Coverage in Pulse: A doctor-led lobbying group has urged the health secretary to review the GMC’s ability to appeal its own fitness-to-practice tribunal. In a letter to Matt Hancock, The Doctor’s Association UK said the GMC’s right to appeal the MPTS has led to ‘significant unwelcome and unintended consequences’.
Dr Philippa Whitford MP joins The Doctors’ Association UK in leading the call of over 1200 UK doctors for a public investigation into the GMC’s handling of the Bawa-Garba case. Collectively, we call for the GMC to take responsibility for its actions and learn valuable lessons from the outcome of this case. Applying a genuinely reflective approach, as is expected of doctors in their practice, would be a significant step in restoring the confidence and trust in the GMC as a regulatory body.
Dr Cicely Cunningham, DAUK’s Learn Not Blame Lead, in The Guardian: “In 2015, Dr Hadiza Bawa-Garba was convicted of gross negligence manslaughter for her part in the death of six-year-old Jack Adcock from sepsis. She was subsequently struck off the medical register after the doctors’ regulatory body, the General Medical Council, argued that the conviction meant that she could not be fit to practise. The court of appeal ruled on Monday that Bawa-Garba should be reinstated. I believe it was the right decision.”
DAUK welcomes the publication of the Joint Committee on Draft Health Service Safety Investigations Bill (HSSIB) report and are pleased that the report agrees with our written submission that the provision for the HSSIB to accredit NHS trusts to do their own ‘safe space’ investigations is an enormous conflict of interest.
DAUK Chair Dr Samantha Batt-Rawden, who sat in court during the Dr Hadiza Bawa-Garba appeal tells GPonline: ‘Particularly concerning to all of us has been the GMC’s line of argument. To an observer, it seems the crux of their argument is that system failures were not relevant in Hadiza’s case, and should not have been taken into account by the MPTS when determining her level of culpability and her sanction.’
Learn Not Blame is DAUK’s exciting new campaign, which will be launched over the coming months. We aim to empower individual doctors to be part of a transformational change process working towards a revolution in the culture of the NHS. The campaign has been born out of a growing awareness amongst clinicians of how a toxic mix of defensiveness and concern for reputation management above all else can lead to blame-seeking culture. This is bad for doctors and worse still for patient safety.
Today The Doctors' Association UK submitted written evidence to the Draft Health Service Safety Investigations Bill inquiry. The Bill will see the the current HSIB, under NHS Improvement, become an independent body.
In the submission DAUK welcomes "the creation of an independent body to investigate serious incidents in healthcare" and "the development of a culture that focuses on systemic learning from errors, rather than attributing individual blame".
However, DAUK expresses concern regarding the following areas:
- the power that the Bill grants to the Secretary of State for Health to appoint Chair of HSSIB, remove non-executive board members and veto the Chief Investigator.
- the process by which HSSIB will be able to accredit Trusts to carry our their own "safe space" investigations which DAUK describes as an "obvious, and enormous conflict of interest" in allowing Trusts to investigate themselves.
- prohibitions on protected disclosure; in the context of the case of Dr Bawa-Garba of and of Dr Chris Day, there must be confidence in the "safe space" to allow staff to speak freely.
- the fines of up to £20,000 for not submitting evidence to HSSIB on time. DAUK questions this and propose that fines be used to fund Human Factors training for healthcare professionals
- the Bill only applies to NHS-commissioned services. DAUK feels that the private sector should be subject to the same rigorous and independent investigative processes.
Today The Doctors’ Association UK has written to Dame Clare Marx to express our concern regarding the make up of the working group for the GMC review into gross negligence manslaughter. The GMC has previously has stated that this will be an independent review, commissioned by the GMC. They go on state “The working group comprises a wide range of perspectives, experience and expertise, with membership drawn from across the medical profession, including doctors in training, the legal system, employers and patients.”
The Doctors’ Association UK was disappointed to see a lack of junior doctors currently in training on the review panel into gross negligence manslaughter, which was launched in response to the conviction of Dr Bawa-Garba, a junior doctor and a trainee.
We have therefore petitioned Dame Clare to consider expanding her working group to include more junior doctors in currently training, to represent the viewpoint of those working in similar conditions to Dr Bawa-Garba.
We look forward to engaging in the review in due course.
As the first stage of the DAUK's new campaign, Learn Not Blame, DAUK has responded to a rapid policy review into the use of gross negligence manslaughter in England and Wales. The DAUK is of the firm belief that the current application of GNM is a barrier to achieving a culture of openness and learning in the NHS. In our opinion, it is imperative that lessons are learnt from the case of Dr Hadiza Bawa-Garba, and that no doctor or healthcare professional should ever be scapegoated for system failures within an NHS at breaking point.
Our recommendations are:
1. A higher bar for the CPS to consider pursuing a prosecution for GNM.
2. The law on gross negligence manslaughter (GNM) be urgently reformed, with a legal test of GNM related to healthcare to include actions being “wilful or reckless”, and system failures taken into account as mitigation.
3. The creation of an independent investigative body, or significant strengthening of the Healthcare Safety Investigation Branch, whose first priority will be to explore the systemic failures that ultimately surround medical error.
4. Written reflections undertaken by doctors for the purposes of education or training be subject to legal privilege.
5. An amendment to Section 35A (1A) of the Medical Act 1983 that currently allows the General Medical Council (GMC) to compel doctors and organisations to disclose written reflections for Fitness to Practise hearings.
6. The repeal of Section 40A of the Medical Act that allows the GMC to appeal MPTS verdicts, which should be final.
7. Assurance from the Department of Health that Parliament will not grant the GMC the power of automatic erasure for the offence of GNM.
Our full submission can be found here: