Doctors, including GPs and one medic who travelled from America, assembled outside the Court of Appeal in London on Wednesday and Thursday, and have been attending the hearing, to show their support for Dr Bawa-Garba, the junior doctor who was struck off the medical register following a successful appeal by the GMC in January.
Speaking to GPonline Dr Samantha Batt-Rawden, chair of new campaigning and lobbying organisation The Doctors Association UK (DAUK), and a registrar in emergency and intensive care medicine, described the atmosphere as ‘one of disbelief’.
‘For those of us observing it’s still hard to believe that we have got to the stage where an otherwise dedicated and hard working doctor has been criminally prosecuted and taken to court by the GMC for what were essentially honest mistakes [made when] working under pressure,’ she said.
Dr Bawa-Garba is appealing a decision made in January by two High Court judges that she should be erased from the medical register rather than receive the year's suspension that had previously been imposed by the Medical Practitioners Tribunal Service (MPTS).
Their ruling followed a successful appeal by the GMC, which argued that suspension was ‘not sufficient’ to protect the public or maintain public confidence in the medical profession.
On Wednesday, the opening day of the appeal, Dr Bawa-Garba’s counsel James Laddie QC said there was particular concern in the medical profession over the court’s decision to disregard ‘systemic failings’ which contributed to the environment in which Dr Bawa-Garba came to make the mistakes leading to the death of six-year-old Jack Adcock in 2011.
Dr Batt-Rawden, who sat in court during the appeal’s opening yesterday, said: ‘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.
‘This has huge ramifications for the medical profession and for patient safety. We are all working in an immensely pressured system, with widespread staffing issues and rota gaps. Hadiza’s story of doing the jobs of several doctors at once, across multiple wards and multiple floors, with a failing IT system, in the absence of senior colleagues or indeed a consultant is sadly increasingly common.
‘Before this case I don’t think any doctors thought that mistakes made whilst simply trying their best under such pressured circumstances would ever lead to a criminal conviction, or erasure from the register. Now, all of us are feeling vulnerable.’
In written argument before the court, Ivan Hare QC for the GMC said the appeal should be dismissed because the High Court was correct to decide that the MPTS failed to apply the relevant rule of the GMC (Fitness to Practise) Rules Order of Council 2004 and undermined the rationale for making criminal convictions conclusive evidence of the offence committed in disciplinary cases.
A GMC factsheet about the Dr Bawa-Garba case also highlights that the criminal court took into account systemic issues when considering their verdict and they were also considered by the Court of Appeal when Dr Bawa-Garba unsuccessfully sought permission to appeal her conviction for gross negligence manslaughter.
GP Dr Yaso Browne, from the Isle of Wight, has also been attending the court case this week. She told GPonline: 'NHS GPs are as vulnerable as any other doctor. We are all finding ourselves at ever-increasing risk due to numerous challenges such as workforce shortages, underfunding, inadequate or unreliable IT systems matched against expectations that some would argue are unachievable.
'We need to assess whether the gross underfunding of the NHS can continue to be ignored in the context of the risk that each individual healthcare professional is taking. We need to openly discuss shared accountability if healthcare workers are going to feel safe to continue working in conditions that are setting them up to fail.'
In response to Dr Bawa-Garba’s case, The Doctors' Association UK has launched a new campaign ‘Learn not Blame’.
'We must move away from a culture of blame and fear, to one of learning,' Dr Batt-Rawden said. ‘We repeatedly fail to learn from scandals such as Mid-Staffs and Gosport and the NHS urgently needs a safe space to enable staff to speak up about patient safety issues.’
She added that there are ‘no winners’ in a culture which seeks to blame one individual for medical error whilst failing to address wider system failures.
‘Our ongoing campaign seeks to empower doctors to be part of a transformational change process working towards a shift from a culture of blame, to one of learning.'
She concluded: ‘An unsuccessful appeal today would do further damage to a profession whose morale is already at rock bottom, and signals a further move away from the open, transparent NHS that we all want to see.’
The hearing is expected to conclude on Thursday with judgment reserved.