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Reaction: Dr Hadiza Bawa-Garba reinstated to the medical register

Read all the reaction to Dr Hadiza Bawa-Garba’s successful appeal against GMC court case

Charlie Massey, GMC chief executive:  

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.

Although gross negligence manslaughter cases in medicine are extremely rare, this 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.

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.

Dr Chaand Nagpaul, BMA chair:

We welcome today’s judgement of this important case reversing the erasure of Dr Bawa-Garba from the medical register and restoring the decision of the Medical Practitioners Tribunal. We recognise the hard work of all involved, including Dr Bawa-Garba’s legal team, in securing a positive outcome. The BMA was pleased to be able to intervene in this case on behalf of the entire medical profession. 

We hope that Dr Bawa-Garba will now rightly be given space to resume her career. 

Today’s successful appeal in no way detracts from the tragic circumstances of this case and the unexpected death of a young boy, and we once again send our deepest condolences to Jack Adcock’s family. 

The GMC’s successful high court appeal in January, which overturned the Medical Practitioners Tribunal’s (MPT’s) 12-month suspension of Dr Bawa-Garba and resulted in her erasure from the medical register, caused widespread alarm amongst doctors and undermined the role of the Medical Practitioners Tribunal’s Service (MPTS). 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.

Today’s 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 Rob Hendry, medical director at the Medical Protection Society (MPS):

We are very pleased the appeal submitted by Dr Bawa-Garba’s legal team has been successful. MPS supported Dr Bawa-Garba for seven years; we know how much this will mean to her, and to the profession. The strength of feeling on this case amongst our members and the wider healthcare community has been unprecedented.

It is vital that lessons are now learned to avoid other doctors having to go through the same ordeal. A gross negligence manslaughter conviction should not automatically mean that a doctor who has remediated and demonstrated insight into their clinical failings is erased. The removal of the GMC’s power to appeal MPTS decisions - a recommendation by Sir Norman Williams which was accepted by the Government - must also take effect quickly.

While we await the introduction of the necessary legislation, the GMC should publicly commit to stop using their power of appeal immediately. This would be a real statement of intent from the GMC as it seeks to regain the trust of the profession. Swift implementation of the William’s review recommendations, and timely completion of the GMC review led by Leslie Hamilton, will be key in rebuilding confidence.

Dr Chandra Kanneganti, BMA GP Committee member and chair of the British International Doctors Association (BIDA):

I think patient safety is the winner here. The judge said that the 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.

I think it’s a great judgement. This will encourage doctors, including our GP colleagues, to reflect more now, now that any error they may do, they have some support. We have a support culture not blame culture. This is a huge impact - not just nationally - internationally now because everyone is looking at us to see how this will go on. This will go on to become 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.

Professor Derek Bell, president of the Royal College of Physicians of Edinburgh:

We note today’s ruling and are pleased that Hadiza Bawa-Garba has won her Court of Appeal challenge. Looking ahead, it is vital that lessons are learned from this case. It is important to explore the wider issues that create the potential for patient harm, particularly understaffing. We must encourage an open and no-blame culture where the focus is on identifying and addressing risks and failures in systems of governance, and where all staff and patients are empowered to raise concerns over standards of care. Only by doing so can we ensure that we learn from cases such as this and prevent similar tragedies from occurring.

Sarah Harris, regulatory partner at law firm Kingsley Napley LLP:

Practitioners will welcome this decision, which raises further awareness that poor practice by doctors may well, in many circumstances, be partly attributable to systematic failings in the hospital setting.  With increasing cuts and under-funding, health practitioners will be pleased to hear that such factors are properly being considered by fitness to practise panels and that the Courts are supporting those panel decisions.

 

 

Readers' comments (20)

  • Time for the Heads to role at the top of GMC. The whole leadership must resign to gain the professions confidence. After all if we make error of judgement or worse a mistake we are hung high and dry by the GMC. So the GMC leadership should lead by example and resign.
    It is now time to debate publicly funded GMC.
    The current toxic work environment and increasing scrutiny and sanctions on the doctors is making all to work defensively and live in fear of complaints and investigations.
    It can not be an environment to develop and culture professionalism where one has to constantly watch their back for fear of complaints, mistakes etc.
    We certainly can not be the fall guy for the system failure and organisational failings. It’s time that the managers at CCG Hospitals should be held accountable for poor decisions.
    Finally BMA has to get behind the profession and not simply be a hogwash.

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  • Who is Massey answerable to? Seems like nobody

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  • I want to ask all my friends to rename GMC. for example
    PDC (persecute doctor council)I would welcome suggestions,

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  • The overpaid GMC officers should all resign for gross career slaughter
    I wold resign if I were one

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  • Good judgement
    Happy about verdict.
    At last, Justice is done.
    GMC needs a radical change.

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  • 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 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.

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  • If Dr BG could be accused of manslaughter, now that we understand the context of her working conditions better, isn’t there a case of corporate manslaughter against her employer?

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  • GMC should reflect on this entire episode.
    NHS is under-resourced and under-doctored-Systemic failings will continue-GMC role must adapt and improve.

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  • BMA as our supposed union should be representing our interest a whole lot better.In an under-doctored,underfunded dangerous health care system presiding unopposed over a decade or more of underinflationary increases in renumeration,and unopposed cuts in funding the service far from protecting the service and represent those who pay suscription,the BMA ineptitude has made the service more dangerous and unstable and is alienating more and more Drs from the establishment.WE NEED ANOTHER UNION.

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  • Third world health service; first world expectations.
    Judged and punished as if working in ideal conditions, when the actual situation is anything but.
    When you do CPR the first question you ask is, “Am I safe?”
    When you turn up for work, you need to ask, “Are these conditions safe to work in?”
    Anyone employed by the practice should walk out if they feel at risk of being blamed and punished for the consequences of excessive workload, and inadequate support.
    As for partners, I’m afraid you put yourself at risk by continuing to hold a contract which makes you responsible for doing the impossible.

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