You will probably all be aware of last week’s High Court ruling regarding Dr Hadiza Bawa-Garba following the tragic death of a 6-year-old boy in 2011. As doctors we strive to provide the best possible care for our patients, and so in this instance where such a catastrophic outcome has occurred we can only express the deepest possible sympathy for the family.
Dr Bawa-Garba was involved in the child’s care at time of the incident. As the doctor held responsible for the outcome, Dr Bawa-Garba was subsequently convicted of manslaughter and suspended from the GMC register by the Medical Practitioners Tribunal Service (MPTS) in 2015 for a year. The GMC appealed the MPTS decision arguing for Dr Bawa-Garba to be erased from the medical register, and the High Court last week ruled in favour of the GMC. The relevant Trust where Dr Bawa-Garba worked has acknowledged systemic failures which contributed to the events that day.
This entire episode raises wider issues about the GMC’s approach to such cases – this includes its decision to appeal a judgement reached by the MPTS, the lack of adequate consideration of systemic failings, concerns regarding gross negligence manslaughter law as it affects doctors and the impact of using personal reflective learning material which could be used as evidence against doctors.
This ruling has also brought into sharp focus the difficult and pressurised environment in which doctors now work. A climate in which many doctors feel fearful and vulnerable, as they are forced to work without the support, colleagues or resources to provide safe, let alone high, quality care.
I understand many of you may be feeling deeply worried and uncertain following this ruling, including about recording of reflective learning or how and when to raise concerns regarding working under pressure. The profession is right to demand clarity and certainty as a matter of urgency. Without this we run the risk that doctors will practice medicine more defensively, be less open and fail to learn and improve from experiences. This would have the perverse effect of undermining patient safety and is why we are seeking direct answers from the GMC and others.
Like many of you, I believe that the greatest risk to patient safety is an under-resourced, understaffed NHS which is forcing doctors, nurses and all healthcare staff to work under the most challenging of conditions. Can it be safe to manage patients in corridors without the facilities they need in a hospital bed? Can it be safe for patients who should be admitted in an emergency to suffer ambulance delays of several hours? Can it be safe to work within an environment of perpetual rota gaps? Can it be safe for GPs to spend just 10 minutes with patients with complex co-morbidity of 4 or more problems? Sorting out such examples of serious system inadequacies is what government and regulators should prioritise in their responsibility for safe patient care.
I want you to know that the BMA is here to support you as doctors.
We are urgently seeking to address all the implications that have arisen from this case. I have set up a working group comprising of chairs of all BMA branches of practice, and BMA chairs of all nations, since this is an issue that affects all doctors, working in all environments, across all four nations. We are taking forward the following actions:
I will continue to keep you updated on this matter in the weeks ahead – and I would like to assure you that the BMA is taking the issues extremely seriously and is committed to addressing the questions and concerns this case has brought up.
Chaand Nagpaul is chair of BMA council
Read the news story on the ruling
The GMC is an organization dedicated to undermining the medical profession and perversely threatens patients.
Weak and bland.
There are no winners here. The family have had their lives changed forever. Dr B-G has had her career shattered despite being in an unsafe situation with more variables than was possible to negotiate.
It seems fairly clear that the only winners are the lawyers. With a heavy heart but the knowledge of how the NHS is run I have no hesitation in steering my children away from medicine and into law. Engaging with people, listening, understanding and wanting to support and 'help' seems increasingly to be safer away from the NHS and GMC should anything not go to plan - and any increasing lack of IT, senior support or juniors would be unlikely to end lives or careers.
I could not agree & second all the comments left here. We are in the profession that saves lives. Long shifts, running on empty for hours, insufficient support, & not allowed to make a mistake is the name of this profession. If we do make a mistake we are encouraged to “reflect” on it & when needed our regestering body uses the same notes to incriminate us of manslaughter going against the tribunal.......
All this is when its an individual.
B_G case has not highlighted but is crying out loud of the failure of the system, none of the others palyers in the team are being asked any questions. No. Nothing. You can go!
But hey there you, come here lets put all this on you!
I do think of this case to be hiding more that what has come to our knowledge.
I agree with the comment that a painter is jujding the car electrics!
Also exposes the mindset of GMC & guess who pays for that!
BMA is the only union we have. Its role & purpose is as complex as the profession it serves. But I would feel ashamed & humiliated if Dr. B-G has to resort to “Crowdfunding” to find justice & strongly ask the BMA Council Chair to mobilise BMA for an independent legal team.
We as a community have very little to explain to our children when they ask what happened to this doctor, if they are considering a career in Medicine
If it was any other Workers Union, would we have had the same response. We need prompt action.
GMC should be funded by tax payer like any other government body . I just can’t undersatnd why in this day and age we need such a body when half the NHS is privatised and half heading towards privatisation
BMA has a role to stand with doctors and should ask the government to fund this charade.
Like junior doctors strike, nothing will come out of this
Someone out of BMA will do a shambolic deal and come out with a compromise
This poor doctor will be forgotten soon
All doctors have a short term memory and we will all be hunky dorry in a few months
If BMA fails on this occasion
It is worthless and I will definitely cancel my membership
No use paying such a huge amount
The GMC have no concern for doctors, they are the reason we practice defensive medicine because theyve created a culture of fear. With the GMC I feel like it doesnt matter if what you done was right or wrong, they will always find a way to make you appear guilty, as in the case above they ignored all the failures of the hospital and basically put the entire blame on one doctor.
perhaps its about time we all just unite and refuse to pay them. if such a movement is created ill be the first to join.
So if the pause in CPR to check the boys identify was judged as having no bearing on the outcome i.e. the child would have died anyway why would everyone be making such a fuss? That does not add up and it not my understanding of what happened.
I agree that doctors are treated far more harshly than virtually every other profession but there must be more incriminating evidence about this particular doctor - otherwise surely this is complete madness?
I do agree with the comments above.....”the only winners here are the lawyers”. I have been involved in two legal cases through no fault or wrong doing of my own, a prolonged coroners court case and a child abuse case. I was made to feel guilty and as though I was in the wrong.l spent weeks and weeks of sleepless nights, went through everything I had been responsible for over and over and worried hugely about our processes in the practice. I had to be out of work for days on end paying for locum cover . My legal teams from the defence union were involved for weeks on end. We had some meeting with 4 doctors involving up to 9 legal representatives (barrister, solicitors, legal assistants and secretaries- not a cheap afffair). It absolutely astounded me when I realised judgements were being made and we were being represented by people with very little understanding at all about medicine let alone an understanding of what it is likebeing a doctor, how things are processed in the hospitals and general practice and how we make thousands of decisions and judgements every single day. The coroner was fixated on minute nitty gritty that from a medical perspective you could see had no bearing on outcome and astonishingly totally bypassed things that screamed out to me as a practitioner. I’m left with a feeling of disappointment and dismay.
I cannot imagine what Dr B-G has been through. I hope she has the strength to get on with her life away from medicine and enjoy it.
BMA appears to be failing to provide support to its members when required as evidenced in this case. Action after the damage is done. I would be surprised if any one expects BMA to provide meaningful support.
Highlighting the issues is never going to be enough.
Another addition in BMA in the list of its failures.
The underlying dichotomy makes no sense. Either we are being misled and not availed of all the facts given to a jury where 10 of 12 felt that one individual doctor was responsible for causing a death. Or the jury was misled and asked to measure her practice against unrealistic and unobtainable expectations. The only way to resolve this is to ensure the public we serve draw the same conclusions that we do as professionals when examining circumstances as tragic as the death of a child.