Since Dr Hadiza Bawa-Garba was struck off the medical register, the medical community has been in uproar. Irate voices continue to be heard within hospitals as well as on online blogs and social media. People have been reluctant to engage with the opposing view, leaving nothing up for debate. The medical community has decided that Bawa-Garba is innocent; this is justice delivered from the coffee rooms of the health service.
Yet Bawa-Garba’s failures over the death of Jack Adcock “were not simply honest errors” according to the high court, but “truly exceptionally bad” [pdf]. As a fellow junior doctor, I appreciate how easily errors are made and I will be the first to rise to Bawa-Garba’s defence. I can safely say, without evidence but with confidence, that every doctor with sufficient experience has made multiple errors – yet how many result in a conviction of gross negligence manslaughter? Everyone in the NHS works in the same low-resource, high-pressured environment. The last decade has only seen three convictions of medical manslaughter; this was no ordinary case.
The Medical Practitioners Tribunal Service reviewed Bawa-Garba’s case and, considering the mitigation of multiple failings, they decided to impose a sanction of 12 months’ suspension. They believed a “fully informed, reasonable member of the public” would view this as appropriate.
But would members of the public allow a doctor convicted of manslaughter to treat their children? I believe the tribunal was wrong in coming to this conclusion. The judge and jury were fully informed over the course of a four-week trial and found Bawa-Garba guilty by a 10:2 majority verdict. The tribunal came to their own and less severe view of her culpability, a view many medical professionals would agree with, but in doing so they undermined the verdict of the jury. Distributing justice as we see fit within our profession is disrespectful to the justice system and the people it serves – in this case, the family of Jack Adcock.
When did it become acceptable to be convicted of manslaughter relative to being struck off the medical register?
The GMC successfully appealed this decision, resulting in a sanction of erasure from the medical register. There was an outcry from doctors across the country and beyond, who were shocked by this decision. Petitions were signed and a crowdfunding page was started to aid a legal challenge. The GMC was vilified in the press and on social media. Jeremy Hunt was left “totally perplexed” by the actions of the GMC, leading to a transient surge in his approval ratings among junior doctors.
The wider implications this case has for medical professionals and the potential impact on patient safety is concerning, but where was this perplexion when Bawa-Garba was convicted? There was no comment at the time from our health secretary, nor any fundraising for her appeal. When did it become acceptable to be convicted of manslaughter relative to being struck off the medical register?
There has been a generational shift in public expectations of medical professionals with a greater demand for people to be involved in decisions about their care. Younger generations have been less satisfied with services and this may lead to a fall in public confidence in the profession in the future.
As demand for services rises and budgets fall, maintaining standards in the health service will become increasingly challenging and the risk of errors will inevitably increase. In an era of candour and transparency, these errors are rapidly publicised and scrutinised by the press and social media. Now more than ever, the GMC must act to maintain public confidence in the profession. For this reason, the GMC were correct to erase Bawa-Garba from the medical register.
I am not sure whether the criminal court is the best place to hold a medical professional to account, and I welcome Hunt’s belated review into medical manslaughter. Medical professionals who do their utmost for patients should not live in fear of legal action for honest mistakes. Bawa-Garba was let down by the system that she worked in. I, like many of my colleagues, do not believe she should have been convicted of manslaughter. However, Nicola Adcock is right when she points out that none of us were at the inquest, or present at the four-week trial. I have come to respect the decision of the court – so should my colleagues.
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