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Independents' Day

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)

  • Unlike Dr Bawa Garba's honest mistakes (although someone will still need to explain to me what it was she did that was so terribly wrong)the actions of the GMC have been cold, cruel and calculating, hiding the errors of management and government and further harming patient safety.
    The GMC is broken. There is no trust. Resign or be forced out. No more Govt stooges please.

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  • Council of Despair

    I'm still confused as what actual mistakes were made?

    It would be useful for the profession to know about the 'mistakes' as how are we going to ever 'learn' if we don't agree on what went wrong?

    My understanding is an 'expert' thought that it was obvious sepsis but pretty much most people would have done what the doctor did - so where was the error as I thought that if you made a decision in which a similar colleague would have made then it was one of those unlucky clinical incidents which could have happened to anyone?

    The outcome raises a lot of questions;

    1. The conduct of the initial trial?
    2. Use of lay jury to decide on professional decision making.
    3. The use of experts
    4. Why was the use of the ACE not explored?
    5. Why is there no learning for the legal counsel that made their errors in the initial trial - why is it that only doctors have to learn?
    6. If the Dr had received no support from her colleagues what would have been the outcome? Why was her defence union and the BMA so useless - this should worry all of us.
    7. why does Massey have a job? Imagine if any doctor had made such a feeble decision as Massey and come up with such an excuse 'it was a difficult decision' what would have happened to them? Say what you like about Dr Arvind Madan but he had the decency to resign.
    8. The role of the GMC? Is it now purely political as it can not claim to support doctors - if so why should we fund it?

    so many more questions than answers

    sadly I suspect we will continue to get repeated episodes until the GMC is dissolved.

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  • The GMC proudly proclaims its duty and role of maintaining the publics trust in the medical profession, while simultaneously demonstrating absolute distain for us. This is immediately obvious.
    If the GMC has no respect for those trying to provide medical services to the public, it is by definition also an enemy of the public and not their protector. It's only a matter of time before it is seen in its true colours.

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  • Why are the BMA not setting workloads and staffing levels that are safe as our supposed union.The establishment protects itself.The BMA,GMC CQC and Royal colleges are the example and have been shown in this case to be protecting the system rather than individuals patients and health care workers.If the status quo continues theNHS is doomed to fail.The most important part of the system are the people in it. You fail to make the system safe,the system fails.

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  • I concur with the comments above. I also wonder if the GMC’s actions would have been so cruel and punitive if the doctor concerned was not black and Muslim, given the record of the GMC’s racial bias in disciplinary proceedings.

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  • Why was the BMA not actively and visibly supporting Dr BG?

    Why are the BMA supporting the ongoing Appraisal and Revalidation process when Dr BGs Appraisal was used as evidence against her?

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  • Who exactly does Massey answer to? This seems to be he problem. There is no one who would tell him to resign or be sacked.
    In his highly paid role there is no risk to him of making a mistake or a bad decision. Wonder if he gets independently appraised at all?
    No one talking in public has been robust enough about this. The fact is that the poor boy died of an illness that was no ones fault he had. The doctor did her very best in difficult circumstances.
    Why the supervising consultant is not equally to blame I don’t know. You would think he would have cancelled his other non patient commitments if he knew that Dr BG was just back from maternity leave with loads of other doctors off. And no Consultant review in the whole time he was there.

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  • The consultant was teaching in Warwick,a decent drag from Leicester,and not really on if you are on call.That probably why he ran off to Southern Ireland to escape the s@@@ hitting the fan,or was he advised to leave?

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  • Massey must go - he is clearly totally unsuited to this role and seems to have been promoted well above his abilities

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  • Vincenzo Pascale

    Everywhere, when an Institution is wrong all the Responsible of it have to resign. It's a mere problem of dignity. Because the GMC follow being an Institution, but the responsible have NOW lost any confidence. And I imagine that they have to pay, INDIVIDUALLY,damages in civil proceedings.

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