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Now it is the GMC in the dock

Dr Kailash Chand

Dr Kailash Chand

The GMC’s pursuit of a pediatric trainee, Dr Hadiza Bawa-Garba, claiming she had fallen short of its standards, came to an end when it lost its battle at the High Court yesterday. The facts behind Jack Adcock’s death are complex and were catalogued in the judgment.

On behalf of the profession, my sincere sympathies go to Jack’s family. I accept that no amount of apologies from anyone in the NHS can relieve their suffering at the loss of their son.

In this protracted case, which has been going on since 18th February 2011, there are no winners. A family has lost a loving child and a registrar previously with an unblemished record has been branded a criminal and has now only been restored to the medical register.

The GMC proceedings were at odds with natural justice.So incensed by the GMC’s attitude and treatment of a trainee were individual doctors, including Dr Jonathan Cusack and Dr Jenny Vaughn, as well as organisations such as the Doctors' Association UK, the BMA, the British Association of Physicians of Indian Origin and the British International Doctors Association, that they united to fight this injustice – assisted by medical media, in particular Pulse and the BMJ. Indeed this may not have been possible without a huge crowdfunding initiative and the generosity of NHS doctors, which raised over £325,000.

A thorough and radical root and branch reform of the GMC is required

The judgment proves beyond doubt that the GMC is out of touch with the challenges of working on the frontline and worse still, its actions are viewed as diluting patient safety – one of the principal reasons for its existence. The GMC’s actions were purely punitive against a trainee doctor who trusted the investigation process. The regulator has been found wanting. The GMC’s own tribunal found Bawa-Garba to be at fault, and recommended a 12-month suspended sentence, but did not suggest terminating her license to practice as a doctor. However, in an unprecedented move, the GMC took her to the High Court where it was ruled this January that the appropriate sentence was erasure from the medical register, rather than suspension.

Pursuing Dr Bawa-Garba’s erasure through the courts was a foolish error of judgement on the part of the GMC head, Mr Charlie Massey. Mr Massey has not apologised, and on several past occasions implied that he would take similar action again in such a scenario.

The GMC has shown it cannot be trusted to take a neutral and non-punitive approach when the fault lies in system failures. Much has happened that needs changing – how NHS doctors work, how we are regulated and how we raise concerns. The Bawa-Garba scenario could happen again and again, unless we have legally mandated safe staffing and proper resourcing and funding in the NHS.

Meanwhile the very existence of the GMC to keep patients safe, maintain the confidence in the profession and set standards to deliver safe service have repeatedly been found wanting.

I recall that since early 2000, the profession, including the BMA, has often expressed lack of confidence in the GMC. A thorough and radical root and branch reform of the GMC is required.

Dame Clare Marx has been named as the new chair of the GMC, a welcome appointment in that she is the first woman in history to hold the position. But can she assure the profession of her independence and fairness, in view of her earlier appointment as chair of the GMC-commissioned independent review of gross negligence manslaughter and culpable homicide in medicine? The influence of some within the GMC is having a long standing and damaging effect on the reputation of a regulator, which should be leading the medical profession by example.

Trust between the GMC and the profession has completely broken down, and not for the first time the public will have no faith in the judgement that the regulator passes on either errant or safe doctors who happen to be subject to its investigations. 

Where previously doctors at the sharp end of its stick have made news headlines, the GMC itself has now become the news of the decade. This verdict is a timely warning for the Government too, that action is urgently needed to properly resource the NHS and address the systemic pressures and constraints that doctors are working under and which compromise the delivery of high-quality, safe patient care.

This time, it’s not Hadiza Bawa-Garba but the GMC that is in the dock.

Dr Kailash Chand is a retired GP in Tameside

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Readers' comments (13)

  • So little has been said about the supervising consultant being absent, being told of the poorly child with very abnormal bloods and not even reviewing him. He appears to have strung his trainee out to dry and then left. What struck me about the panorama program was the dignity and self chastisement Dr BW dhowed. She never tried to blame any one else.

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  • DrBG did nothing wrong at all. She diagnosed ' hypovolemic shock' and gave fluids and O2.
    Jack got better. pH 7.24 at 1212 [ 7.08 at 1045]
    50% better pH.
    He was laughing at 1212, drinking juice. At 1630, he was 'bouncing'and at 1900 was transferred by unidentified clinician from observation CAU to ward 28, a general ward[ lower observation]
    A prerequisite for transfer is being reasonably well. Yet she was convicted for ignoring ' obvious deterioration', as outlined by the expert witness [ EW]. There was no such deterioration under her care, it is plain to see.

    Furthermore, the expert witness said that a diagnosis of gastroenteritis is NEGLIGENT with a history of V+D of over 12 hours!!. It amazes me what the defence team was doing.
    Even worse, when the pathologist was asked if he could tell the difference between septic shock or ACEI shock, he said it was outside his expertise. In fact, you cannot tell on PM if Jack had hypovolemic/ cardiogenic shock.
    Jack may not have had sepsis at all, a chest infection does not make it sepsis.
    This is a mess of a trial. It has more holes than Swiss cheese.It has internal conflicts and contradictions, such as at
    J 11 ' obvious deterioration'and a few lines later at J 13 ' signs of improvement'.
    God forbid, it was supposed to be an example of legal 'masterly analysis. This judgement, in my opinion and every single doctor I have spoken to, who has read the Judgement in full, a complete miscarriage of justice.
    Andrew Thomas QC, prosecuting, said: ‘Under their care, Jack’s condition needlessly declined to a point where, before he had been transferred to the next ward, he was effectively beyond the point of no return’.
    We cannot reconcile logically or clinically the beginning of this statement ‘needlessly declined’ with the latter part ‘before he had been transferred’.
    Jack had been unresponsive on admission and had he then declined further he would have become completely moribund and he simply could not be transferred to a general ward in that condition.

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  • Agree with All for one?
    The Dr Bawa Garba trial is probably the greatest miscarriage of British justice of the 21st century. Dr Bawa Garba's personal characteristics make that miscarriage even more apparent (and globally so). Enormous and ongoing damage has not only been done to Dr Bawa Garba but also to the UK healthcare system (doctors and in consequence patients) and also the reputation of the English legal system. The English judiciary should be even more concerned about that erroneous outcome than the medical profession.

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