what it’s like to have a family… despair”.
“I think at a stretch you could say she was jealous of these happy families,” says Dr Das. “I think maybe [an explanation could be] that she is somehow connected potentially to the emotional process of grieving. She was present when a lot of these babies died, sometimes when they weren’t even her patients, it’s almost like she went out of her way to be part of that. And that’s something I’ve never heard of or seen in my clinical experience, but it’s the only logical answer I can come to.”
Murders by medics not as rare as you might think
Image: Elizabeth Wettlaufer confessed to murders in Canada
In the UK, Shipman is the most well known medical killer, but in recent years there has also been Allitt and others – such as the case of ‘Devil Nurse’ Victorino Chua, who was jailed for life with a minimum of 35 years in 2015, for the murder and poisoning of patients at Stepping Hill Hospital in Stockport, Greater Manchester.
After the Letby verdicts were made public, Cheshire police confirmed they are now investigating whether the nurse could have attacked other children in her care before June 2015.
Professor Yorker says that while killers in the medical profession are rare, her research suggests there may be more than those we know about.
She highlights the “sobering” case of Canadian care home nurse Elizabeth Wettlaufer, whose crimes were only uncovered when she told someone she had been murdering and attempting to murder her elderly patients over a period of nine years.
“She would not have been caught,” Professor Yorker says. “She never did it long enough or enough to raise an index of suspicion where you go, okay, we had five deaths a year and now we’ve got 20. She would just do enough to keep it below the radar of the statisticians and risk managers who look at records and incidents of critical patient incidents and deaths.”
One question raised by Letby’s conviction is about her motivations for becoming a nurse – did she enter healthcare in order to kill? Or did this “dark side” develop only once she had started?
Dr Katherine Ramsland, an expert in serial killers who teaches forensic psychology at DeSales University in Pennsylvania, has seen both cases. “It’s a mix,” she says. “Some view healthcare agencies as places of trust where predators have advantages, others are worn down by the demands and decide to ‘reduce’ the workload or set someone up to make them look bad.”
Some can also develop “a delusional belief that they’re helping a patient”, while others see “easy prey for things like theft or self-empowerment, or even thrill,” she adds.
Is Letby a psychopath?
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Letby’s police interview and arrest
A psychopath is someone with an antisocial personality disorder, according to the NHS. This means they are manipulative, lack empathy, and often have a total disregard for the consequences of their actions.
Dr Jane Carter Woodrow, a screenwriter and member of the British Society of Criminology who has written several books about murderers and serial killers, says it would be hard to argue against this in Letby’s case. “How could she not be to be able to do those things,” she says. “It’s the most cowardly act of all killers, [to kill] a child or an elderly person.”
Dr Carter Woodrow says that “once you’ve crossed that line” and “murdered for the first time, I think it gets easier. And you see she feels emboldened as time goes on and the cases kind of escalate, particularly towards the end”.
The fact Letby pleaded not guilty also shows psychopathic traits, she says. “She could have pleaded guilty and not put the parents through this terrible trauma again. She could have spared them all these details they’ve had to sit through.”
During the trial, the jury heard how Letby told one mother, “Trust me, I’m a nurse”, as she killed one baby. She also sent a sympathy card to the parents of another she had murdered.
“I think this was about power,” says Dr Carter Woodrow. “Saying, ‘trust me, I’m a nurse’, all the time knowing what she was going to go and do… it’s like somebody with a card up their sleeve that they’re almost laughing about.”
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CPS on Letby’s ‘darker side’ behind ‘angelic smile’
But Dr Das says Letby should not necessarily be classed as a psychopath. “Psychopaths are impulsive, they lack empathy, they don’t care about the rights of other people, they’re very self-serving, self-centred. You could argue she’s all of those things but crucially, a psychopath is really manipulative and deceitful.
“A psychopath does almost everything for a reason, to benefit themselves. So if somehow killing these babies furthered her career, I suppose you could argue at a push that she was a psychopath. But it doesn’t seem like there’s any logical motivation. She’d have some psychopathic traits but I don’t think she’d be a clinical psychopath.
“Psychopaths are also criminally versatile, so a good psychopath can be violent, they lie and they manipulate. They’re often quite fraudulent and they commit other types of offences like robbery, speeding. She never did any of that, she didn’t have any kind of criminal history, there’s no history of aggression. So she just wouldn’t fit into the pattern of what a true psychopath is.”
Dr Das adds that he does not believe Letby is suffering from psychosis and that she knew what she was doing. Dr Ramsland agrees: “She doesn’t seem psychotic, so she would likely have some sense of her behaviour and the way society evaluates it. Whether she would feel remorse is a different question.”
‘High shame, high denial’
The note written by Letby is an example of “high shame, high denial”, says Professor Yorker, something which applies to “child abusers, paedophiles who act out on their interests, and healthcare killers – and it applies to addiction”.
The 12 steps of Alcoholics Anonymous include a step to take each day at a time, she says, because “you can’t cure these high compulsive addictive disorders – you can only deter them or get into recovery where you take it a day at a time. You just say, for this day, I’m not going to act on my urge to drink, or my urge to binge and purge – or my urge to kill.”
While Letby’s note suggested she was admitting the crimes, her denials in court showed otherwise. But Dr Das says it shows “that on some level a part of her does actually feel remorse”. He continues: “People can commit horrible crimes and still feel guilty. In fact, serial killers, especially disorganised serial killers, often battle with this internal kind of conflict, so they feel compelled to go out and kill but they also feel at times guilty of their actions as well. But whatever that part is, it obviously wasn’t present enough for her to tell the truth during a criminal trial.”
Is there any chance someone like this could be rehabilitated?
Dr Ramsland says this would depend on their motivation and psychological state at the time. “Sometimes, healthcare workers are depressed or stressed, so they harm patients as a way to relieve stress or feel empowered. In that case, medication and therapy could assist to improve their behaviour. If they’re highly predatory, however, they’re unlikely to respond well to treatment.”
The difficulties detecting healthcare killers
Image: Serial killer and former nurse Charles Cullen murdered patients over 16 years
In 2022, the story of US serial killer Charles Cullen was dramatised in the Netflix film The Good Nurse, starring Eddie Redmayne and Jessica Chastain.
He killed patients over a 16-year period and eventually admitted to 30 to 40 murders, but the true number is thought to be closer to 400 – which would make him the most prolific serial killer in US history.
Letby started working at the Chester hospital’s neonatal unit just before her 22nd birthday – around four years before the start of the allegations in the trial – and colleagues raised suspicions more than a year before bosses contacted the police.
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Professor Yorker says such crimes by healthcare workers may take longer to uncover than say, those by serial killers who stab their victims, as they are usually not as obvious until numbers start stacking up. “We can’t predict, we can’t know why somebody that has antisocial tendencies would cross the line to do this. It makes it really hard to detect.”
Another reason for delays in catching healthcare killers is that society is conditioned to believe certain groups of people are “good”, she says. “For example, the Catholic priesthood, the Boy Scouts. We as a society have been in denial for years where we think really good, upstanding citizens like a Catholic priest or a Boy Scout leader could possibly be molesting children.”
This conditioning can be even higher for women, as women make up such a small percentage of killers, she adds. “This is a feminine form of abuse, even though there are quite a few male doctors and male nurses who engage in healthcare serial killing. We as a society recognise masculine forms of violence – bludgeoning, shooting, stabbing, strangling, raping, those kinds of acts are overtly aggressive. What we as a society do not recognise are the covert or the feminine forms of violence – smothering, injecting, poisoning.”
And while people may think serial killers or psychopaths might stand out, Dr Carter Woodrow says it is often the opposite. “It is not really a question of looking different. It’s looking the same as everyone else – and that’s how you fool people.”
The first thing you notice when immigration officers stop a possible illegal moped delivery driver is the speed in which the suspect quickly taps on their mobile.
“We’re in their WhatsApp groups – they’ll be telling thousands now that we’re here… so our cover is blown,” the lead immigration officer tells me.
“It’s like a constant game of cat and mouse.”
Twelve Immigration Enforcement officers, part of the Home Office, are joining colleagues from Avon and Somerset Police in a crackdown on road offences and migrants working illegally.
The West of England and Wales has seen the highest number of arrests over the last year for illegal workers outside of London.
“It is a problem… we’re tackling it,” Murad Mohammed, from Immigration Enforcement, says. He covers all the devolved nations.
“This is just one of the operations going on around the country, every day of the week, every month of the year.”
Image: Murad Mohammed, from Immigration Enforcement, says his team are attempting to tackle the issue
Just outside the Cabot Circus shopping complex, we stop a young Albanian man who arrived in the UK on the back of a truck.
He’s on an expensive and fast-looking e-bike, with a new-looking Just Eat delivery bag.
He says he just uses it for “groceries” – but the officer isn’t buying it. He’s arrested, but then bailed instantly.
We don’t know the specifics of his case, but one officer tells me this suspected offence won’t count against his asylum claim.
Such is the scale of the problem – the backlog, loopholes and the complexity of cases – that trying to keep on top of it feels impossible.
This is one of many raids happening across the UK as part of what the government says is a “blitz” targeting illegal working hotspots.
Angela Eagle, the border security and asylum minister, joins the team for an hour at one of Bristol’sretail parks, scattered with fast food chains and, therefore, delivery bikes.
Image: Border security and asylum minister, Angela Eagle, speaks to Sky News
She says arrests for illegal working are up over the last year by 51% from the year before, to more than 7,000.
“If we find you working, you can lose access to the hotel or the support you have [been] given under false pretences,” she said.
“We are cracking down on that abuse, and we intend to keep doing so.”
There are reports that asylum seekers can rent legitimate delivery-driver accounts within hours of arriving in the country – skipping employment legality checks.
Uber Eats, Deliveroo, and Just Eat all told Sky News they’re continuing to strengthen the technology they use to remove anyone working illegally.
But a new Border Security Bill, working its way through Parliament, could see companies fined £60,000 for each illegal worker discovered, director disqualifications and potential prison sentences of up to five years.
“I had them all in to see me last week and I told them in no uncertain terms that we take a very tough line on this kind of abuse and they’ve got to change their systems so they can drive it out and off their platforms,” the minister tells me.
For some of those who arrive, a bike and a phone provide a way to repay debts to gang masters.
There were eight arrests today in Bristol, one or two taken into custody, but it was 12 hours of hard work by a dozen immigration officers and the support of the police.
As two mopeds are pushed onto a low-loader, you can’t help but feel, despite the best intentions, that at the moment, this is a losing battle.
The officers who confronted the Southport killer have described, for the first time publicly, how they disarmed him – as they joined a list of 70 officers nominated for a police bravery award.
Sergeant Greg Gillespie, 42, PC Luke Holden, 31, and PCSO Tim Parry, 32, were the first to arrive as Axel Rudakubana rampaged with a knife through a holiday dance school last summer.
Speaking to Sky Newsabout what they saw when arriving at the scene, Sgt Gillespie said: “There was maybe 20 or 25 adults and all of them were looking at me, all of them have this look of terror and fear, panic on their faces and I knew whatever it was we were turning up to was really, really bad.”
His colleagues drove fast from Southport police station and were thirty seconds or so behind Sgt Gillespie.
Image: PC Luke Holden (left), PCSO Tim Parry (centre), Sgt Greg Gillespie (right) nominated for the police bravery awards
PC Holden said he saw “a large puddle of blood on the floor outside the door” and said Sgt Gillespie “just looked at me” and asked if he was ready.
“That was it, there was no conversation. There was nothing else going on. He said, ‘Are you ready?’ and I said, ‘Yeah, let’s go’.”
PCSO Parry, who doesn’t carry a baton or pepper spray like his colleagues, went to the back of the building to stop people from entering, help anyone who needed it, and get information on the number of suspects inside.
He said: “It was a horrific scene to really go into because I was so unprepared with the equipment I had.”
Sgt Gillespie and PC Holden identified the suspect at the top of the stairs, a bloodied knife in his hand, and walked towards him shoulder to shoulder.
“I saw him, made eye contact with him, saw his facial expression, saw his body language and the way he moved himself into a position at the top of the stairs, showing us he had a knife,” Sgt Gillespie said.
“He was fronting us, like he was saying, ‘I’ve got a knife, what are you going to do about it?’
“And I think the second he realised he was looking at two people who weren’t scared of him, who were going to attack him, all that bravery that he must have summoned up to attack defenceless children, he lost that straightaway, and he threw down the knife.”
In January, Rudakubana, who was 17 at the time of the attack, admitted the murders of seven-year-old Elsie Dot Stancombe, Bebe King, aged six and Alice da Silva Aguiar, who was nine, as well 10 charges of attempted murder, as well as possessing terrorist material and production of the biological toxin, ricin.
Image: A machete was also found at Rudakubana’s home. Pic: Merseyside Police
Dozens nominated for bravery awards
The Merseyside trio are among 70 officers from around England and Wales who have been nominated for tonight’s Police Federation national bravery awards.
They include two sergeants from Sussex who swam to the rescue of a vulnerable teenager struggling to stay afloat at night off Brighton beach.
Image: Footage of Sergeant Craig Lees and Sergeant Matthew Seekings rescuing a woman from the sea in Brighton. Pic: Sussex police
Police with torches had located her in the sea fifty metres from the shore, but a lifeline they threw to her didn’t reach.
Sergeant Craig Lees said: “We could see that she was starting to struggle with the cold and tide, and she began to dip under the water. We knew we needed to do something, and that was that we needed to get into the water and swim out to her.”
His colleague and friend Sergeant Matthew Seekings said: “I don’t think it’s in the blood of any police officer to watch somebody at risk or somebody needing help and not do something.
“When you’re in the sea, it’s pitch black, you don’t even know where the bottom is, it’s terrifying, and I can only imagine how the female was feeling.”
Image: Sergeant Craig Lees and Sergeant Matthew Seekings who are nominated for a bravery award. Pic: Sussex police
Battling their own fatigue, the two officers managed to get the girl to shore, where colleagues and paramedics were waiting to take over.
In Devizes, Wiltshire, PC Nicola Crabbe was called to a town centre fight between two men, one of whom had a knife.
Image: PC Nicola Crabbe from Wiltshire police who is nominated for a police bravery award
‘Just saturated in blood’
“They were grappling, and they were just saturated in blood,” said PC Crabbe, who confronted the man she thought was the knifeman.
“I was in the middle of the road when I grabbed hold of him, and there was a member of the public just there, and that’s when he explained to me that I had the wrong person.”
Image: CCTV image of PC Nicola Crabbe from Wiltshire police dealing with a fight in Devizes. Pic: Wiltshire police
Armed only with a baton and Pava pepper spray, she grappled with the suspect, trying to find his knife.
She said: “At one point he grabbed my hair and kind of dragged me around a bit, so I Pava’d him which just had no effect at all.”
PC Crabbe managed to restrain the knifeman until colleagues arrived and arrested him.
The full list of award winners will be announced on Thursday night during a dinner at a west London hotel.
A group of Labour MPs has urged Sir Keir Starmer to do more to tackle the rising cost of living amid fears the party could lose the next election to Reform.
The MPs are launching a new splinter group, the living standards coalition, to shift the focus to everyday concerns such as food, energy bills and housing.
In a letter to the prime minister, the group’s members warned that one question would be on the mind of voters at the next election: “Did this Labour government make me better off?”
“After 14 years of living in a no-growth economy and with some of the highest bills in Europe, our constituents are struggling to make ends meet,” they said.
“More of them are turning away from democracy and towards populism as they can’t afford a decent life.”
The coalition is the latest splinter group to form since the party’s landslide election victory a year ago.
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Other groups include the Labour growth group, which focuses on delivering economic growth, and MPs in Red Wall constituencies in the North who are alive to the threat Reform poses in their seats.
While the MPs stress they are supportive of the actions the government has taken so far, the forming of a new group could be interpreted as a sign of restlessness in the parliamentary party, especially given the fallout of last week’s botched welfare vote.
In the letter, first reported by The Guardian, the MPs write: “We are here to support your efforts to go further and faster on raising living standards. We come from every corner of our party.
“To raise living standards, we support government interventions that will help to increase incomes and lower costs.
“We welcome interventions that will raise incomes. We welcome investment in labour- intensive building, education, and healthcare jobs that will raise living standards through employment. We welcome the Employment Rights Bill that will get wages rising.”
They added: “We know that some will try to stop us raising living standards.
“They will try to block us from building the affordable housing and windfarms we need to get bills down. They oppose the way we have raised revenue from the very wealthiest to invest in childcare and our NHS.
“We are glad you are keeping this government’s focus on raising living standards. We stand in support of you. It is the most important issue to our constituents and the country.”