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The medical profession has been rocked over the last week by the case of Dr Hadiza Bawa-Garba.
This distressing case has raised serious issues, about our day-to-day practice, our relationship with the GMC, the huge pressures we work under, and many others. We’re taking each concern very seriously.
Many of the anxieties raised around the case are being tackled by the BMA, and we are determined to continue this work to ensure that no doctors find themselves in a similar position to Dr Bawa-Garba. I have personally contacted Dr Bawa-Garba, with the support of the entire association, offering her, and her family, support.
Yesterday I had a meeting with GMC chief executive Charlie Massey and other senior GMC figures. The Junior Doctors Committee submitted case studies of concerns raised by themselves and BMA members. These were used to highlight a system beyond breaking point, and the inadequacy of the current guidance for doctors on these issues. We were very clear about the anger, frustration, and most importantly fear that has spread throughout the profession, due to issues brought into sharp focus by the GMC’s recent actions.
Assurances we have received from the GMC to date include;
Also this week we have spoken to many others with concerns about this case, including the Academy Trainee Doctors Group, The Academy of Medical Royal Colleges and Health Education England. We will be working further with them in the coming weeks. The JDC Deputy Chair for Education & Training will be attending the Conference of Postgraduate Medical Education Deans, where we will be discussing issues around reflection for both doctors and appraisers.
Doctors are understandably angry at recent events, and have been keen to take a stand against such deplorable behaviour from our regulatory body. We’ve put together a Q&A for doctors who are thinking about resigning their GMC registration as a personal protest against its decision to appeal the High Court to have Dr Bawa-Garba’s name erased from the medical register, a move not without significant risks.We’re working with the BMA’s legal and policy teams, who have been analysing the case. We’ll be flagging and updating advice and guidance as necessary. There’s much information already out there and we’ll soon have a dedicated page on our website, so you can go to one place for updates. We have updated the practical steps in our raising concerns guidance to better consider the ongoing problems with systemic pressures.
A crucial issue raised by this case is about how doctors are supported after returning from long periods of leave, such as maternity leave or Out of Programme Experiences. We have been working with Health Education England on the Supported Return to Work project following the ACAS agreement in 2016 which has provided £10 million a year in new investment to improve the return to work process. In addition the BMA has guidance on returning to practice after prolonged absences and a BMJ learning module on returning to work.
These are just a few of the many steps that the Junior Doctors Committee are doing to improve our working lives. While the focus and attention is rightly on the tragic case of Dr Bawa Garba the committee we also continue to work on Study Budgets, the ARCP Review, Rota Gaps, Rostering Guidance, Bullying and Harassment, the Gender Pay Gap and preparation for the 2018 review of the 2016 Terms and Conditions for Junior Doctors, amongst many other things.
Doctors deserve to work and train without fear of losing their livelihoods, owing to pressures beyond our control. We deserve clear guidance from those with the power to damage or end our careers, and we must fight for the no-blame culture that we know keeps patients and doctors safer. I know that one or two meetings, and this blog will not end the fear and anger which is sweeping the medical profession.
The Junior Doctors Committee will continue to make clear to government, employers and our regulator that until we move to a blame free culture, resource and staff the health service properly, the fear, anger and disillusion will not end.
The JDC and the BMA will not stop until we have straight answers and meaningful actions to address the concerns raised not just by this tragic case, but by day-to-day experiences in the NHS.
Jeeves Wijesuriya is chair of the BMA junior doctors committee
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I fully endorse Jeeve's excellent work on this. I have no wish to be pedantic, but the BMA has been criticised for being slow off the mark in support of this doctor. To be fair, at the time of the incident, was she a BMA member?
Any concerns about staffing or equipment standards must be advised to the patients when informed consent is sought. Patients must be given 'all the information necessary to make a decision'. And that includes knowing of 'issues'. That's the GMC ethical requirement.
Write concerns on the consent form to ensure concerns are recorded (unless a manager gives a written order a doctor is not to do so), but do not resign, and do not cease 'reflecting'.
Time to stop paying the compulsory fees to the GMC, and to rethink their funding and role.
Time for the government to stop promising a NHS gold standard service , given that it has underfunded for years.
I am incensed by this case. I have made a number of mistakes over the years, and have seen a lot of poor care related to institutional and system failures. There but for the grace of God .
GMcK GMC 2843447
Fortunately I had to take I’ll health retirement from General Practice but you all have my full support.
When I came back from maternity leave, they announced on my first day back that I was on call - new hospital, new rotation and I hadn’t worked for 8 months. It was incredibly stressful. There was no process at all in situ - it’s high time this is properly sorted out to help both doctors and patients stay safe and feel supported. I hope the BMA can produce something that forces trusts to properly address this.
Is anyone else concerned of the wording:
"A commitment that it will never ask a doctor to provide their reflective statements if investigating a concern about them"
So the gmc won't ask the doctor to provide their reflections, but would have no issue asking the trust to provide them and to use them as evidence. Really doesn't settle any fears held by myself or other students.
This case is so tragic. I have no special insights into what Dr. Bawa-Gaba may be did, or did not, do. But there appears strong circumstantial evidence that major system failures set her up to fail. The contrast between the way this matter has been handled by the police and our regulators stands in stark contrast to the approach in aviation when there is a serious untoward incident. When there is an aircraft accident a report is prepared completely independent of the process of attributing blame. Anyone who has read a UK AAIB report cannot fail to be impressed about the level of detail considered.
All our jobs were becoming increasingly 'undoable' anyway and to now find that we may be held personally and legally responsible for chronic system failures is, for me, the last straw. At nearly 59, and after 23 years of front line care as a consultant in T&O, I am so looking forward to tendering my resignation later this year. How sad to feel I am leaving in this toxic environment.
New hospital next week, and I'm starting on nights. What could possibly go wrong?
But what is being done to reinstate Dr Bawa-Garba?
The GMC had very large numbers of options on Bawa-Garba, to "make the public safe".
For example, restrict practice away from acute work or paediatrics, retrain, non-hospital work etc etc
There own panel recommended a different course of action.
But they chose the most severe sanction possible.
Being struck-off by the GMC resonates round the world, limiting her ability to register in Canada, Australia, Nigeria, South Africa etc
When given so much power, Wisdom demands it to be used justly.
The judge gave a suspended sentence, but GMC insists it can never be spent
I am worried about non medical related cases that have happened to doctors and they are being investigated by GMC. Doctors being suspended because of convictions which do not necessarily concern their practice. I feel all these need to be discussed. BMA needs to support all its doctors.
have you read Terence stephensons e mail.
I don't think they get the point made here!!
Actually they do not want to!
There should be stronger action . We need the press and the public on our side to hear our story......
How do we get them to sit and notice....
Who was responsible for the rota and staffing, what about responsibility for the IT failure? Surely these systemic failures meant responsibility for this tragic outcome should be shared by others in the Trust? How was a Reflective Practice document ever considered appropriate to be used as evidence in court? We can be pretty confident no High Court Judge has ever been in the position this trainee doctor found herself in. What was she have supposed to have done, downed tools and gone home? What were the GMC doing appealing their own decision? Dr Bawa Garba is a scapegoat who has been hung out to dry on the flagpole of political expedience by those cowards at the GMC.
This is excellent. I appreciate his work.
Bma, GMC or royal colleges.. I see all preach and no action. All political statements. Very good piece by Jeeves but i need to know what is Bma’s position on this. Was she negligent or not? If so, what was her mistake so other members can learn a lesson. If she was not neglegent, then (provided she was a bma member when the incident happened) i would like to know what is being done to get her re-instated.
Make no mistake doctors, this needs to end NOW, otherwise this case could (and surely would) be used as a precedence in all future neglegence claims.