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The recent decision by the High Court in England to uphold the GMC’s appeal to remove Dr Hadiza Bawa-Garba from the medical register has caused a huge amount of uncertainty, fear and doubt amongst doctors.
We have all been asking similar, serious and troubling questions in the aftermath of this tragic case. I don't want to spend too much time on the specific circumstances – there is plenty of background to read here.
It is impossible to forget that, at its heart, this case concerns the death of a young child, and we must pause to reflect on that. None of us can imagine the grief that Jack Adcock's family must feel, particularly given the ongoing high-profile coverage.
It is precisely because this is such a tragedy that it is causing such concern among doctors. It is crucial that we learn from cases such as Jack’s and do all we can to prevent further deaths, yet the high-profile conviction and erasure of a doctor still in training is a threat to our still-nascent culture of open reflection, learning, and improvement.
Whilst our legal system in Scotland is different, what happened has shaken doctors – and our perception of the system in which we work – in the same way. Nikki Thomson, Deputy Chair of BMA Scottish Council, expressed that so eloquently in her recent blog on the subject that I simply advise you read it here.
For my part, I shall lay out the work that the BMA is doing in Scotland to represent and protect you, our members. Local meetings, as well as our network of representatives in every Health Board, have helped us to hear the concerns of colleagues from medical school through to retirement, and from the borders to the islands. Regular contact and additional meetings with the Academy Trainee Doctors Group, the Academy of Medical Royal Colleges, and NES ensure that we can put to them the views of our membership, make clear the effect that this case has had, and draw the profession together in a response. Finally, we continue to work with Scottish Government to explore their role in protecting and improving a culture of open learning.
We have met directly with the GMC and made clear that we believe they were wrong to pursue the appeal to strike Dr Bawa-Garba from the register. By doing so, they failed to give sufficient weight to wider system pressures and failings. The impact of the ruling will result in a huge step backward, towards a culture of blame and scapegoating of individual doctors.
The GMC’s successful appeal will not improve patient safety or promote reflective learning - it knows it has a long way to go to regain any trust from the profession.
There are three special meetings that have either taken place or are being organised across Scotland. Last Monday, more than 100 doctors from across the West of Scotland registered for our event in Glasgow to discuss and share their concerns and our response. Similar events are planned in Tayside and Dumfries and Galloway. We have also added a special session, with myself and the UK Junior Doctors’ Chair, to our Scottish Conference on April 21, which you can sign up for here. The strength of feeling raised amongst our profession was clear at our Glasgow meeting, and has been reflected across the UK, including the gathering of doctors in George Square at the weekend.
We know that it is important that you continue to hear from us on this issue and we will keep you informed of what we are doing, who we are meeting, and developments which affect you in Scotland – both face to face through the meetings I’ve highlighted, and electronically with emails to members and other media like this blog.
Since the verdict, some progress has been made – although we are clear there is much more to do. Following our discussions, the GMC has pledged to never ask doctors to provide their reflective statements if investigating concerns about them and to work with the BMA and the Academy Trainee Doctors Group on guidance on reflection.
The GMC has also agreed to work with the BMA and the wider medical profession to improve how doctors of all grades can register safety concerns about working in an under-resourced environment. This is clearly a key issue, and we will be looking at it closely in Scotland – in particular with a safe staffing bill due to come before Parliament in the next year.
We have also launched an online space allowing doctors to report to us their experiences and examples of how the system is preventing them from providing safe care. This is a place you can use to highlight the issues you face on a day to day basis, and will help support our calls for more resources and a better understanding of the serious issues underfunding creates.
You can also find updated guidance on our website on raising concerns, reflection notes and new legal FAQs on GMC fees and registrations.
I don't pretend for a moment that this blog will allay your fears – the situation is much too complex for that, and the ground we have to cover is still extensive. But I hope it gives you a sense of the action we are taking, and you can be assured that we will keep you updated.
Dr Adam Collins, Chair of BMA Scotland’s Junior Doctors Committee, writing for BMA Scotland
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