Re: GMC to push for erasure of paediatrician convicted of manslaughter
It appears that hundreds of healthcare professionals and members of the public believe that in this case the GMC is not acting to uphold the reputation of the profession and they are also raising concerns about whether it is acting in the best interests of patient safety. This is extremely serious. For the GMC to therefore "carry on regardless " is very worrying,
I have significant concerns about these gross negligence manslaughter convictions, especially some of the recent ones ( Dr Bawa-Garba, Mr David Sellu ). It is a fact that the job of the prosecuting QC in any GNM trial is to try to aggregate as much blame as possible onto the single individual (s). This approach may not allow a just outcome. Having heard from multiple healthcare workers who have experienced this process at first hand, what is concerning is how the role of systems can be downplayed in a court of law. Relevant systematic improvements can be excluded from even being put before the jury if they occurred after the death as well as the true significance of other individual's acts and/ or omissions and their responsibilities (as they are not on trial). I believe that the criminal law is a very blunt instrument when it comes to dealing with the complexities which invariably lie behind many tragic deaths in healthcare. I, and many others, also have grave concerns about a possible racial bias which must be considered urgently by all of the agencies involved in these prosecutions. To its credit, the independent MPTS tribunal heard the whole picture in the Dr Bawa-Garba case and decided to suspend rather than erase.
The GMC is using its powers to appeal this, arguing for her erasure from the register on 7/12/17. Having looked at the 2015 act, this power should be exercised rarely yet it seems the GMC are not doing this. I understand that there have been a very substantial number of appeals that have been instigated by the GMC over the past year, much higher than the numbers appealed by the PSA historically. I note that when this power was granted to the GMC the comment by Niall Dickson at the time was that an appeal decision would be used "rarely... and only if essential for patient, professionals and healthcare systems." How do they square this with the fact that in 2001 the following statement from " A Commitment to quality and Excellence" was signed by the then president of the GMC, Sir Donald Irvine CBE along with a host of other leaders of relevant organisations.
"The Government, the medical profession and the NHS pledge ... without lessening commitment to safety and public accountability of services, to recognise that honest failure should not be responded to primarily by blame and retribution but by learning and by a drive to reduce risks for future patients."
The decision to go for erasure is wholly disproportionate given what seems to have happened here. The contextual matters in this tragic case were vital in understanding why it occurred. There are many issues here for the whole medical profession to consider. I also note that historically, a conviction for GNM did not mean automatic erasure. I quote particularly the case of Dr Garg where a whole systems review, which was considered by the MPTS, meant that he was not erased. The Secretary of State for health has put a priority on Safe Spaces and learning as part of a just culture when it comes to error. The GMC's actions in this case promote the opposite effect, namely blame and punishment as part of further retribution which they feel must be the portion for Dr Bawa/Garba.
None of the above is about letting unjust acts committed by healthcare workers to be over-looked or not taken seriously. However, these were honest errors by a trainee against a backdrop of major systems failures which the MPTS appreciated and fully took account of and the GMC has not. The chilling message it is sending by this act will be heard by trainees and consultants up and down the country who are currently struggling with huge challenges in trying to deliver safe care for patients
Competing interests:
No competing interests
15 November 2017
Jenny R Vaughan
Consultant Neurologist and patient safety campaigner
Rapid Response:
Re: GMC to push for erasure of paediatrician convicted of manslaughter
It appears that hundreds of healthcare professionals and members of the public believe that in this case the GMC is not acting to uphold the reputation of the profession and they are also raising concerns about whether it is acting in the best interests of patient safety. This is extremely serious. For the GMC to therefore "carry on regardless " is very worrying,
I have significant concerns about these gross negligence manslaughter convictions, especially some of the recent ones ( Dr Bawa-Garba, Mr David Sellu ). It is a fact that the job of the prosecuting QC in any GNM trial is to try to aggregate as much blame as possible onto the single individual (s). This approach may not allow a just outcome. Having heard from multiple healthcare workers who have experienced this process at first hand, what is concerning is how the role of systems can be downplayed in a court of law. Relevant systematic improvements can be excluded from even being put before the jury if they occurred after the death as well as the true significance of other individual's acts and/ or omissions and their responsibilities (as they are not on trial). I believe that the criminal law is a very blunt instrument when it comes to dealing with the complexities which invariably lie behind many tragic deaths in healthcare. I, and many others, also have grave concerns about a possible racial bias which must be considered urgently by all of the agencies involved in these prosecutions. To its credit, the independent MPTS tribunal heard the whole picture in the Dr Bawa-Garba case and decided to suspend rather than erase.
The GMC is using its powers to appeal this, arguing for her erasure from the register on 7/12/17. Having looked at the 2015 act, this power should be exercised rarely yet it seems the GMC are not doing this. I understand that there have been a very substantial number of appeals that have been instigated by the GMC over the past year, much higher than the numbers appealed by the PSA historically. I note that when this power was granted to the GMC the comment by Niall Dickson at the time was that an appeal decision would be used "rarely... and only if essential for patient, professionals and healthcare systems." How do they square this with the fact that in 2001 the following statement from " A Commitment to quality and Excellence" was signed by the then president of the GMC, Sir Donald Irvine CBE along with a host of other leaders of relevant organisations.
"The Government, the medical profession and the NHS pledge ... without lessening commitment to safety and public accountability of services, to recognise that honest failure should not be responded to primarily by blame and retribution but by learning and by a drive to reduce risks for future patients."
The decision to go for erasure is wholly disproportionate given what seems to have happened here. The contextual matters in this tragic case were vital in understanding why it occurred. There are many issues here for the whole medical profession to consider. I also note that historically, a conviction for GNM did not mean automatic erasure. I quote particularly the case of Dr Garg where a whole systems review, which was considered by the MPTS, meant that he was not erased. The Secretary of State for health has put a priority on Safe Spaces and learning as part of a just culture when it comes to error. The GMC's actions in this case promote the opposite effect, namely blame and punishment as part of further retribution which they feel must be the portion for Dr Bawa/Garba.
None of the above is about letting unjust acts committed by healthcare workers to be over-looked or not taken seriously. However, these were honest errors by a trainee against a backdrop of major systems failures which the MPTS appreciated and fully took account of and the GMC has not. The chilling message it is sending by this act will be heard by trainees and consultants up and down the country who are currently struggling with huge challenges in trying to deliver safe care for patients
Competing interests: No competing interests