This site is intended for health professionals only


Folic acid legal case ‘putting doctors off GP career’

Young doctors claim to have been discouraged from a GP career based on the High Court’s findings against Dr Philip Mitchell earlier this month.

20-year-old Evie Toombes, who has a rare neural tube defect called lipomyelomeningocele, successfully argued that she should not have been born – and that Dr Mitchell was at fault for not advising her mother to take pre-conception folic acid supplements.

Following the ground-breaking legal case, nearly 500 doctors have signed a ‘Wall of Support’ for Dr Mitchell, expressing anxiety about the future ramifications of the case on their careers.

The wall was set up by Doctors’ Association UK, which has collaborated with The On-Call Room, NHS Million and GP Survival to support Dr Mitchell and his family.

It comes as NHS Resolution, which has covered the legal costs and will also pay damages to Ms Toombes, said this week it accepted the verdict.

Dr Mitchell’s law firm, Clyde & Co, explained that the decision not to appeal was based on the specific nature of the case – whereby a pre-trial judge had decided not to allow expert witnesses to give evidence.

But GP Survival chair Dr John Hughes said: ‘We are concerned to see many comments from junior doctors suggesting that this judgement makes them less likely to choose GP as a career option, and from established GPs saying this has strengthened their intention to retire early, both worsening the crisis in a profession with significant workforce shortage.’

A doctor named Ceri wrote on the forum: ‘I am appalled and saddened by this judgement. For a junior doctor like myself it really only serves to cause anxiety and put me off choosing general practice as a career option.’

And a Dr Hannah Morgan said: ‘As a junior doctor just a few years into my career and with many friends who are GPs, I am fearful of what the future holds for doctors if cases like this continue to occur.’

Commenting, DAUK chair Dr Jenny Vaughan said: ‘We sincerely hope that the Toombes v. Mitchell ruling last week will not have a negative impact on the complex trust relationship that exists within every consultation which is essential for a caring and compassionate health service.

Dr Vaughan said they ‘recognise that young people born with a disability have many challenges to overcome’ but added: ‘We have been contacted by hundreds of doctors who have great concerns that this judgement may promote defensive medicine at a time when we are all under pressure to see more patients in less time in an increasingly unsustainable system.’

Dr Mitchell said he had been ‘really touched by and so very appreciative of the kind words of support posted on the wall by colleagues and interested members of the public’.

‘I am fortunate to be in such a strong position benefitting from a caring family, friends and a supportive work place. ‘

And he said that although the ‘last five years have been difficult for a number of reasons both professionally and personally’ in the ‘last 12 months I have found a satisfaction at work that I thought I would never appreciate again despite the looming trial’.

He added: ‘Reflecting on this, I have re-examined my own motives and values that underpin my professional and personal beliefs. I recognise that it remains a rare privilege in this society to be in a job where mutual trust remains not only vital for the health of a care system but also to my sense of satisfaction.’

He added: ‘I sincerely hope that the ruling last week will not have a negative impact on the complex trust relationship that exists within every consultation that is essential for a caring and compassionate health service.’

READERS' COMMENTS [8]

Monica Stevens 17 December, 2021 7:55 pm

I would not even call it ‘defensive ‘ medicine, just ‘impossible ‘ medicine.

Reply moderated
Douglas Callow 17 December, 2021 8:30 pm

to not allow or consider expert witness testimony moves us into very dangerous waters

Reply moderated
Patrufini Duffy 17 December, 2021 10:24 pm

Law in itself, is one of the most corrupt and double-standard hypothetical ideologies known the man.

Reply moderated
Keith Greenish 18 December, 2021 1:18 pm

This is madness. Without a transcript of the proceedings it is impossible to be certain how the plaintiff’s case was proven. Preconception folic acid advice was in the public arena 20 years ago, so unless Dr Mitchell actively advised AGAINST folic acid how can he be deemed guilty? What proof is there that he did advise taking folic acid and that was simply forgotten by the plaintiff’s mother? What is to stop any doctor recording advice even if it was not given? That leaves the only solid evidence base for future claims being voice recordings of every single consultation, to be kept for posterity.

Reply moderated
Keith Greenish 18 December, 2021 1:28 pm

This is madness. Without a transcript of the proceedings it is impossible to be certain how the plaintiff’s case was proven. Preconception folic acid advice was in the public arena 20 years ago, so unless Dr Mitchell actively advised AGAINST folic acid how can he be deemed guilty? What proof is there that he did advise taking folic acid and that was simply forgotten by the plaintiff’s mother? What is to stop any doctor recording advice even if it was not given? That leaves the only solid evidence base for future claims being voice recordings of every single consultation, to be kept for posterity.
PS I’ve since rad the posting of 2nd December in which it is noted that Dr Mitchell had recorded that preconception advice including use of folic acid WAS recorded in the patient notes. So the judge in this instance effectively awarded damages against the GP for the consequences of the mother’s forgetfulness or unwillingness to follow medical advice. There but for the Grace of God …………..

Reply moderated
Matthew Ashton 20 December, 2021 3:31 pm

Complete madness. Dr Mitchell you have my full support. I quite understand this will sway some junior doctors away from General Practice as no matter how defensive you may choose to be you still can’t avoid the” blame” when you are not to blame .

Richard Greenway 21 December, 2021 2:45 pm

No natural justice here. Banning expert witness testimony makes this unsafe. This basically means that GP is responsible for disease- whatever they do.
How does that leave all our patients on the pill -when 60/ 100,000 get a DVT -these are now our “fault” despite warnings and informed consent?
Pregnancy is physiological and a personal decision. Whether you take nationally available advice or that or a healthcare professional is your choice -but the state shouldn’t be paying for this unless no–fault compensation comes in.

Paul Thornton 22 March, 2022 10:59 pm