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Following the January 2018 High Court ruling in the case of Dr Hadiza Bawa-Garba, there was an outpouring of anger and concern from the medical profession. The case has been subject to so much debate, with particular concern focusing on the huge pressures in which doctors’ work and their fears of being blamed and punished for factors outside their control. In August, following a further appeal supported by crowdfunding and with legal interventions by the BMA and others, the High Court’s ruling was overturned, paving the way for Dr Bawa-Garba to re-enter clinical practice.
The outcome of this appeal signalled the end of a lengthy legal process for Dr Bawa-Garba, although there are still hoops to go through before she can return to practice. This however, doesn’t mean that the concerns that spoke to so many doctors are resolved. This case has also shone a light on so many wider, underlying problems that we as the BMA must continue to work hard to address. This blog lays out the work that we are continuing to take on to address concerns and make improvements for our profession.
We are working to ensure that appropriate support for doctors returning to training are in place, addressing the negative culture of bullying and harassment, supporting doctors who raise concerns about unsafe practice and improving how we share concerns about training environments.
We are also pushing to prevent the criminalisation of medical errors and for changes to the role of our regulator, seeking legal protection for doctors’ written reflections and tackling racial inequality in the health service.
Workplace culture has an impact on patient safety and doctors working lives. We know that our members are working under intense pressure and many are working in bullying environments. As a result, their wellbeing and mental health suffers. Rates of burnout are higher than ever before. We’re taking forward important work to address these issues with a three-year bullying and harassment project (due to finish this year), which aims to improve and create a more supportive working environment. You can read more about the project here and find guidance on how to address bullying and harassment in your workplace here. BMA President Dinesh Bhugra is driving forward a project on wellbeing. In addition to the work listed below on raising concerns, our member relations staff can support individual members in helping them raise concerns.
The junior doctors committee has worked with the CQC to offer junior doctors the opportunity to contribute to its regulatory activity, allowing them to raise concerns directly. CQC has introduced an annual junior doctor focus group which will invite feedback on issues such as staff engagement workplace culture and morale. You can read more about this here.
Returning to training
Returning to training after time out of practice is a challenging process. We know that time out may impact upon skills, knowledge and confidence – so to better support doctors who return, we have:
Sharing and raising concerns
To improve how we share concerns about training environments, and supporting all doctors to raise concerns about unsafe practice, we are:
GNM, culpable homicide and the remit of the GMC
Many doctors remain unhappy with the GMC’s decision to appeal the sanction handed down by the Medical Practitioners Tribunal. The recommendations (accepted by Government) of the Sir Norman Williams rapid review of gross negligence manslaughter (GNM) in healthcare supported the BMA’s call to:
We have also called for these changes in our submission to the GMC’s independent review into GNM and culpable homicide, and in our evidence to the Health and Social Care Select Committee inquiry into GNM and patient safety.
But we must go further, as without openness and the ability to learn from our mistakes there is a risk we will practice medicine more defensively and fail to fully reflect and thereby learn from our mistakes. As such, we have also:
Tackling racial inequality
A concern that has rightly received recent attention is the high proportion of cases investigated by the GMC against black and minority ethnic (BME) doctors. The reality however, is that the problem is far worse. Racial bias in the treatment of BME doctors is a long-standing problem throughout our health service, and referral numbers to the GMC from employers suggests a significant disparity between doctors from BME backgrounds and white doctors.
This prejudice is brought into sharper focus by the apparent lack of difference in referral numbers between locally trained doctors from BME backgrounds, and those trained internationally. To help tackle racial inequality in the health service, the BMA:
Our vision for the future
Given the profession’s genuine concerns following the Dr Bawa-Garba case, and the current perilous state of the NHS, there has never been a more important time for doctors to come together to develop a positive vision for the health and care system. That’s why the BMA recently launched 'Caring, supportive, collaborative: a future vision for the NHS' – a project which aims to be an honest conversation about the sort of NHS in which doctors want to work.
As this work takes shape the BMA and we as your junior doctors committee will continue to work with government, employers, training bodies and our regulator to bring about a system in which all doctors have the support, resource and confidence to do the best they can for each patient.
Jeeves Wijesuriya is chair of the BMA junior doctors committee.
Apologies, although a lot of work is going into doctors being supported and the blame GMC underwent for suspending Dr Bawa garba, if a reflextive root caue analysis was done of where the problem started, it would probably lead to a joint enterprise between children services and which ever hospital departments to maliciously damage this doctors progress.
After all, This particular hospital provides a useful comparator in terms of the Mc Cann Case where doctors were involved, a child died but the LA just claimed " resonable parenting". arguably the cricumstance are stighly different for the doctors but it was the same hospital and LA who did the serious case review which usually happens when a child dies.
So infect GMC actions are a result of process abuse by social care?....
My wife is a hospital doctor in a "high risk" environment. To avoid stress and problems , we have simply reduced her working hours from 48 to 40.
The wider problem is that Britain 's social and professional circles reflect what was happening in the American racial inequalities in the 1960's civil unrest.This is a black young doctor who was professionally "lynched".
She's not the first, nor the last, but given GMC has taken owenership of this case, who is to be the " Martin Luther King" or the "Kennedy" to fix this?
I have followed Dr Bawa Garba 's situation with interest over time . She is senior SpR. My problem is her consultant . Who on earth is he/she ? . Why were they not defending her
If the country is in no better a state that 1960's america it is probably time to go to the high court to get orders to put the unemployed ethnic minority doctors who the managers make all excuses not to employ .Excuses such as " the work has run out or decreased" should not be an excuse to prevent ethnic minority doctors getting access to work and put MAPS who are being paid higher rates in those roles...
After all the Americans did it in 1964 to ensure diversity in education.- court order to put blacks in college......
Really Good information. Thanks https://www.bma.org.uk
THE PRESENT SUSPENDED SENTENCE MUST GO APPEAL. THE FOLLOWING MERITS OF CASE ARE STILL OUTSTANDING.
A)This is the same social services and the same Trust that dealt with the Mc Cann case. Doctors dealing with a child that is now absent/dead.
If there was no guilty verdict for the McCann parents , no guilty verdict for HBG
b)if the Downs syndrome MRI death Giuseppe Ulleri
had no individual to blame and is a trust issue- the same for leicester Royal Informary
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Interesting stuff to read. Keep it up.