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Appeals court rules in favour of Bawa-Garba appeal

A court has ruled in favour of Dr Hadiza Bawa-Garba in her appeal against the controversial High Court case, which saw her struck off the medical register in January.

The ruling quashes the High Court's decision in favour of the GMC to declare Dr Bawa-Garba unfit to practise earlier this year.

The GMC had taken its own tribunal to court to overturn its decision to allow Dr Bawa-Garba to remain on the medical register following her 2015 manslaughter conviction relating to the death of six-year-old patient Jack Adcock.

But the Court of Appeal said in today's ruling that the Medical Practitioner Tribunal Service (MPTS) decision to suspend rather than erase was more appropriate.

Following the ruling, Dr Bawa-Garba is being restored to the GMC register and the MPTS will decide if further action needs to be taken.

The judgment read by Sir Terence Etherton, master of the rolls, said the decision ‘was not a decision of fact or law but an evaluative decision based on many factors’.

He said: 'The Court of Appeal sets aside the order of the divisional court that Dr Bawa-Garba should be erased from the medical regulations and restore the order of the tribunal that she be suspended from practice for 12 months subject to review.’

Commenting on the verdict, GMC chief executive Charlie Massey said: 'We fully accept the Court of Appeal’s judgment. This was a case of the tragic death of a child, and the consequent criminal conviction of a doctor. It was important to clarify the different roles of criminal courts and disciplinary Tribunals in cases of gross negligence manslaughter, and we will carefully examine the court’s decision to see what lessons can be learnt.

‘As the independent regulator responsible for protecting patient safety we are frequently called upon to take difficult decisions, and we do not take that role lightly. We are sorry for the anguish and uncertainty these proceedings have had on Jack’s family, Dr Bawa-Garba and the wider profession. This was a complex and unusual case; while the decisions we took were in good faith, we know that investigations and hearings are difficult for everyone involved.'

He added that the case 'has exposed a raft of concerns, particularly around the role of criminal law in medicine, which is why we have commissioned an independent review to look at how it is applied in situations where the risk of death is a constant, and in the context of systemic pressure'.

And said: ‘It has also been a lightning rod for the profession, highlighting issues that have gone unaddressed for far too long. While the GMC is not responsible for decisions to prosecute gross negligence manslaughter cases, we have reflected on what we can do to address the concerns we’ve heard about this case. Doctors have rightly challenged us to speak out more forcefully to support those practising in pressured environments, and that is what we are increasing our efforts to do.’

BMA chair Dr Chaand Nagpaul said today's verdict 'raises serious questions over the GMC’s ill-judged handling of the case' which 'caused widespread alarm amongst doctors and undermined the role of the MPTS'.

He said: 'We know that doctors going through MPT hearings find it stressful enough and the perception of a risk of double jeopardy can only exacerbate this problem. 

'Today’s judgement vindicates the BMA’s position that the MPTS is the right body to determine a doctor’s future in these complex and difficult cases, in which wider systemic pressures affecting patient safety need to be considered. It demonstrates that our call, acted upon by the Government, to remove the GMC’s right of appeal of MPTS decisions, was the right one. 

'It also raises serious questions over the GMC’s ill-judged handling of the case. As a regulator it has lost the confidence of doctors and must now act to rectify their relationship with profession.

'Lessons must be learnt from this case which raises wider issues about the multiple factors that affect patient safety in an NHS under extreme pressure rather than narrowly focusing only on individuals.'

He added that the judgement is 'a wake-up call for the Government that action is urgently needed to properly resource the NHS and address the systemic pressures and constraints that doctors are working under and which compromise the delivery of high-quality, safe patient care'.

Dr Chandra Kanneganti, BMA GP Committee member and chair of the British International Doctors Association, told Pulse that 'patient safety is the winner here'.

He said: 'The judge said that the [MPTS] tribunal looked at all the issues. It looked in detail about systemic failures, how to support Hadiza, how to get her back to training - they looked at everything - so they could not understand why she should not be back on the GMC register.' 

He added that the verdict will promote a 'good culture where everybody can reflect on the things that go wrong and try to learn from their errors, not blame each other for that'.

Dr Bawa-Gaba's appeal case

Dr Bawa-Garba was struck off the medical register after the High Court ruled in favour of the GMC in the case against its own fitness-to-practise tribunal in January this year.

James Laddie, the QC representing Dr Bawa-Garba, claimed at her appeal hearing last month that there were ‘systemic failings which contributed to the environment in which Dr Bawa-Garba came to make the mistakes which led us to this court’.

Dr Bawa-Garba had originally diagnosed Jack Adcock with gastroenteritis and failed to spot from blood tests that Jack had sepsis, or review chest X-rays that indicated he had a chest infection.

Following the initial High Court ruling, which caused an uproar from the medical profession, the Government has announced its intention to strip the GMC of the power to appeal MPTS decisions. However the GMC has said it will continue until legislation changes.

 

 

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Readers' comments (59)

  • Best news I've heard all year!!

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  • Took Early Retirement

    Me too. Sack Massey and all his running-dogs.

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  • The ruling appears to confirm that the High Court's judgement was based on incomplete evidence. The question now is whether sleeping dogs should be let lie or whether the criminal conviction should be appealed.

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  • Now who has the balls to sue the GMC for damages? Hopefully some money left in the pot!

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  • Lesson must be learnt heard this a lot before.Will Mr Massey do the honorable thing,bet he will fight it.What about the prof we he will not either.Mmmm lets see.They need to bui;ld bridge with the profession and reflect on the damage they have done.

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  • Took Early Retirement

    And, where would this poor woman be without £333k of crowdfundung? Answer- still struck off. The BMA didn't help her, I believe, it was down to us, her colleagues.

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  • Firstly great news for Dr Bawa Garba who has been treated absolutely atrociously by the legal system and the GMC.
    And some hope for the rest of us and for better patient care.
    Time for all the Hunt appointed sycophants to be shown the exit- current trends suggest they will not do the honorable thing left to their own selfish devices.
    The GMC as it stands is dead in the water. Nothing more than a bunch of government stooges hiding governmental underfunding and ineptitude by finding convenient scapegoats.
    Sue them into oblivion and start again.

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  • Massey's position is untenable.

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  • Hurrah.
    Massey resign or be sacked.
    GMC hands off independent Tribunal
    Hi would say that Dr BW should sue the GMC to get back lost earnings. however, it would be doctors paying for this.
    Doctors should not have to pay for an organisation who is there to protect patients. Patients should.

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  • "This was a case of the tragic death of a child, and the consequent criminal conviction of a doctor … We are sorry for the anguish and uncertainty these proceedings have had on Jack’s family …" - yet more emotive language from the boss of the GMC.

    The GMC needs to be clear whether it is a professional organisation that protects the public by supporting fitness to practice decisions based upon facts and fair risk assessments, or a political organisation with the power to punish individual doctors on the basis of popular opinion.

    Charlie Massey may "fully accept the Court of Appeal’s judgment", but he cannot stop himself from playing politics with peoples’ lives.

    In 2016, 1300 doctors signed a statement of no confidence in Charlie Massey. Surely it is now time for him to go.

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  • Government stooges

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  • Best News
    Good luck BG
    Sue them for your loss of Income at least!!

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  • Hearty congratulations to Dr BW and a great day for the profession. Time to cleanse the GMC and take those responsible for trying to scapegoat this young colleague.

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  • Always "learning lessons". This is a major error of judgement on the part of the GMC. In fact its hard to think of anything that could be worse. All responsible should resign.

    Nobody will though. They just plough on causing havoc. Answerable only to themselves.

    And no apology as yet for the previous witchfinding years.

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  • Thanks to the ill-made decision of the GMC the Adcock family and Dr Bawa-Gaba have all yet again had to endure more expense and suffering going through our yo-yo legal system.
    Now it is time for the GMC to be reassessed and brought into line. Their actions have been nothing short of shameful in the Bawa case (and Meadow 2005). Not only have they demonstrated incompetence and bad judgement, but they have also shown their arrogance in their decision to disregard the declared intention of HM government to repeal Section 40A of the 1983 Medical Act and will continue to appeal their own MPTS decisions as and when they choose. Doctors are rightly encouraged to look at and learn from their mistakes, but do the GMC? Have they learnt from the Williams Committee Report? NO. Do they really listen to the Profession ?? I wonder. Time for change.

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  • This verdict and the farce leading to the appeal demonstrates that the profession has no confidence in the Gmc. It is time for change in one of 2 direction; if the Gmc wishes to continue to victimise rather support doctors and wants to be an advocate for patient safety at doctors expense, then the profession should not be funding it. If however, heads roll and the Gmc becomes a responsible profession led self regulatory body balancing public protection, patient safety and doctors support, I would be happy to continue funding the organisation. I doubt the latter will occur however and neither will the lame BMA take a firm position on this.

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  • I sincerely hope this is a line drawn under this tragic and devastating death.
    It is a great pity the GMC appealed the tribunal decision and they have let down the medical profession by doing so in this case.
    There should be resignations of those responsible for this ill judges decision.

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  • How many more cases have there been like Hadizas ? It must be time to find out surely.

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  • Great news! I hope Dr Bawa-Garba can continue with her career.

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  • WHAT THIS LANDMARK TRIAL MAKES CLEAR IS THAT....SHOCK/HORROR....DOCTORS ARE HUMANS WITH RIGHTS TOO....ALTHOUGH THE DAILY NUTTER VIEWS US ALL AS "FILTH AND SCUM", THE LAW CANNOT OPERATE IN SUCH A MANNER.

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  • A disgrace that crowd funding was needed to get this outcome which was obvious to anyone reading through the facts of the case.

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  • It's good news and bad news. Good that the GMC's own Tribunal is proved right. Bad news that Bawa-Garba still carries a criminal record for manslaughter! Yes - I know what that the case was not about quashing the criminal conviction. The point is that the people who set up Bawa-Garba have gotten away scot-free! This is ridiculous!!

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  • as mentioned by some above:

    1) so many others have suffered the same fate-at least thousands of Drs and Nurses. The problem is ,as this case has demonstrated( and dr day's) ,that you have so many bodies that can inflict damage on you -Hospital trusts,deaneries,GMC,civil courts,criminal courts etc that its hard to know where to start.

    2) what no one is talking about is that if Dr Bawa Garba had lost this appeal what would have happened to her immigration status.Presumably in addition to losing her professional identity she would have been stripped of right to stay,had her passport marked,been rendered stateless and homeless,denied access to the very healthcare system she served and then finally been deported.

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  • From here on in, anyone who turns up for work where staffing numbers are not full and at least adequate should simply walk away as we are being potentially criminalised for doing our best in man made cuts, shortages, unsafe working etc. I remember the 72hrs of covering 6 wards on your own, afraid to ring the boss, registrar not available and being bleeped every 5 mins, here today only by good fortune or luck?
    . Now BMA grow a pair and support your Drs and as a GP safe working limits are also needed, we are not machines and no one is out there defending us (other than ourselves). Why are govt only interested in A&E? why do they not want to know how much we are all doing each day? Let's not let this tragic case not result in addressing the hell we are all having to work in. That way no other poor families will need to suffer due to human's trying their best in the mess of known but unaddressed system failures.

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  • Well done. I am very happy with the decision . Hadiza should be compensated for every thing she lost.
    Thanks to all those who helped with crowdfunding

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  • What wonderful news for her. Next stop - overturn her original conviction of manslaughter?

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  • This is the correct outcome, I feel so sorry for this doctor to have had to go this process to gain some semblance of british justice
    My belief in the British judicial system has been dealt a major boost, conversely, my belief in the gmc has been severely compromised

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  • Can’t believe this issue is still operating. I thought we’d long ago made the obvious connection between stupidly onerous working conditi9ns and medical errors. 1-in-2s etc? 80 hour weekend anyone? Try telling that to the general public of today; they won’t believe you!
    And yet in 2018, we still vilify a poor doctor for trying to work under impossible conditions and all of the individuals surrounding and causing this sad state of affairs are taking several paces backwards and hiding in the shadows. Where’s the supervising consultant? Nowhere to be seen or heard of. Where’s the management of the trust? None to be seen. Spineless cowards the lot.
    Unbelievable.

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  • Just what happens to individuals or organisations who TRY to play GOD. ONE DAY YOU WILL HAVE TO EAT THE HUMBLE PIE!!

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  • The moderator has also removed DS's comment asking questions re Enalapril. Why?

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  • Anonymous ex GP comment - removed. Why?
    What is offensive exactly?
    Moderator, answer please.

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  • Is PULSE also now slave to daily mail style public perception??
    Worrying.

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  • Took Early Retirement

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  • Thank you TER.
    As doctors we have opportunities and in my eyes a duty of care in medically educating our patients and parents but sometimes it seems "the system" rather prefers us to keep quiet at the dangerous expense of leaving them in the dark.
    Mentioning obesity and addiction - painful as it may be for them it is for us, too, as we risk complaints - are more examples.
    Not conducive to the adult-adult relationship we so ethically aim to achieve.

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  • Yet:

    Jack's mother Nicky Adcock said the verdict was an "absolute disgrace" that set "a precedent for doctors to do exactly what they like," pledging to fight the decision to the Supreme Court.
    (Sky news)

    Doctors doing "what they like"...

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  • Great news that Dr B-G has been vindicated. All doctors can sleep a bit better tonight. The hospital enquiry into this tragic death identified multiple system failures and 79 areas for change / improvement. Is there not a case for the senior management at Leicester Royal Infirmary to face a charge of corporate manslaughter?

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  • I wish some journalist had guts to ask the mum about role played by her action of giving enlapril to her son when it was not prescribed .
    I hope Dr Bawa sues GMC for loss of earning and mental anguish caused to her by their actions.
    Let doctors unite together and ask for GMC to be funded by patients as it aims to protects them and not doctors.

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  • Pradeep, I thoroughly agree with your first statement. One wonders if there has been an ACEI cover up here? ACEIgate?

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  • I wonder if Charlie Masseys ruddy complexion (which I am certain reflects regular brisk walking across windy hills) has become a deeper shade of red depicting a degree of embarrassment at the abysmal show put on by the organisation he represents.

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  • This case needs to be presented at all medical school interviews after asking A Level students the question: "Why on earth do you want to be a doctor?!"

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  • Great result. But now, every single Dr involved with the work of the GMC, from Appraiser to Council member needs to examine their conscience and ask themselves why they should not resign immediately.

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  • I am so glad that the justice has been served but it came as result of huge uproar with in the medical profession and caused a lot of anguish and suffering to dr BG.
    There is a fundamental problem with the role played by the GMC. While the GMC claims its role is to protect the patients it is not doing exactly that. If the whole system is unsafe and rotten then just picking the easy pray to hang them dry is absolutely cowardly and disgraceful. GMC should have balls to hold any hospital responsible and shut down the services if deemed unsafe to stop any mishap from unsafe practices such as in this case one doctor doing the job of 4 with no support on ground. The hospital management should have been put on trial for allowing a doctor to work in unsafe environment which led her to make mistake. I hope the pressure should be put on the GMC to stop persecuting well meaning doctors when they are forced to work in criminally unsafe environment. Best wishes to Dr BG.

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  • @Stupidity has many names.
    Absolutely spot on!
    The GMC has been negligent in protecting patients in this case because the Goverment poodles have deliberately ignored the root causes preferring to deflect blame and go for the low hanging fruit.
    Utterly abhorrent behaviour from the 'regulator' and I would like to see the individuals there hung out to dry so they know exactly what it feels like.

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  • medicine tastes awful

    re dr dongle

    As above. The mother seems determined to play doctor, to give him enalpril which ‘may’ be pivotal in his cardiac arrest as this preceded this cardiac event. The law in Medication administration apply- the care homes will not give paracetamol or any products unless is written and signed by a licensed prescriber only in the charts – so if this was not written and signed by a doctor – the rules of medication administration was violated by the parent. How much did this contribute to this sad outcome- greater than 50%?

    Nurses go by this rule that no medication is given unless is written and signed by a doctor- (period).

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