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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)

  • I hope this event will galvanise our profession against the evil forces at work (GMC,NICE,CQC to name but 3). This event clearly outlines the sexist, racist soul destroying nature of GMC for doctors working in a failing system. I hope the nonsense behind the failing system also become clear. This may be a turning point in the same way the reaction to Trump may bring back respectful politics. Lets be clear about the villains and be positive for our future

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  • What I've learnt from this is that there's no such thing as goodwill anymore. If you take on more than you can cope / usual duties - it is your fault for doing so.
    The next time the hospital / manager / other colleagues ask for help - use this case as the example of why you are not able to help out.

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  • What about the unauthorised dose of Enalapril that was mysteriously given to the boy an hour before he died that this doctor did not know about? What about all the arguments in her defence by the paediatricians in an open letter recently? This is unfair and everyone above is correct to state that we have to say no to extra unsafe work from now on. Also how come we can;t take Hunt et al to court over the 100 extra deaths PER day due to this Govt's policies and underfunding of the NHS and Social Care? I just hope there is something here about the case that we are not being told that explains this otherwise we are at the end game.

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  • Turn out the lights--you say Scumbag racist/sexist establishment......Action is needed BMA.
    Don't hold your breath on last one. BMA is not list racist sexist or whatever you call it
    As far GMC is concerned:-GMC needs to change the slogan to:-'Don't give damn about the patients and screw the doctors'. Wrote to GMC telling this. Got reply 'did not want to reply to my letters in future. "The doctor was not one us" like ex chancellor Osborne's brother there you have it

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  • Disgusting story, makes me very sad. Makes a total mockery all that we do.
    If this doctor is at fault then so is the Trust that placed her in this position of hopeless workload. I trust the GMC will take the trust’s responsible adults to the cleaners as well. Fat hope of that.

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  • Shameful act by an organisation of complete self interest.

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  • Am still waiting for the gmc to get back to me to tell me how and who decided to appoint Charlie Massey!

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  • This unfortunate Dr has been scapegoated for the systemic failures of the hospital where she worked. This could happen to any one of us, in many hospitals.
    As for class and ethnic bias, compare and contrast how this Dr has been treated with the case of the young medical student in Oxford who stabbed her boyfriend whilst intoxicated with drugs and alcohol.

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  • The failure of the BMA to speak out about the injustice suffered by this young Dr is inexcusible. Even Jeremy Hunt has tweated his concerns. SHAME ON YOU BMA.

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  • Vinci Ho

    Putting aside the sentimentality as a result of this verdict, I would want to discern the facts from this matter like this:
    (1) The original indictment was manslaughter . And I would be surprised the label was anything other than involuntary manslaughter (in contrast to voluntary) because this was criminal negligence with no intention of committing murder(mens rea) . She had served for her sentence for manslaughter but the question left was whether she could carry on practising medicine or not?
    (2) The legal challenge from GMC was the Medical Practitioner Tribunal Service’s recommendation of 12-month suspension was incorrect and she should be removed from the GMC list to protect the public . According to Lord Justice Ouseley, her personal culpability carried so much bearing in causing death of the patient that she would be a harm to the public if allowed to carry on practising .
    (3) Here is the appetite for an appeal to Supreme Court: Does this personal culpability in this involuntary manslaughter (with no intention to murder) equate to the immediate conclusion that she would be a harm to the society if she was to be allowed to practise medicine after some other sanction(s) ? The 12-suspension was incorrect . What about 24 , 36 , 48 months etc suspension instead? Are the current criteria to judge whether she would be a harm to society practising more medicine ,being properly challenged in court? If John Worboys , the black cap rapist convicted of 19 serious sex crimes, was allowed to be released after 9 years and now being confirmed as no threat to the public , the sanction(s) on this doctor’s career cannot be a permanent one.
    (4) Would be essential to know if there are previous case references to refer to in the legal literature. But , otherwise , this case will set a new example and reference for future cases , which is exactly what MPS was concerned of.

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