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GMC gross negligence manslaughter review to look at 'diversity matters'

The GMC’s review into how gross negligence manslaughter is applied in medicine will look at ‘diversity matters’ around doctors that come under investigation, it has been announced.

This comes after the British Association of Physicians of Indian Origin (BAPIO) said that the ‘pursuit’ of Dr Hadiza Bawa-Garba ‘reflects the inherent bias that exists within the GMC’, with the GMC responding that the accusations were ‘troubling and without merit’.

The GMC also announced the review, which was announced in January following doctors’ concerns after the GMC's successful high court appeal to strike off a doctor convicted of the offence, will be led by Dame Clare Marx, chair of the faculty of medical leadership and management.

Dame Clare said that while gross negligence manslaughter convictions involving doctors ‘are rare’, there is ‘a critical need to examine the wider issues around how these cases’.

She said: ‘Each step of the process will be explored from local investigations post incidents, to diversity matters surrounding the doctors subject to investigation and whether regulatory processes at the GMC could be improved in such cases.

‘Doctors are often working in an immensely pressurised system where mistakes can happen.'

In a statement, the GMC said the review will also look at ‘the pathway leading from reporting to investigation and prosecution; distinguishing between errors and exceptionally bad failings; the role of expert witnesses; and the need for reliable data to support a genuine understanding of incidence and trends'.

After the high court verdict, GPs raised concerns about the use of reflections in the trial, with some saying that GPs ‘can no longer reflect openly and honestly, so the chances to learn from our mistakes is gone’.

However, the GMC said their review, which is due to be completed by the end of the year, ‘aims to support doctors in raising concerns and encourage reflective practice, while improving patient safety’.

Charlie Massey, chief executive of the GMC, said: ‘As well as addressing the issues with criminal prosecutions a further aim of this review is to encourage a renewed focus on enabling a learning, no-blame culture, reflective practice and provision of support for doctors in raising concerns.’

Shortly after the GMC announced its review, the health secretary also announced a ‘rapid review’ into manslaughter charges, with the GMC adding that the two reviews 'will inform each other'.

Readers' comments (18)

  • When your actions no longer match your words, all trust is lost. Repeated denials are making this worse not better.

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  • I think intent should be a function of manslaughter charges. If you deliberately offer unnecessary surgery, or see patients out with your competence for more money that is very different from an honest ‘mistake’ (or bad outcome).

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  • Cobblers

    Bid and Small intent is there.

    https://en.wikipedia.org/wiki/Manslaughter_in_English_law

    Voluntary and Involuntary Manslaughter. Look up Mens Rea.

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  • Have Massey and Spephenson not resigned yet? They are absolutely useless.

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  • Council of Despair

    tbh i don't think race was the issue in this case and I'm not a big fan of the GMC - these are the issues as I see it ...

    1. Dr BG's reflection were passed on by her consultant to the prosecution and were used against her.

    - I've recived an email from my responsible officer basically telling me that I MUST reflect or face sanctions.

    - when I reflect it's almost always about what can be done better or differently, however, others may view that as an admission of a mistake/error/sub standard care which is what I think happended in the BG case.

    - I've always assumed that reflections were used in apostive way to improve care but the GMC have now admitted that reflections can be used against you.

    So the first issue is that we have been ordered to reflect or face sanctions AND reflection can be viewed as an admission of fault AND can be used against you.

    2 - in the origional manslaughter case - a lay Jury made the decision guided by th ejudge BUT they are not in a position to understand how we as professionals work in our role so it was not a judgement by peers and we don't know what their thought processes were in order for them to come to the conclusion that the care was way below expected. It's clear that the majority of her peers think that she did not generate errors that was in any way way below expected.

    so the second issue why are we being judged by lay men on our professional capacity.

    the third issue is why wasn't any consideration of the pressures and risks at the hospital not taken into account. It is really starnge but let's say a driver crashed a car killing a pedestrian and it was discovered that the brakes were faulty - you would expect that to be looked into but the fact that Dr BG had to cover for multiple colleagues not being mentionned is outrageous.

    - why wasn't the administering of the ACE not questionned as this may have been the catual cause of death?

    basically there are lot's of issues with the origional trial.

    3. press coverage - I think race played a part here but hey the daily mail has to sell papers and to be fair they hate all doctors just foreign looking ones more.

    4. the GMC made a totally illogical decision in my view to score some browny points with the public and press.

    issues

    - if the GMC are basically going to allow the criminal or civil court to make decisions on Drs competance then why have the GMC at all - they are redundant.

    - one expects the GMC to look at the overall safety issues and on the GJMC site it says 'Rigorous reviews and regular monitoring activities, such as our annual survey of doctors in training, help us to deal quickly with any concerns and to make sure that doctors are receiving the supervision and experience they need to treat patients safely and well.' well where was the supervision and where was the support to treat patienst safely?

    The GMC are hoping to get away with this but they must not. They have failed us and the public terribly.

    The GMNC have also basically said that

    - we can't walk away on duty - we have to cover and take all the risks.
    - if we have concerns then we have to report it but we have seen what happens when you whistle blow and are you really going to report it to the oerson who writes your reference?
    - the GMC also doesn't care about the circumstances that you are in should an issue occur - think about that.
    - if you do have an issue you MUST reflect on it - lol
    - the reflection can and will be used against you.

    4. where is the CQC - you know the safety folks?

    5. where is NHSE and you know - we must whistle blow etc

    6. where are the Royal Colleges, BMA etc..

    7. where are the defence unions etc

    I could go on but it will depress everyone but I think thinsg are just getting worse daily and can not see anything positive about medicine in the UK.

    I think the race issue re: GMC is a red herring though and they are just going along with it as they know they will get away with it. The race issue is a factor for the press coverage and indirectly may influence the GMC i.e. they just want to please the press.

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  • David Banner

    Discussing Diversity is a useful trendy smokescreen for the GMC to deflect attention from their catastrophic handling of this case. They can exonerate themselves from accusations of racism, then publish endless guidance lecturing all of us on the diversity issue.

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  • There must be no trust in the GMC at all from the majority of medics who pay their fees.

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  • AlanAlmond

    It’s unfortunate if the appalling reality of what has happened to this poor Dr are lost in a side show of arguments about race. There are so many really fundamental and worrying aspects about this case that need to be talked about, but I fear a simplistic media will take the lazy option. Anonymous Locum above good analysis

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  • GMC has failed to follow their own guidance they give us. Failed to be honest about their mistake, failed to reflect and correct their error. I hope the Professional Standards Authority come down on this failed organisation like the way they treated Dr Garba so they can taste their own medicine.

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