Dr Sarah Jacques, DAUK GP co-lead, has called for the new Health Bill to include stronger safeguards and transparency measures.

Speaking to Pulse Today, Dr Jacques expressed concern that the new Health Bill grants ministers sweeping powers over access to patient data.

Health Bill

She said the proposals showed ‘a total disregard for our personal information and the consequences of sharing that information with the powers that be’.

And she warned that expanded access could ultimately be driven by financial interests rather than patient benefit.

Dr Jacques said: “With what they are proposing, certain groups have unfettered access to identifiable data. It’s not what a single patient record should really fundamentally be about.

Data grab

“It should be just for the clinician and the patients. It shouldn’t be for groups of people to do data grabs for their own benefit.

“I don’t necessarily disagree that we perhaps need more information for research and things like that, but there has to be a different way of going about getting that information, and it needs to be transparent.

“We need to know who is asking for it, why they’re asking, and when they’re accessing that information.

Understand the implications

“We need to understand the implications of what it would be someone shared that information for research purposes.

“Nobody’s going to have a say in any of that in the current guise of the bill.”

Read the article in Pulse Today full.

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Dr Steve Taylor was speaking to Pulse after new figures revealed the money spent on primary care in the past decade by NHS England and ICBs.

The data, Pulse reported, showed that ‘primary care consistently received one of the lowest shares of funding’.

Underfunded primary care

Dr Taylor said: “Successive governments have underfunded primary care and in particular GP services.

“These figures demonstrate what is seen week by week with issues of access to services.

“These figures demonstrate government would be better off spending NHS funding on community services rather than gimmicks.

“There are 6,300 neighbourhood centres already in walking distance of 80% of people – GP practices.”

Read the Pulse article in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Dr Hadiza Bawa-Garba is free to practise without conditions again after the Medical Practitioners Tribunal Service delivered its verdict today.

The MPTS said that it was ‘in the public interest’ for the current order on her registration to be revoked with immediate effect.

The GMC, which had previously ruled that Dr Bawa-Garba should be struck off the medical register permanently, remained ‘neutral’ in the most recent hearing.

This marks the end of the case for Dr Bawa-Garba, after the death of 6-year-old Jack Adcock, who tragically died after Dr Bawa-Garba made an incorrect diagnosis of gastroenteritis with moderate dehydration when in fact he had sepsis.

Dr Bawa-Garba was found guilty of manslaughter and the GMC later struck her off the register permanently.

The case caused a huge backlash from the medical profession, including GPs, who pointed out that there were severe systemic failings that contributed to Jack’s death.

In 2017, an MPTS ruling found that Dr Bawa-Garba’s actions had fallen ‘far short of the standards expected’ and did contribute to Jack’s death. It imposed a 12-month suspension on her.

However, the GMC appealed the decision, calling for a complete erasure from the medical register, which a court upheld. But following an appeal by Dr Bawa-Garba, this was later overturned by the Court of Appeal.

In 2019, an MPTS tribunal allowed her back on the medical register with conditions, finding that her fitness to practise had been impaired by account of her extended absence from medicine.

Dr Bawa-Garba, who was a paediatrician in training at the time of Jack’s death, has been practising since November 2020 with conditions.

Today, the MPTS removed these conditions. It ruled: ‘Dr Bawa-Garba has already demonstrated sufficient insight, fully remediated following her conviction.

‘While Dr Bawa-Garba had only resumed clinical practice in November 2020, the Tribunal was struck by the volume of evidence she has been able to produce detailing all aspects of her clinical practice and the steps she has taken to ensure her skills and knowledge are now fully up to date.

‘The Tribunal took account of the multi-sourced and multi-angled feedback before it, all of which set out the view that Dr Bawa-Garba is a competent, safe and reliable clinician about whom no further concerns had been raised. Further, the Tribunal gave careful consideration to all of the testimonials provided on Dr Bawa-Garba’s behalf, all of which were positive.’

Dr Jenny Vaughan, chair of The Doctors’ Association UK and Learn Not Blame Campaign Lead, who has been supporting Dr Bawa-Garba throughout the case, said: ‘We welcome the news that Dr Hadiza Bawa-Garba had her licence to practise medicine fully restored today to allow her to work independently. We are also pleased that the GMC opted for a neutral stance.’

‘Healthcare desperately needs an open, transparent, learning culture, where harm is minimised by learning from error and failings. Scandals such as Mid-Staffs, Gosport and Morecambe Bay repeatedly demonstrate how a culture of defensiveness and denial can escalate into widespread cover-up leaving families fighting for answers. The climate of fear amongst the medical profession created by the GMC’s actions over Dr Bawa-Garba only makes it more likely that this will happen again. Jack Adcock should have received better care and his death was a tragedy. Our thoughts are also with his family.’

Read the full article here.

A coalition of medical organisations is calling for the GMC to swiftly be stripped of its powers to appeal fitness-to-practise tribunal decisions, as an FOI revealed this has happened in a further 14 cases since the Bawa-Garba fallout.

It comes as GPs were last month given 12 weeks to respond to plans for sweeping GMC reforms, including quashing the GMC’s powers of appeal. Under those plans, the law may be changed by spring 2022.

But a letter to health secretary Matt Hancock, signed by ‘coalition’ of 13 medical organisations including the Medical Protection Society (MPS), BMA, RCGP and Doctors’ Association UK (DAUK), called for this legal change to instead be included in the forthcoming Health and Social Care Bill.

The Bill is also due to start being implemented from 2022, but an MPS spokesperson told Pulse that this route would give greater certainty that the changes will actually take place, as well as likely being much quicker.

Reforms to professional regulation are often delayed and there are limits on how much reform can be introduced via secondary legislation – the proposed mechanism for the GMC reforms – while the Bill could complete its passage through Parliament by the middle of 2022, they said.

Any legislative change would deliver on a Government commitment made in 2018, when the Williams review into gross negligence manslaughter in healthcare following the case of Dr Hadiza Bawa-Garba recommended that the GMC should lose the right. 

Although the Government accepted the review’s recommendations ‘in full’, relevant legislative changes have yet to be made.

The MPS revealed that the GMC has challenged ‘at least’ 14 MPTS decision since the start of 2018, according to data obtained through an FOI request. This comes after Pulse exclusively revealed in March 2018 that the GMC had launched appeals against its own tribunal 23 times in the 10 months since gaining the right to do so in 2017 – with seven doctors struck off as a result.

MPS president Professor Dame Jane Dacre, who coordinated the letter, welcomed renewed Government commitment that the GMC should be stripped of the power but argued the move ‘should not be held up while a wide range of other complex proposals go through a round of further consultation’, almost three years after the original commitment. 

Professor Dacre said: ‘The strength of feeling on this issue from right across the healthcare community is clear to see.

‘The GMC’s power to appeal decisions made by the MPTS has led to fear across the medical profession and a lack of confidence in the GMC. Implementing this change as part of the forthcoming Health and Social Care Bill would give the profession confidence that their concerns and the recommendations of the Williams review are now being acted on.’

The powers are ‘unnecessary’ as the Professional Standards Authority (PSA) also has the authority to appeal MPTS decisions’, while the GMC is ‘the only UK health regulator’ to have such a right, she added.

She concluded: ‘There has never been a more important time to address this shortcoming.  Covid-19 has sparked discussion about the extent to which individuals should be held to account when working in pressurised and extreme circumstances, and now more than ever, the regulator needs to be able to operate in a way that instils confidence amongst patients and doctors.’

Meanwhile, Commons health select committee chair Jeremy Hunt this morning Tweeted his endorsement of the call for the ‘vital change’, saying it should be ‘actioned ASAP’.

‘[The] Bawa-Garba ruling had a chilling effect  & undermined efforts to create a learning rather than blame culture’, he said.

Last month, the Government published its plans to update legislation to enable swifter resolution of fitness-to-practise investigations, as well as quashing the GMC’s powers to appeal FTP decisions – which it has had since 2017.

A number of the proposed changes come in the wake of the high-profile case involving Dr Hadiza Bawa-Garba, which led to a review into FTP proceedings.

In 2018, the GMC said it would not halt appeals against FTP decisions until the law is changed, claiming it has a ‘statutory duty’ to do so in the meantime.

And a 2019 review found that the regulator should acknowledge its relationship with doctors has been ‘severely damaged’ from the Bawa-Garba case and that it ‘must learn’ from it.

Read the article here

A doctors’ union has warned about the implications of the proposed new doctor apprenticeship scheme, warning it could waste GP time and produce ‘inadequately trained’ doctors.

Doctors Association UK (DAUK) said its members have ‘voted unanimously’ to oppose the new scheme which is being worked up by Health Education England and which is aimed at enabling candidates to become doctors without undertaking a traditional undergraduate medical degree.

On the back of reports it will have ‘a heavy primary care focus’ the DAUK warned that GP trainers would not have the capacity to train the apprentices.

DAUK chair Dr Jenny Vaughan said that while the organisation agrees with the aim to diversify and widen participation in medicine, it questions ‘why it is necessary, considering there is a surplus of fully trained final year medical students unable to secure FY1 placements’.

Dr Vaughan added that it could create a ‘two-tier system’, as it is ‘unlikely the same levels of competence will be achieved’ as those undertaking an undergraduate medical degree with the bulk of the scheme spent ‘in service provision’.

And she said: ‘With a near record numbers of students and junior doctors currently in training, the consultants and GPs who provide most of the clinical teaching are already under strain, and we question who will be supervising these trainees and if they really have any more capacity to do so.’

DAUK GP advisor Dr Lizzie Toberty said: ‘This apprenticeship scheme risks spending a lot of time and money to develop inadequately trained doctors. Without a thorough and rigorous grounding in the sciences we risk dumbing down our health system. If patients do not have access to doctors with adequate clinical knowledge their treatment will suffer.’

She added that ‘alarm bells’ have been ringing given the primary care focus of the scheme, adding that there is an inference that general practice does not require the same level of knowledge or skills, as a hospital doctor, signalling a ‘huge underestimation of the role’.

She added: ‘We strongly recommend HEE focus on making current medical school places more affordable and accessible to those from all backgrounds, and develop schemes to allow students to study part time and have jobs alongside their medical degrees – or provide them with bursaries.’

But HEE retorted to the claims, saying that the same medical schools as currently have undergraduate medical students  will deliver this degree apprenticeship  with exactly the same exams and assessments including the MLA  as for the traditional course so there will be no difference in competencies achieved.

It also refuted the claim that there is a shortage of foundation placements, with those placed on waiting lists usually found positions.

HEE deputy medical director for undergraduate education Professor Liz Hughes said: ‘We are working with employers, the Institute for Apprenticeships and Technical Education, Medical Schools Council, the GMC and a number of other stakeholders on developing a medical degree apprenticeship.  

‘A proposal is currently in the early stages of development and there will be significant opportunities to help shape and implement the plans. The expectation is that such an  apprenticeship could make the profession more accessible, more diverse and more representative of local communities while retaining the same high standards of training.’

Read the original article here

The DAUK presented the survey findings in a cross-party briefing on 3 November, which involved representatives from the Conservatives and Labour, as well as various smaller parties.

Dr Vinesh Patel, GP partner and DAUK committee member said:

‘Following our roundtable meeting with MPs on Tuesday, we are proud to have been able to raise the issues highlighted by primary care staff respondents in our survey. 

‘We discussed issues such as the mental health of staff, rising workloads, the GP-bashing within the media and the importance of primary care in this pandemic, and we are confident that we will be able to work together to tackle these issues going forward.’

The briefing made six policy recommendations to the group of MPs and peers:

1) A commitment to urgent ring-fenced funding for primary care in line with that provided to acute trusts.

2) An urgent review of the Public Health England PPE guidelines and revision to be in line with WHO recommendations and an urgent review of PPE stockpiles with provision for primary care/

3) Urgent recognition of the issue of digital deprivation and a review of support needed for the most deprived areas to ensure that the most vulnerable patients are able to access services.

4) Ring-fenced funding for 24-hour mental health support for all NHS workers, including primary care staff across the devolved nations.

5) Urgent action on lack of access to flu vaccinations, and a cash injection to ensure GPs can carry out a Covid vaccination programme, if and when required

6) MP support to combat the damaging narrative that GPs have not been open during the pandemic.

Read the full Pulse article here.