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Gold, incentives and meh

GP leaders instruct GPs to stop written reflections in light of Bawa-Garba case

GP leaders have declared they have no confidence in the GMC, following the recent case of Dr Hadiza Bawa-Garba.

At the LMCs Conference in Liverpool today, LMC leaders also called on the BMA to advise GPs to ’disengage from written reflection in both appraisal and revalidation’ until new safeguards are put in place, with the chair of BMA Wales warning that royal colleges have been asked to submit their members’ reflections to the GMC.

They voted in favour of the motion that said it had ‘no confidence in the GMC as a regulatory body’, despite BMA leaders warning against the motion.

The GP Committee warned that it would harm the relationship with the regulator.

As part of the same motion, conference agreed to lobby the Health Select Committee to review the GMC’s conduct in the case, with proposer Dr Zoe Norris arguing that GPs cannot rely on a review a commissioned by health secretary Jeremy Hunt.

Dr Norris, chair of the BMA GP Committee’s sessional subcommittee, said: ‘GPs have lost all confidence in the ability of the GMC to be objective and to genuinely balance patient safety against the reality of being a doctor in the modern NHS.

’When you after your 14 hour day in your eighth month of working a partner down with another sick, with your list going up and up, when you make a mistake, are you confident that the GMC will be fair objective and balanced in its investigation of you? GPs have no confidence in the GMC as our regulatory body.’

However, BMA Wales chair and GPC pensions lead Dr David Bailey, said: ‘We have to have a GMC, we have to have a regulator, the public demands it and rightly so.

’We can’t start from scratch again and actually whilst there are real problems at the top of the GMC, the people who work for it are actually by and large people who understand the problems that doctors have, have empathy, have professionalism and are trying to do a good job so we have to try and reform the GMC from within, we have to change their policy particularly in light of the Bawa-Garba case but starting from scratch is not the way to do it. The way to actually engage with the GMC is not to pass a motion of no confidence.’

Motion passed in full

THE GPC: That the GPC seeks the views of conference on the following motion from the Sessional GPs Subcommittee: That conference, following the recent case of Dr Bawa-Garba;

(i) has no confidence in the GMC as a regulatory body

(ii) directs GPC to advise GPs disengage from written reflection in both appraisal and revalidation until adequate safeguards are in place

(iii) request the Health Select Committee review the GMC’s conduct regarding this case

(iv) mandates GPC to urgently implement a system whereby GPs can make collective statements of concern regarding unsafe care.

Readers' comments (38)

  • BMA leaders warn against motion?
    Who cares. we do not HAVE a healthy relationship with our regulator, the GMC.
    Now it is your job BMA leaders to represent us- or you too should stand aside and allow those who will.
    And quite right too about a different reviewing body. I wouldn't trust anything with Hunt's grease stains on it.

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  • I trust that the quoted Dr David Bailey will not be involved in any future engagements between the BMA and GMC.
    He is right that a regulator is needed, but sometimes best to rip it up and start again.
    Also good motions passed. Now lets get on with it. Thats another month that Dr Bawa Garba has not been working.

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  • Ripping up the GMC would just open a barn door for the government to take control of regulation itself. I believe an independent and fair regulator is essential. The GMC is not fit for purpose as it is - the fish stinks ftom it’s head. Given that a vast proportion has declared no confidence (and I am sure a number of other colleges will follow), the moment has come for the GMC leadership to resign and make way for a parliamentary inquiry into its failings.

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  • It's high time GMC appreciate that they have abondoned their Slogan “Protecting patient and supporting Doctors”.
    They have become the arm the Govt . Why should profession put up with the regulatory body
    who exploits the subscriber?

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  • GMC has lost the trust of GP’s! This is serious and must be addressed and resolved! Hunt is now presiding over a crisis. He must fix it or risks demoralized workforce who will make the NHS unmanageable! Perhaps that is his long term aim! Blame the GP’s!!

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  • Hallelujah! I really hope this momentum for change keeps up, then maybe some of us medical refugees may think of returning home...

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  • great to see some positive actions here.

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  • Finally a ray of hope for us all and a beginning perhaps for a reversal of the GMC’s
    Appalling treatment of this poor young doctor. The criminal case was wrong, the attitude of the GMC was wrong and we felt powerless to help her. I sincerely hope that this is start of something new that patients and doctors can feel confident in.

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  • I suspect Dr Bailey is another 1 session a week clueless joker. If the public demand a regulator they can jolly well pay for it !

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  • I have not met a doctor yet who has confidence in the GMC.

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  • I presume the GMC leaders have very thick skins and will be in denial about their gross incompetance

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  • Well done Zoe. And boo, David Bsiley.

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  • What was the point of me doing all the significant event analyses and reflective analyses as one of the five rolling criteria for annual appraisals and revalidation if I’m now instructed to not write reflections?! All the hours I put in for appraisals etc. so that I couldn’t be over criticised seem to have been for nothing.But that takes nothing away from the awful treatment that the junior doctor got for an event that could have been for any of us assuming that I’m not the only doctor who accepts that he or she isn’t perfect.

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  • What is GMC doing about failing NHS. These organisations wag their tail to the government otherwise they will cease to exist.simple as that.

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  • Vinci Ho

    This is how the world is going at the moment. Because of all the anger and discontent towards establishments, populism rises . Populism is a phenomenon and bears certain moral argument , whether one likes it or not . If the establishment insists its way resisting drastic changes ,it faces the real threat of extinction. History has provided that lesson repeatedly.
    This is an uproar and outcry at the right time and right place. Those who choose to defend the indefensible should be so ashamed of themselves.
    Let’s hear the voices of the rebels.......

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  • Vincenzo Pascale

    So far I've not worked in the UK, because I perceive the GMC as enemy. I'm used to to feel Spanish or Italian Medical Council very close to our needs, even having in count the needs of our patient.

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  • Zoe Norris has more spine, integrity and more B***s than our other so called leaders...... HSL should take note....... Zoe Norris has significantly more support talking to my colleagues than HSL whom we perceive, as a small group of GPs, to be a light weight and ineffectual. Is there anyone else out there who feels Zoe would represent us better than HSL?

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  • Judges and Juries depend on expert opinion. In this Judgement that of Dr Simon Nadel [ 10]
    But, he is patently and obviously wrong on several counts.
    At 10] he states this from the 1st set of tests' Any competent Junior doctor would have realised the condition [ Sepsis] ', the conclusion' DR BG is ' manslaughter negligent' for failure to do so.

    BUT, when the Consultant Dr O'Riordan is shown these tests at 1630, he does not say ' Gosh, Dr BG, this is severe Sepsis'. HE FAILS TO RECOGNIZE what a junior doctor should have, according to Dr Nadel. So, Dr Nadel is just plainly wrong.
    However, this is also Dr BG's fault for NOT EMPHASIZING these tests.
    Come on, this is utter rubbish.
    Either the tests are recognizable or they are not. The Consultant did not recognise the condition. [ actually because it is equally applicable to ACEI AKI in dehydration]
    Dr. Nadel's statement is wrong ipso facto and thus so is the conviction
    There are many other such obvious medical mistakes in his evidence and that is what we should be looking at.
    THE PRIME PROBLEM is the completely wrong medical expert opinion.

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  • Took Early Retirement

    "We can’t start from scratch again and actually whilst there are real problems at the top of the GMC, the people who work for it are actually by and large people who understand the problems that doctors have, have empathy, have professionalism and are trying to do a good job so we have to try and reform the GMC from within, we have to change their policy particularly in light of the Bawa-Garba case but starting from scratch is not the way to do it."

    Appalling to read this. Where does he get his information from?

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  • This comment has been moderated

  • I suspect the RCGP is also an organisation of haters of frontline non academic frontline working GPs,who are not involved in the powerpoint and prawn sandwich brigadesr academics.They are pretty poor at recognising who does most of the FtF contact and supporting them, they seem to tow the governments line and release load of unrealistic research.If I ever get time in the next few days when the membership department is open I will have great pleasure in extracting myself form the College.Of course they dont provide 8-8 7 days a week service 9 til 5 only.

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  • load of bs &offensive diarrhoea

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  • All for one,10.24pm I tend to agree the GP expert witness assessment was wrong, but there were other subtle emotional factors at play, including wanting to absolve the mother of any feeling of responsibility for having had the ACE given, Dr Bawa-Garba was the convenient scapegoat.

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  • wow David Bailey....
    where did you get that information about GMC. Just look at the MPTS site and that revels all

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  • Actually, dissolving the GMC and starting from scratch (including looking at medical indemnity, compensation) is exactly what we need David. If the GMC were truly a learning organisation there might be a hope, but all evidence, even now, suggests they merely want to make soothing noises until the bad press dries away and continue exactly as before.

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  • Why do we have to support a regulator that has such little faith in its health service that it feels the need to pay for private healthcare for its staff?

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  • Thanks vv 3:48pm 10-3-18
    @David Bailey
    I see you are listed on the GMC advisory forum Wales.
    No conflict of interest there I hope?

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  • GMC is not fit for purpose as it is no longer supporting its own principles of safe medical practice. It’s GMP is soon to be Gone Medical Practice.
    It stands silent on issues of safe working environment and safe working limit on doctors and by doing by so it is part of the problem. It no longer support doctors or stand together with doctors when patient safety issues are raised due to crumbling of support services all around GPs who feel unsafe working in a very pressurised environment which is unsafe. Unsafe volume of work complex problems increasingly dealt in general practice with ever shrinks big time and resource which is unsafe for the doctors and the patients.
    The GMC by remaining silent on these issues supports the political narrative and is not fit for supporting doctors.

    The GMC should be fighting with the doctors to demand for better working conditions which will lead to increased patient safety

    There should be recognition of safe working limits and number of appointments cap.

    There should be a airline pilot style DOCPIT 20 point checklist for trainee doctors at start of the oncall shift to ensure that they work in supported safe work environment and not put them self at risk of facing manslaughter charges when something goes wrong due to organisational shortcomings

    Let’s see GMC fighting for the safe practice of medicine and NOT JUST WAIT IN THE WINGS TO BLAME DOCTORS FOR THE MISTAKES DUE TO SYSTEM FAILURE and hang them dry.

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  • The jury decided that Dr Bawa-Garba was guilty as charged, after being told of the challenges she faced. So be it.

    There is the issue as to why Mr Massey decided (or if not him, who was it?)that the GMC needed to go to the High Court and have its own MPTS determination overturned.
    Any suggestion that in some way this was necessary 'for the protection of the public' is spurious'. So what was the GMC's motive?

    Once the High Court had been approached, it had to support the due legal process. But that legal process was in the hands of a jury - albeit they were not Dr Bawa-Garba's peers, and could have had little real insight into the problems she faced, and just who was responsible for her being in such a situation.(A question they were not specifically asked to consider).

    Those who challenge this whole process will have to seek a clearer definition of how a doctor's peers are identified (or any professional person's). This has been a problem since the concept of 'trial by peers' was devised after Magna Carta - so a lot to take on. Good luck.

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  • The problem with fitness to practice procedures goes much deeper than the Bawa-Garba case. The suicide rate for doctors under going Fitness to Practice Tribunals is a national disgrace and points to a serious underlying problem with The GMC's procedures and a lack of support for doctors. I do not feel that refusing to engage with reflections in appraisal will make any difference.
    As most annual subscriptions become due on August 1st( and many others on February 1st) ,may I propose a campaign to refuse to renew annual subscriptions until the GMC engages with the medical profession to ensure that doctors receive fair treatment from tribunals and the GMC undertakes not to seek judicial reviews of it's own tribunal findings. Regulation of the medical profession is not independent and appears increasingly political so I don't see why we should pay for it. It is time to protect overworked doctors from a system that is weighted against them.

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  • Looks like David Bailey is just trying to keep his job. I wonder how many sessions he actually does seeing patients. We need a new GMC and run by people who actually sees patients not the 1 to 2 sessions GPs whom the rules do not affect them very much. Let them face the possibility of manslaughter charges like all of us so no such unworkable rules will come out.

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  • The paper trail that Doctors have been obligated to have for years has always had "right" things to record and "wrong" things to record - who would be foolish enough to not submit a carefully curated list of events with "significant events" being at the level of discussing how to deal with a patient who was five minutes late for clinic and the discussion that ensued?

    Mine will for the foreseeable future remain a Potemkin village for the same reason - it is what everyone wants there to be.

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  • 'might harm relationship with the regulator'?? It's already awful!
    Surely : 'might wake up the regulator to the dire condition the relationship is in due to their actions' would be more accurate.
    Perhaps we ought to pass similar motion on the BMA???? Wake them up too?

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  • Also stop honest reflections in significant events ? which can be used as well.We want to improve and all learning should be free from this fear so continue to improve but dont document ?

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  • CENSORSHIP?

    The Medical Tribunal seems sensible
    If the organisation cannot be rebuilt from scratch
    Remove everyone except the medical tribunal
    For Us by Us
    Regulator run by medical professionals
    or those with a medical history..

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  • CENSORSHIP?

    Its insulting that Appraisal forces people to be dishonest...
    Plead the fifth .. the right to remain silent

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  • GMC or no GMC I am out of here. Canada bound!! and proud to say a really Good GP is leaving and
    I am leaving nothing behind, neither will I have any memory of being a Gp in UK for 15 years!.
    Indeed there is more to life than all these.
    Just take the bold decision to change course as you are solely responsible for your happiness in this short life.
    Bye bye everyone, bye bye GMC , bye bye RCGP , Bye bye BMA and bye bye NHS.

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  • In my view - the only subscription worth every penny is (in my case) the MPS - they have fought my corner in an incredible way - if anyone thinks they can rely on crown indemnity they are fooling themselves... I am not sure what happened to poor Dr Garwa - did she have indemnity & help - or can even the likes of the MPS not help any longer - I have not heard any comment from the side of the Societies..

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