The Court of Appeal quashed the divisional court's decision to erase Dr Bawa-Garba from the medical register, and restored a one-year suspension imposed by the Medical Practitioners Tribunal Service (MPTS).
The court ruled that the MPTS 'was entitled to take account of systematic failures at the hospital, and failures by other staff who worked there, when deciding what action to take in relation to Dr Bawa-Garba'.
Dr Bawa-Garba was struck off earlier this year after the GMC appealed against the 12-month suspension, arguing that she should be struck off because the tribunal decision showed it had taken a less severe view of her actions than an earlier court that convicted her of gross negligence manslaughter (GNM).
However, the appeal court rejected this view and the GMC has now confirmed it will not seek to pursue the case further.
Dr Bawa-Garba's initial GNM conviction followed the death of six-year-old Jack Adcock at Leicester Royal Infirmary in 2011. She received a two-year suspended sentence in 2015 but was able to continue working. The medical tribunal ruling came in 2017, followed by the controversial GMC challenge that led to her being struck off in January 2018.
The case has sent shockwaves through the medical profession, with former health secretary Jeremy Hunt criticising the GMC and warning that patients could be put at risk because of the impact it would have on doctors' willingness to reflect openly on mistakes.
GPonline reported earlier this year that hundreds of GPs had boycotted written reflection within weeks of a Dr Bawa-Garba being struck off. Meanwhile, seven out of 10 GPs no longer believe recording reflective notes is safe, a poll by this website found last month.
BMA chair Dr Chaand Nagpaul said: 'We welcome today’s judgment on this important case reversing the erasure of Dr Bawa-Garba from the medical register and restoring the decision of the MPTS.
'We hope that Dr Bawa-Garba will now rightly be given space to resume her career. Today’s successful appeal in no way detracts from the tragic circumstances of this case and the unexpected death of a young boy, and we once again send our deepest condolences to Jack Adcock’s family.
'The GMC’s successful high court appeal in January, which overturned the MPTS' 12-month suspension of Dr Bawa-Garba and resulted in her erasure from the medical register, caused widespread alarm amongst doctors and undermined the role of the MPTS. We know that doctors going through tribunal hearings find it stressful enough and the perception of a risk of double jeopardy can only exacerbate this problem.'
Dr Nagpaul said the ruling 'raises serious questions over the GMC's ill-judged handling of the case'.
GMC chief executive Charlie Massey said: ‘We fully accept the Court of Appeal’s judgment. This was a case of the tragic death of a child, and the consequent criminal conviction of a doctor. It was important to clarify the different roles of criminal courts and disciplinary tribunals in cases of gross negligence manslaughter, and we will carefully examine the court’s decision to see what lessons can be learned.
‘As the independent regulator responsible for protecting patient safety we are frequently called upon to take difficult decisions, and we do not take that role lightly. We are sorry for the anguish and uncertainty these proceedings have had on Jack’s family, Dr Bawa-Garba and the wider profession. This was a complex and unusual case; while the decisions we took were in good faith, we know that investigations and hearings are difficult for everyone involved.
‘Although gross negligence manslaughter cases in medicine are extremely rare, this case has exposed a raft of concerns, particularly around the role of criminal law in medicine, which is why we have commissioned an independent review to look at how it is applied in situations where the risk of death is a constant, and in the context of systemic pressure.'