Read the Jenny’s full analysis in the BMJ here:

https://blogs.bmj.com/bmj/2019/06/06/medical-manslaughter-will-the-findings-of-an-independent-review-be-a-tipping-point-for-change/

You can now listen to Jenny’s full speech as a podcast on the ICS site, including advice on how doctors can avoid litigation.

They had two panels of experts. Professor Sir Norman Williams summarised the recommendations of his review and Sir Robert Francis clarified the law. They also heard from a healthcare ethicist, Dr Suzanne Shale and Professor Pali Hungin, member the current GNM/CH review set up by the General Medical Council (GMC).

Charles Massey took part in the second panel along with the Professional Standards Authority (PSA), The Nursing and Midwifery Council (NMC) and Keith Conradi from the Healthcare Safety Investigation Branch (HSIB). DAUK, Dr David Nicholl and more recently GP Survival have been calling upon the Health and Social Care Committee to conduct a public inquiry into Hadiza’s case since February. DAUK has corresponded with Dr Sarah Wollaston asking the HSC to question Charlie Massey over his decision to appeal the MPTS tribunal decision in the case of Dr Bawa-Garba now overturned, as it was legally flawed, by the Appeal Court. DAUK was invited to submit a written briefing for the HSC alongside a briefing from the BMA, now published on the Parliament website.

This briefing will be used by Members to inform their line of questioning towards the regulators and other panelists as well as being published.

Dr Samantha Batt-Rawden, Chair of DAUK said, “We thank the Health and Social Care Committee for asking for written evidence from grassroots doctors. The case of Dr Hadiza Bawa-Garba has had a profound impact on doctors, and trainees in particular, who now feel vulnerable that they too may face a criminal conviction for honest mistakes made whilst working under pressure. It is crucial that the HSC hear from doctors, the very people whom the current legislation on gross negligence manslaughter directly affects.”

The DAUK committee are keen to hear your thoughts and keen to represent the views of our members in the briefing. Please get in touch if you have any suggestions as to what to include.

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’.

Earlier this year, the Court of Appeal overturned a GMC-led High Court decision to strike-off Dr Hadiza Bawa-Garba, after the MPTS had called for her suspension following the death of Jack Adcock.

Following the case, the Government launched a ‘rapid review’ into the use of gross negligence manslaughter charges in medicine, concluding that the GMC should no longer have the right to appeal MPTS decisions.

However, Pulse revealed that the GMC is not intending to halt appeals against the MPTS until the law is changed.

The letter, which is co-signed by other lobbying groups including GP Survival and Doctors in Unite, said the case made doctors ‘feel that we too, could be pursued through the courts for errors made whilst simply trying our best’.

It said: ‘We, the undersigned, all agree that the GMC cannot be trusted to take a balanced and considered approach in the sanction of doctors who have made honest mistakes in the context of system failures.’

The letter added: ‘We are concerned that should the GMC’s action continue unchecked, that there will be a further breakdown in trust between the medical profession and its regulator, and the NHS will continue to move towards a culture of fear and blame, rather than one of learning.’

The association then urges Mr Hancock to:

• Call upon the GMC to cease appealing MPTS verdicts

• Confirm that the GMC’s right to appeal MPTS verdicts will be repealed, as per the recommendations of the Williams Review

• Set out a timeframe for when and how this legislation will be changed

The letter comes after the appeals court told the GMC to show ‘restraint’ after it quashed another GMC-bid to sanction a doctor last month.

“Campaign group The Doctors’ Association UK (DAUK), who last month called for an investigation into the GMC’s ‘aggressive pursuit’ of Dr Bawa-Garba, said the regulator had used its right to appeal ‘in every case to impose harsher conditions or sanctions on doctors’, adding that the GMC has ‘failed to appropriately reflect on its ongoing use of appeals’.

Doctors’ confidence

Dr Rinesh Parmar, DAUK treasurer, said: ‘Doctors’ confidence in their regulator the GMC has been severely damaged in the wake of the Bawa-Garba case. This [is] evident with thousands of doctors signing letters to the GMC throughout the case and following Dr Bawa-Garba’s appeal.

‘The actions of the GMC during the case and its desire to continue with these appeals further damages the relationship between doctors and their regulator. The GMC is seen as an organisation that is unable to appropriately reflect on its actions, learn from mistakes and remediate going forwards when seeking to impose harsher conditions to those determined by an independent tribunal.

‘DAUK will be calling on the government to confirm when it will be upholding the recommendations of the Williams review and stripping the GMC of its right of appeal.’”

In our letter DAUK also:

-expresses concern regarding the news that the GMC has continued to appeal MPTS verdicts following the judgment in Bawa-Garba v GMC

-expresses concern that this week Lord Justice Bean urged that the GMC show ‘restraint’ when exercising this power in the judgment of Raychaudhuri v GMC on the 14th September, and in discussing the case appeal judges expressed ‘regret that it was brought’.

-expresses concern that the GMC is currently appealing the MPTS verdicts of four doctors in the courts in order to impose a higher sanction. DAUK has asked Mr Massey to grateful clarify if this is indeed the case.

-states that we still do not feel that doctors, the patient safety community and the public, have been provided with a clear understanding of how the GMC came to the decision to appeal the MPTS verdict in Dr Bawa-Garba’s case, or indeed the processes which the GMC follows when deciding to appeal the MPTS verdicts of other doctors’ cases.

-confirms that Dr Sarah Wollaston has informed us the Health Select Committee will hold an evidence session on gross negligence manslaughter and patient safety in the Autumn.

-informs Mr Massey that we will be urging the Government to move forward with the legislative changes needed to repeal the relevant amendment to Section 40A that allows the GMC to appeal MPTS verdicts in a timely matter.

-calls upon Massey to cease appealing MPTS verdicts urgently.

-supports the petition started by Dr Jenny Vaughan that calls on the GMC to ensure that the court fees awarded to Dr Bawa-Garba are not paid for from the subscription fees of the doctors who supported her.

-extends an invitation to both Mr Massey and Professor Terence Stephenson to the formal launch of our Learn Not Blame campagin in Westminster hosted by Dr Philippa Whitford MP in November.

read the full letter here

We welcome Mr Massey’s apology and will be taking him up on his offer to meet DAUK. We will be responding to this this week in light of the news that the GMC has continued to appeal MPTS verdicts in the courts. This is despite the recommendations made by the Williams Review and widespread concern following the GMC’s actions in Dr Hadiza Bawa-Garba’s case.

read charlie massey’s reply in full

The Doctors’ Association UK believes the GMC made a serious error of judgement in aggressively pursuing Dr Hadiza Bawa-Garba in the courts, when it sought to have her struck off for honest mistakes made whilst under immense pressure.(1) This was against the advice of its own expert panel, the Medical Practitioners Tribunal Service (MPTS), who determined that Dr Bawa-Garba presented no greater risk to patients than any other competent doctor. The GMC’s action prompted widespread concern amongst the medical profession and patient safety campaigners that a junior doctor was being scapegoated for widespread systemic failures.

On Monday 13th August, the Court of Appeal threw out the GMC’s arguments and ruled that Dr Bawa-Garba could be reinstated on the medical register.

The Doctors’ Association UK believes that the GMC has shown it cannot be trusted to take a balanced and non-punitive view in its assessment of doctors in the context of system failures. The Doctors’ Association UK’s central campaign, launched in response to the GMC’s actions in Dr Bawa-Garba’s case, is Learn Not Blame, which seeks to address the problems of the blame culture within the NHS. In the spirit of this, we do not seek to scapegoat any one particular individual or group of individuals working within the GMC.

Instead, The Doctors’ Association UK has brought together over 1200 GMC-registered doctors, including Dr Philippa Whitford, MP, in writing to the GMC. Signatories include Mr David Sellu, whose conviction for Gross Negligence Manslaughter was quashed after he spent 15 months in prison. Other signatories include prominent whistleblowers and campaigners. 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. Lessons must be learnt to ensure that learning, openness and honesty is prioritised over blame, defensiveness and scapegoating.

Dr Samantha Batt-Rawden, Chair of DAUK, said “The GMC’s decision to pursue Dr Hadiza Bawa-Garba’s erasure from the medical register has led to an unprecedented loss of confidence in the GMC. As doctors, we recognise that mistakes happen. The GMC must now hold itself up to the same level of scrutiny that the GMC expects of doctors. We call on the GMC to reflect openly on its actions and to refer itself to the Health Select Committee for consideration of a public investigation. This, we believe, is a crucial first step towards restoring the trust of doctors and the public in the GMC.”

Dr Cicely Cunningham, Learn Not Blame Campaign (2) Lead, said “The GMC’s actions have set the patient safety agenda back by decades. We would like to see the GMC reflecting openly and honestly on its misjudgements in this case. A genuine attempt to learn from its mistakes would be a step towards restoring the confidence of the medical profession, and in moving towards the just culture the NHS so desperately needs”.

CONTACT

Contact@dauk.org

NOTES TO EDITORS

1. On 28th February The Doctors’ Association UK (DAUK) wrote a letter to Mr Charlie Massey, Chief Executive of the GMC expressing overwhelming concern regarding the handling of the Bawa-Garba case. This letter was signed by over 4500 doctors and several MPs.

2. Following the case of Dr Hadiza Bawa-Garba DAUK launched our campaign Learn Not Blame, seeking to change the way medical error is approached in the UK. Our aim is to transform the current culture of blame and fear, into one of learning. We believe this is vital for patient safety, and have received cross-party support for the campaign, as well as backing from our peers. More information on the campaign can be found here.

The Doctors’ Association UK is 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. We are therefore delighted that the report has recommended that the entirety of part 3 of the draft Bill, relating to Trust accreditation, be dropped.

The Doctors’ Association UK is also pleased that the report agrees the value of the HSIB as an independent body, bringing medicine in line with the rail and aviation industries. ‘Safe space’ investigations will allow staff to speak freely and determine what went wrong to prevent similar mistakes happening again. If ‘safe space’ investigations are to carry the confidence of the public, the independence of the HSIB must be assured.

The Doctors’ Association UK’s central campaign is entitled “Learn Not Blame”, and seeks to engender a national conversation about the need for a just culture in the NHS. We are campaigning for a step change in the NHS so that honest error is used to drive learning and change for a safer, better NHS, rather than being a focus for individual blame. The creation of a truly independent body is a welcome step towards this.