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GMC successful in High Court bid to strike off junior doctor

The GMC has won a High Court bid to have a junior doctor struck off the medical register, against the decision of its own tribunal.

The Medical Practitioner Tribunal Service decided in June last year that erasing trainee paediatrician Dr Hadiza Bawa-Garba from the register would be ‘disproportionate’ and recommended a 12-month suspension instead.

But the GMC disagreed and told the High Court in December that she should be struck off 'to protect the public' after her actions resulted in the death of a six-year-old boy.

The case sparked anger within the medical community, with hundreds of doctors writing to the GMC to voice their concerns that its actions would lead to ‘criminalisation of clinical error’ and worsen patient safety

In the judgment handed down this morning, the court ruled that Dr Bawa-Garba’s original sanction of suspension should be replaced with a decision to remove the doctor’s name from the medical register.

Lord Justice Ouseley said: 'I come firmly to the conclusion that the decision of the Tribunal on sanction was wrong, that the GMC appeal must be allowed, and that this Court must substitute the sanction of erasure for the sanction of suspension.

'The Tribunal did not respect the verdict of the jury as it should have. In fact, it reached its own and less severe view of the degree of Dr Bawa-Garba’s personal culpability.

'It did so as a result of considering the systemic failings and failings of other, and then came to tis own, albeit unstated, view that she was less culpable than the verdict of the jury established.'

The Medical Protection Society, which represented Dr Bawa-Garba, warned that the case would have worrying implications for doctors.

MPS medical director Rob Hendry said: 'The outcome of the GMC’s appeal against the Tribunal decision on this case is disappointing and its implications will understandably be of concern to the healthcare community.

'This challenge was brought by the GMC following their recently acquired right to appeal - a power which we opposed on the basis that it creates an unnecessary and unjust duplication of the Professional Standards Authority’s function.'

The MPS argued that 'while the criminal courts dispense justice - including punishment - the regulator’s role is to protect patients'.

Mr Hendry said: 'When considering whether a doctor is fit and safe to practise every case must be assessed on its own merits and should not be solely determined by the criminal sanction handed down by the court. Gross Negligence Manslaughter cases are usually complex, involve systems failures, and are devastating for all concerned. A conviction should not automatically mean that a doctor who has fully remediated and demonstrated insight into their clinical failings is erased.

'This appeal decision may jeopardise an open, learning culture in healthcare at a time when the profession is already marred by low morale and fear. We are considering all options in the interests of our member and the wider profession.'

GMC chief executive Charlie Massey said: 'This has been a tragic case; a family has lost their son in terrible circumstances and a doctor has lost her career.

‘In today’s ruling the court has confirmed that the Tribunal was simply wrong to conclude that public confidence in the profession could be maintained without removing the doctor from the medical register.'

Dr Bawa-Garba was a registrar at the Children’s Assessment Unit at Leicester Royal Infirmary on 18 February 2011, and the most senior doctor on the shift, when a six-year-old child with sepsis died. Dr Bawa-Garba continued to work at the hospital trust up until she was convicted of manslaughter by a Crown Court Jury in November 2015.

The MPTS said in a June 2017 hearing however, that erasing Dr Bawa-Garba from the GMC register would be ‘disproportionate’, that her actions were neither ‘deliberate or reckless’ and that she did not ’pose a continuing risk to patients.’

Mr Massey said: ‘The ruling clarifies that tribunals cannot go behind the jury’s verdict when a doctor is convicted in a criminal court.

'As the ruling makes clear, the Tribunal were wrong when they decided to suspend the doctor’s registration because in doing so they "reached their own less severe view of the degree of Dr Bawa-Garba’s personal culpability" than was established in the criminal court; which found that Dr Bawa-Garba’s failures that day were not simply honest errors or mere negligence, but were truly exceptionally bad.

'The judgment also found that the Tribunal did not give the weight required when considering the need to maintain public confidence in the profession.

‘We know the strength of feeling expressed by many doctors working in a system under sustained pressure, and we are totally committed to engendering a speak-up culture in the NHS. Doctors should never hesitate to act openly and honestly if something has gone wrong.’

 

Readers' comments (78)

  • Is this not "double jeopardy?"

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  • I feel that this is a disaster for the Medical Profession. The decision may be correct in law, but will be immensely harmful for doctors. We are not machines, but culpable human beings. If we are honest, most of us learn by making mistakes, hopefully not tragic ones like this. This judgement seems to put public confidence in the Medical Profession ahead of whether this doctor is a danger to that public, which the vast majority of the medical profession agree she is not. I am glad that I have just retired!

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  • In Summary:
    When asked to 'help out' when the system is failing (like this doctor covering for a missing colleague) JUST SAY NO!

    When asked to work harder to keep patients out of hospital because beds are full, just say no.

    When asked to prescribe medication instead of a patient getting it from a consultant, just say no.

    When asked to perform pre-referral tests to help secondary care, but you are not an expert in the field so cannot interpret them as well as a consultant, just say no.

    It's simple. I think I might start doing that and highlight this case in the reasoning.

    Apologies in advance for anyone working in my local A+E who will have to see patients who turn up having left hospital without the right tto drugs.

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  • Disgraceful This doctor now bears the full weight for a Trusts failings

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  • Could this challenged in the high court on appeal?
    Crowd funding would be needed (can’t see the BMA stepping in).

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  • The laws an"Ass".
    The jury where never put in the position on knowing the truth, and the whole truth, adn the multiple failings of the Trust, so came to an incorrect verdict.
    Even if the verdict was correct; does not a doctor have the opportunity to remediate, ever??
    Practice of medicine in this country has become much more risky, and in the NHS unacceptably so.
    Many doctors put themselves out to try and do the best for patients, good, but only the patients infront of you. Dont try and "save the NHS", dont concern your self that patients may not be seen, you will not be thanked.
    Oh except GPs, our contract says we must see every one who wants to be seen, regardless. An impossible position to be in.

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  • MPTS should now be liquidated as it can be overridden meaning it is a waste of time and resources. GMC has usurped the role of a dictatorial organization bringing regulation of doctors to the brink of anarchy. Sad day for Doctors, there's no hope left. Even murderer's get parole - a Doctor is not entitled to slightest reprieve. Her ethnicity did not help either.

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  • This is depressing.

    But I have to agree with @ Obi | GP Partner/Principal25 Jan 2018 12:30pm, this is what it will have to come to. You will not get rewarded for going above and beyond but severely punished if things go wrong.

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  • gmc for patients only. we just pay their wages

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  • The MPS said, “They are considering all options.”
    Let’s hope if they can appeal this they will.
    I fear that if a dr is covicted of manslaughter the GMC have successfully argued that it is this which means a dr is struck off. The law is wrong it appears in this case, if this is the reasoning. It may mean the details were not a concern of the GMC in this instance. I think they maybe be simply saying, “The Law is the Law.” This is wrong.

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