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Doctors practise in 'a climate of fear' after Bawa-Garba case, says GMC review chair

The chair of an independent review of gross negligence manslaughter charges in medicine has said the medical profession is ‘at a crisis point’.

In an interim report, ahead of the review’s final report in early 2019, chair Leslie Hamilton described doctors as working in ‘a climate of toxic fear’ following the Dr Bawa-Garba case.

The case saw Dr Hadiza Bawa-Garba struck off the medical register following a conviction of gross negligence manslaughter, only to be reinstated after an appeal of the High Court decision.

Mr Hamilton said: ‘Doctors report that this case has created a climate of fear within the medical profession, which is compounded by the increasing pressure of work, particularly for many trainees, who feel unsupported…

‘The medical profession is at a crisis point. There is a climate of toxic fear.’ 

This comes after the chair of the GMC apologised to doctors for the ‘fear and anguish’ caused by the Dr Bawa-Garba case.

Meanwhile, the GMC’s chief executive Charlie Massey told Pulse he ‘didn’t anticipate the degree of outcry’ following the case.

Mr Hamilton added in the interim report that the review’s working group, which includes former RCGP chair Professor Clare Gerada, meets monthly to discuss responses to the review. 

He said: ‘One of the messages coming through very forcibly so far is about the importance of a competent and fair local investigation in the aftermath of an unexpected death of a patient which focuses on what has gone wrong and why, and what lessons can be learned, rather than on finding someone to blame.

The review, which launched in February 2018, is investigating why there are fewer GNM cases involving healthcare organisations compared with individuals.

It will also address concerns over whether enough consideration is given to ‘system pressures, errors or failures’ surrounding the doctor at the time of the patient’s death, and to ‘diversity matters’, after the GMC was accused of ‘inherent bias’.

Readers' comments (14)

  • Vinci Ho


    Fundamentally, there is a marked difference in the interpretation of ‘fitness to practise ‘ between MPTS and GMC on numerous occasions. You wonder why? Remember, this is a pattern that keeps repeating itself. The two regulatory bodies are , in essence, fighting to discredit each other . So what is the endgame here ?
    As being alluded in previous comments , this cannot prevent conspiracy theorists from speculating that certain group was ‘gaining’ out of this chaos . After all , demeanour of GMC is never short of belligerence , bigotry and brutality .
    In addition to the failure in providing explanations for the hefty casualties through suicide during previous FTP proceedings , there is sufficient ground to call for an independent inquiry .

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  • Vinci Ho

    The statement from Justice Bean today is monumental:

    Lord Justice Bean said in the judgement that the MPTS ‘were well placed to make an evaluative judgment of the nuances of how the various individuals had interacted and that judgment should have been accorded great weight, not only by the court but by the GMC in deciding whether to bring an appeal at all’.

    He added: ‘The discretion given by section 40A(3) to appeal against any decision which the GMC consider not sufficient for the protection of the public is a wide one, but in my view it is a discretion to be exercised with restraint where it involves a challenge to a finding of fact in the practitioner’s favour.’
    ......................................

    The meaning of ‘ discretion to be exercised with restraint where it involves a challenge to a finding of fact in the practitioner’s favour ‘ is far reaching. This comment has literally labelled GMC as ‘anti-practitioner’ in line of its vigilante-obsession to be the ‘protector of the public’ ( rather than the guardian of GMC regulations’ ). This obsession had gone unchallenged such that any doctor committed a mistake but exonerated by MPTS on fitness to practise , would go under the microscope of GMC which considered the doctor as a danger to the public fundamentally .
    Based on this ideology , it is hard to see GMC will ‘reflect’ and ‘redeem’ upon this criticism from the Appeal Court .
    ....................
    Fundamentally, there is a marked difference in the interpretation of ‘fitness to practise ‘ between MPTS and GMC on numerous occasions. You wonder why? Remember, this is a pattern that keeps repeating itself. The two regulatory bodies are , in essence, fighting to discredit each other . So what is the endgame here ?
    As being alluded in previous comments , this cannot prevent conspiracy theorists from speculating that certain group was ‘gaining’ out of this chaos . After all , demeanour of GMC is never short of belligerence , bigotry and brutality .
    In addition to the failure in providing explanations for the hefty casualties through suicide during previous FTP proceedings , there is sufficient ground to call for an independent inquiry .

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  • Maverick

    Just leave...

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  • What is the BMA doing ?
    Why can’t they push for the law to restrain the GMC from appealing against most decisions to be excercised asap
    How else do you stop this modern day dictatorship by the GMC

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  • Hmmm
    Doctors practicing in a climate of fear !!
    How exactly are the GMC protecting public interests by encouraging this climate ?

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  • We will see more referrals, unnecessary investigations, over treatment and antibiotics resistance and rising health costs due to the GMC. Staff shortages are already being exacerbated by experienced doctors leaving the country due to the GMC's climate of fear.

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  • The system and laws has not changed. Flexible interpretation of "Gross Negligence Manslaughter" means all doctors are at risk. The NHS is like a war zone now. I cannot see any soldier (like Bawa Garba) defending civilians on 4 floors and failing to prevent a terrorist killing one being charged like Barwa Gaba. All the doctors are only staying here due to age and family. Most who can go will go or has gone or change to teaching or working for the quangos. Anything but seeing patients. Sad.

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  • A Doctor cannot make any mistakes. How dare you?!

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  • Council of Despair

    Vinci Ho | GP Partner/Principal17 Sep 2018 9:39pm

    it's an interesting perspective

    GMC vs MPTS

    the MPTS seems to have the support of the state indicated by the ruling that the GMC will have the power to challenge the MPTS removed. also reading in between the lines from the comments on PULSE it appears that doctors are more supportive of the MPTS. So it appears that the GMC has alienated itself - but for what purpose?

    in addition - is the GMC actually fulfilling its aim of protecting patients and restoring confidence - where is their evidence on this? I have not seen any patient groups come out in support of the GMC - if anything the GMC has been criticised by the public eg Nick Ross' letter.

    I think the GMC needs to be challenged on their decision making and questioned more carefully as to why they are making the decisions they are making and on what evidence they are making those decisions.

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  • It was a climate of toxic fear before BG. It’s just made it media front page ( well page 4!)

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