This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

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.



Related images

  • High Court - legal - Royal Courts of Justice - RF

Readers' comments (59)

  • 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?

    Unsuitable or offensive? Report this comment

  • 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.

    Unsuitable or offensive? Report this comment

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

    Unsuitable or offensive? Report this comment

  • 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.

    Unsuitable or offensive? Report this comment

  • 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?!"

    Unsuitable or offensive? Report this comment

  • 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.

    Unsuitable or offensive? Report this comment

  • This comment has been removed by the moderator

    Unsuitable or offensive? Report this comment

  • 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.

    Unsuitable or offensive? Report this comment

  • @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.

    Unsuitable or offensive? Report this comment

  • 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).

    Unsuitable or offensive? Report this comment

  • In the UK the only time the GMC ever goes after a white British doctor is when he/she deliberately goes out to kill patients. If you’re not white british the GMC will unleash the dogs of hell to come out and get you regardless. BME doctors should emigrate to countries where they will be valued and respected for what they do and not treated as criminals.

    Unsuitable or offensive? Report this comment

  • The advice by Mr Ivan Hare, a barrister who is favored by the GMC has caused more damage than is possible to doctors. The fees paid to him with our subscriptions is sinking us as a profession! He was involved with Michalak and now with this case and many others.

    Forget Mr Massey - his sweaty responses show that he is out of his depth and under control of the barristers.

    We should focus on where our subscriptions are being spent. As forensic accountants say - FOLLOW THE MONEY. The barristers like Mr Ivan Hare are milking us.

    Unsuitable or offensive? Report this comment

  • Re enalpril

    According to last nights Panorama, the mother suggested that he had not had his evening dose.

    It was not written up by Dr B.

    The nurse talked to Dr AN other who seems to have said that it was ok for mother to give it.

    Subsequent arrest/ collapse of child.

    The nurse was also convicted of manslaughter, and I believe struck off.

    Unsuitable or offensive? Report this comment

  • This child was given enalapril by his mother.

    Unsuitable or offensive? Report this comment

  • Panorama says clearly that the mum RECALLS to ask A nurse who then asked Another doctor who said yes give it...
    Why haven't we heard of this other doctor in this whole saga? Has anyone heard of him/her before?
    Wouldn't he/she ALSO be on trial or at least have been mentioned more consistently?
    I encourage everyone watching last night's Panorama and make up their own minds.
    To me it also sounds like a cover up and if it is then the shocking truth is that no doctor is ever safe as the public just have to claim something which then counts as evidence.
    What really got to me on an emotional level was the photo of Hadiza's proud family on the day of her graduation.
    What a beautiful shot!

    And her tears.

    Unsuitable or offensive? Report this comment

  • Another complete disgrace in my opinion is the case against nurse Amaro.
    Everyone should read the CHARGES AS READ-NMC against her. A completely biased statement.
    I fully understand Isabel Amaro's reasoning and wonder if another "protect your own" mechanism is at work here.

    Unsuitable or offensive? Report this comment

  • I just shudder to think what this poor doctor has been through. Very very few of us would have had the guts to keep going. I wish her all the best for the future.

    Unsuitable or offensive? Report this comment

  • My suggestions
    1. GMC needs to write a reflect on their role publicly.
    2. Freedom of information act to compel GMC to make know the total funds used to pursue this case.
    3. Government and doctors need to consider if the current funding from Doctors of GMC is appropriate, ... a case of doctors funding both sides of court case is inappropriate.
    4. Someone needs to take responsibility of patiently explaining the to Adcock family, as I feel there may be a communication gap that after almost 7yrs of going through all the facts they still strongly feel Dr Bawa-Garba was individually largely responsible for the death of their son.
    5. Reorganisation of the GMC needs to considered for them to effectively perform their role.

    Unsuitable or offensive? Report this comment

  • Good that sanity prevailed in the end. Now people tried to crucify her for an error in her line of duty working alone under unimaginable pressure. If they would have had their way, she would be buried 6 ft under by now. (I wouldn’t wish that even on my worst enemy). Now all these people- the GMC heroes of patient cause ( paid for by doctors ) who were involved in overturning their own tribunal decision , the judge and lawyers who accepted the GMC appeal and wrongly convicted her initially , the NHS Trust who put her in that vulnerable situation , the other people who contributed in any way in undermining her position either clinically by giving Ill-timed medications ( I do believe ein this case, deterioration was unusually sudden and the Enalapril angle is crucial- hats off to Dr Garba for not pursuing that although it is her best defence) etc or by calling for her head - have all seriously failed in THEIR line of duty. They should be now facing as serious consequences as her or actually worse because they acted wrongly in spite of the privilege of having lots of time, mountains of evidence both documentary and as provided by extremely intelligent and learned lawyers, other professionals. Nobody will have the decency to accept their mistake ( as humbly as Dr Garba did) and resign. All these individuals should be named, sacked and put behind bars and face disciplinary action first from their own regulatory bodies and then the courts. If you want to be operated by a surgeon whose hands shake at fear of legal consequences and possible ruined life on the slightest mistake, that’s your choice, but implement same consequences for any profession. Just because the nature of our profession (day in and day out !!) means any error causes morbidity or mortality doesn’t mean we will be crucified for an error while lawyers who mess up cases of their clients and lose, judges giving wrong judgements which are later overturned or lead to unnecessary suffering of human lives, politicians misguiding public, taking wrong decisions - likes of Nigel Farage , Boris Johnson, who lied to the entire nation, influenced Brexit votes and then disappeared from the scene when things turned sour etc etc should all face dreadful consequences which should shame them publically and ruin their personal & professional lives. Honestly, I don’t want that, neither for them, nor for the doctors. We are all humans and can make errors.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say