The doctors and nurses were in charge of ward four at the Grantham and Kesteven general hospital and the Independent has learnt from sources close to the inquiry that the consultant paediatricians Charith Nanayakkara and Nelson Porter are held at fault for the 58 days during which the serial killer was at large.
Sister Barbara Barker, a specialist sick children's nurse, and Moira Onions, a midwife made nursing manager, have also been criticised by the inquiry team. However, last night colleagues and parents of Allitt's victims said the inquiry appeared to have sought individual scapegoats for the deaths and brain damage wreaked by Allitt.
All four will be given the opportunity to respond to the report's allegations before it is finalised over the next few weeks. But their medical colleagues and the parents said yesterday that they feared the final report could divert blame from senior health service managers and the shoestring budgets that they believe caused the tragedy.
According to a Trent Regional Authority report on the hospital's staffing levels, there should have been double the number working on the children's ward with at least five more doctors.
Allitt, 25, received 13 life sentences last year for numerous attacks on her patients after she began work in February 1991 as a nurse at the Lincolnshire hospital. She was appointed only because of a shortage of nurses, and a shortage of funds which meant better qualified nurses could not be hired.
Virginia Bottomley, Secretary of State for Health, appointed an inquiry chaired by Sir Cecil Clothier QC, whose report is expected next month. The parents and health service organisations have been critical of her refusal to hold the inquiry in public. Parents giving evidence to Sir Cecil told the Independent they feared a 'whitewash'.
'We were not asked any questions, just told to say what we wanted to say,' one parent said. The three-member inquiry team did not include a paediatrician, an omission that led the British Medical Association to complain privately that Dr Nanayakkara and Dr Porter were not being judged by their peers and that no specialist paediatric evidence was submitted.
The BMA said yesterday that the association was 'appalled' by the burden of blame the doctors could be asked to carry.
Anticipating the Clothier conclusions will be critical of staff, three leading medical experts will lend public support on Thursday to Dr Nanayakkara and Dr Porter. They will criticise the inquiry for failing to ask pertinent questions about staff numbers, and hope an eleventh-hour revision of the Clothier team's conclusions will be possible.
Among the experts will be David Southall, an authority on Munchausen's syndrome by proxy, the compulsion to inflict injury so as to give medical care that is believed to have driven Allitt.
Unison, the health service union representing most nurses at the hospital, also fears nursing staff, including Sister Barker and Mrs Onions, will be made scapegoats. 'Our concern is that criticism will be deflected from more senior management,' Bob Quick, the union's regional official, said yesterday.
It has been claimed that Dr Nanayakkara was suspicious of the death of Liam Taylor, aged seven weeks, Allitt's first victim. He tried without success to persuade the Grantham coroner, Thomas Pert, to order a specialist post-mortem examination that could have established that the baby had been killed.
The hospital could not appoint a permanent pathologist because of a bureaucratic logjam, and mistakes were made in post-mortems.Reuse content