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Independents' Day

'Dr Bawa-Garba could have been any one of us'

Dr Punam Krishan reflects on a ruling with potentially enormous ramifications for all doctors

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As a passionate and dedicated doctor and as an equally tired and often exhausted mother, I read the verdicts of our GMC and judicial system about a fellow doctor mum with gut wrenching sorrow and insurmountable rage.In many ways words come easily, in many more ways words cannot be expressed in any comprehensible manner. 

A little baby has died, never an outcome wished by anybody. I cannot imagine how the family are feeling and truly pray that wee Jack rests in peace. On the other side, there is a mother who has been robbed of her entire existence with a criminal record and is now a blacklisted doctor. How is she? What is her life now? What future do her kids have? I cannot even try to imagine the darkness over this family. A death of many sorts, something that has left us - as a nation - numb. 

This could have been me. It could have been my friend. It could have been any doctor anywhere in the world who goes out to work everyday with the sole intention to do no harm. Never does it cross our minds that anything less than perfect is acceptable. We are intuitively this type of person. This then gets engrained through military medical training and further through our daily practise. We do not want to harm. 

Left hung out to dry by a blame culture profession and an unforgiving society, this is the fate of medics today

We wake up in panic, we obsess over detail. We cry into our pillows and pray only to deliver our best. Many of us end up on medication to manage our work related anxieties because we are terrified of this very outcome that we have watched take place in modern day Britain today.

To go beyond the duty of care is a concept we understand, for we do it on repeat every single day. We leave our own babies, our own elderly, unwell or vulnerable relatives, our own domestic turmoils at home to come out and take care of all of yours. Is this even a consideration for mankind these days? 

I understand, from speaking to several paediatric colleagues, that Dr Bawa-Garba was arrested two weeks post-partum, torn away from her exclusively breastfed baby on a charge of manslaughter. Questioned for over seven hours, putting her own baby at risk of dehydration, this has been allowed in our country today. Is this what our society now accepts as right? Prior to this the same people would have praised her for being an exceptional and outstanding doctor. Left hung out to dry by a blame culture profession and an unforgiving society, this is the fate of medics today. 

We are doctors. We are not God. We are not superheroes and do not have special powers to transform life. We can also make mistakes but the difference between our job and every other person’s job out there, is that our mistakes can directly harm life. 

That is why when we say, ‘we are tired working these horrifically long hours back to back’, the government needs to listen to us. When we say we are hungry, having not had a bite to eat in 12 hours, management needs to factor in time for our breaks so we can feed ourselves. When we are stressed, the NHS must recognise the need for support to be given to us. If we cannot have these basic rights, how can we be expected to perform at 110%? How can we never misjudge or make an inadvertent error? We are struggling as a profession and yet today we witness brutality to someone who was trying her best to medically manage many sick patients without any senior support. 

Even at a supermarket checkout, one customer gets managed at a time. Everyone is happy to wait their turn. People still go off sick with stress. We manage a hundred patients a day, sometimes at the same time. We have hundreds of results thrown at us all to be actioned there and then. We have bleeps going off every few minutes, charts being presented, relatives questioning, managers moaning and not to mention the ticking clock constantly echoing in our ears. We are one person. Help us. 

We don’t moan for money, we moan for our sanity because long after our patients leave us, we still go over their story in our heads and reflect on anything else we could’ve done to be that extra bit more perfect. 

We get let down by everyone and are respected by few. The only one thing we all had until now was hope that our own medical council would look out for us; that our council would review the blame culture and understand a team is what delivers good patient care, not an individual person. Our council needs to look beyond inaccurate data and look at the facts without fear of what ‘everyone will think’. 

For the public to understand, we do what our medical council set out for us as good medical practice. We can recite these principles for they are our daily mantra. We do our annual appraisal and we log our personal development journey, which is experiential. We are the most self-critical beings out there who are constantly striving for perfection. We rarely compliment ourselves but rather focus on our flaws. But now we learn that all of this could actually be used as evidence to condemn us of crime in the absence of professional integrity by fellow colleagues. Wow! 

Moving forward, shall we be practicing defensive medicine or shall we be doing the right thing? Will the right thing cause us harm later down the line? We are truly damned if we do and damned if we don’t. I don’t think a junior doctor will ever want to reflect again which is a sad sad loss to what was a highly effective and useful personal development tool. 

A message to those senior doctors too who are out there, who may find it easy to sleep whilst their juniors are doing their work, afraid of not wanting to disappoint their bosses. Let this case be a learning point for you. Do your job, be where you’re meant to be and never forget your professional integrity and responsibility to your trainees. They look up to us to teach them through example. Let us all work together and support one another because the powers that be will never do this. If we can’t take care of our own, we may as well all quit medicine and live with mistakes that won’t tear us away from our entire existence.

Dr Punam Krishan is a GP in Glasgow

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Readers' comments (35)

  • Bye bye reflection. GMC in one swoop managed to undermine the one thing that they were task to do- further patient safety. Now doctors will not communicate, will not reflect, will not share information and will practice defensive medicine. More doctors will stop working in under- resourced environments because they now know that if things go wrong- then for sure they will be held criminally responsible for systemic problems.

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  • I hope that doctors do not forget this case next week and that collectively something can be done.

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  • Thank you Putnam. That's a descriptive and thoughtful insight into the mind of a young doctor and mother. It deserves wider publication.

    More outrageous facts about this case seem to be coming to light (wasn't aware about the circumstances of her arrest).

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  • Maverick

    Thank you Dr Krishan. Your article eloquently summarises the detail of this horrific miscarriage of justice perpetrated by the GMC against Dr Hadiza Bawa-Garba. Your article deserves to be published in the national press and viewed on our TV News Channels. It should be presented to Parliament for debate.

    Well done Nigel Praities (editor of Pulse) for supporting the overwhelming opinion of your readership and campaigning so hard to see justice done. It's great to read that you're behind poor Dr Bawa-Garba and that your publication is working tirelessly to overturn this travesty. Thank you for engaging with the national press to ensure that the voice of UK medics is not ignored.....

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  • In this whole mess, I still see a glimmer of hope looking at the mobilization of Doctors this GMC intervention has resulted in. GMC won it's case but lost the precious little credibility it had left. This is something they should have let go instead of over-riding and degrading the Medical Tribunal. The feeble attempt at appeasing Doctors by minimal reduction in annual fees was a wasteful half hearted effort to make amends. GMC has proved once and for all - it is not there to protect patients or Doctors. It has it's own agenda and mind, irrational and vile. It needs to go to a Fitness to Practice panel where the Medical Community will give its evident verdict. Erase into oblivion.

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  • Just noticed my misspelling of your first name Dr Krishan. Profound apologies.

    Your post still inspires me and I believe it would give patients and their relatives an insight into the reality of medical provision.

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  • The anger in the piece is real and, I suspect, is shared by many of us.

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  • Cobblers

    I believe this is the final nail in my career's coffin. I have enjoyed being a locum after a long time as a GP Principal. Now I look at Appraisal, Revalidation in 2019 and now this travesty of justice which frankly deserves to make each doctor look after number one. Themselves. Goodwill has gone. The NHS is dying, get away from the sinking ship or it will take you down with it.

    I will enjoy cancelling my direct debit to the GMC in August. And await their impotent emails and letters.

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  • Just Your Average Joe

    The GMC has lost its way - It was meant to be self regulation of doctors, and has sacrificed itself at the altar of patient protection, when there was no reason to punish a doctor who was sadly let down by systemic failures hidden from the Jury in the criminal case.

    The high court judgement is therefore flawed in expecting the panel who spared Dr Bawa-Garba erasure from the register, to act in the same way as directed by the jury verdict.

    The panel did not have a legal duty to follow the flawed verdict, as they were aware of the full situation of that sad day, where Dr Bawa-Garba was left to carry the burden of the days events and the sad death, whereas the jury were only given a piecemeal of information that suited the prosecution case.

    Hence the judge in the original case allowed a flawed trial, and failed to allow justice by refusing leave to appeal.

    This is what the GMC should have appealed, the GMC that should be supporting doctors, while protecting patients. Like the thousands of patients who benefited from Dr Bawa-Garba's time and care in the time she was allowed to continue working before she was given her flawed verdict.

    The time she was working and learning her speciality so she could continue to help other children, who will not be protected as there is one less doctor in the NHS which is crying out for more doctors.

    GMC - the management and leadership who were involved in prosecuting Dr Bawa-Garba should all resign in shame, and if they refused be sacked by us, the doctors who pay for our own self regulation, as I hope I speak for many if not most, do not want a regulator who persecutes doctors.

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  • Vinci Ho

    Question: what will the future doctor-patient relationship become?
    The 'healing hands' must put on their most secure gauntlets before providing the remedy.
    The 'sufferer' demands zero mistake and any deviation is unforgivable .
    Should something goes seriously wrong , shackles will be applied permanently to 'a pair' of hands.
    This will be compounded by the inevitable outcome of working by scale in bigger institutions , hence , sacrificing continuity .
    Thanks to GMC , this represents the beginning of the end of the most respectable relationship in human history........

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  • I would have been broken by this, yet Hadiza Bawa Gabra carries on. Awesome!
    Hadiza, you are inspiring. You have probably saved innumerous doctors and the health-care they provide. There will be few able to claim that. Salutations

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  • A sad article but true. I could relate myself and my colleagues. Defensive medicine is what we practice now and I can see the reason! What a tragedy. This is high time we should look after yourself because truly if you cannot look after yourself how can you look after others!

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  • Thank you Dr Krishan for speaking out our hearts. You have expressed every one of our’s life.
    We are doctors, not to harm anyone
    but we are not God.
    This article deserves to be published on national levels.
    I always wonder there is a lot for patients care, who is there for Doctors Care ?

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  • Many thanks for the comments and for taking the time to read this article. At least in dark times though, we can learn that we are protective of our own even if powers above do not support us. Solidarity within our profession is what should never ever be compromised.

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  • End of the line?

    lETS NOT FORGET THE POOR NURSE ... Scapegoated for organisational deficiencies

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  • End of the line?

    ?? foreign nurse doctor
    Easy targets

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  • End of the line?

    I Agree Maverick .....
    Well done Nigel Praities (editor of Pulse) for supporting the overwhelming opinion of your readership and campaigning so hard to see justice done. It's great to read that you're behind poor Dr Bawa-Garba and that your publication is working tirelessly to overturn this travesty. Thank you for engaging with the national press to ensure that the voice of UK medics is not ignored...

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  • GMC has certainly lost its way. If they cannot understand the pressures we work under and then fight with their own tribunals and hunt out doctors like this then they are now a truly finished. Not fit for purpose. shame on you GMC

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  • Thank you for this article. All fair minded people would agree we work in intolerable unsafe conditions and our goodwill is taken advantage of at every opportunity by the government, NHS and ultimately by patients. Now we risk criminal prosecution too. This is too far and the GMC as well as the NHS is guilty and have blood on their hands.
    I qualified in the 1980s and strongly feel I have been exploited throughout my career. I worked inhuman hours along with my junior colleagues supported by seniors who said helpful things like " I have every confidence in you" instead of coming to help with a procedure you'd never seen or done before. The pressure has never been worse than now but never been better either.
    I am immensely relieved none of my children have followed me into medicine and until we have humane working conditions with proper support I cannot encourage anyone to become a doctor.

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