'Inconsistent' handling of medical errors unfair on doctors, BMA tells review

Rules for reporting and investigating serious clinical incidents in the NHS are 'not clear and consistent' and discrimination against BME doctors must be tackled, the BMA has told a review triggered by the Bawa-Garba case.

Responding to the GMC-commissioned review into gross negligence manslaughter, led by Dr Leslie Hamilton, the BMA hit out at inconsistent arrangements for reporting and investigating serious clinical incidents within healthcare settings.

It also highlighted the importance of removing ‘significant racial inequalities in the NHS medical workforce’.

The BMA's response to the Hamilton review comes just days after the Court of Appeal overturned a previous High Court decision that Dr Hadiza Bawa-Garba should be removed from the medical register, bringing a close to a controversial case that has provoked intense scrutiny and criticism of the GMC. The case has also sparked claims that Dr Bawa-Garba may have been treated differently had she been white.

Investigations

The union's response says: ‘The BMA is concerned that serious incidents are currently not always investigated in a timely and effective manner, with robust action plans not always properly developed and implemented and learning shared as appropriate.’

It added that without a clear framework or consistent training for NHS organisations, a ‘due and fair process will not always be followed’.

Standardising local processes - for example, by equipping healthcare organisations with a ‘dedicated identifiable team of staff whose duties include advising on the serious incident framework and carrying out investigations’ - could ‘lead to less cases being escalated to the criminal justice system’, the BMA said.

The BMA reponse also highlighted GMC research that found that doctors who obtained their primary medical qualification outside the UK and/or those who are from a black and minority ethnic (BME) background are more likely to receive fitness-to-practise complaints than their white counterparts, and more likely to end up being investigated and face sanctions.

‘Removing the additional barriers faced by BME doctors will depend on effective action being taken to eradicate racial inequalities and discrimination in the NHS so that BME doctors can be confident that they will be treated fairly,’ its response says.

Equality

A recent BMA survey revealed that more than half (57%) of BME doctors said they were afraid that they would be blamed or suffer adverse consequences if they raised a concern, compared to 48% of white doctors.

The BMA added that they were in the process of drawing up a draft action plan focusing on ‘what needs to change to create a genuinely fair and inclusive profession and NHS’.

Earlier this month Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO) told GPonline that Dr Bawa-Garba - the junior doctor who recently overturned the GMC's appeal to have her struck off the medical register following the death of six-year-old patient Jack Adcock - would not have 'landed in such deep trouble' if she were white.

The GMC is currently working on a review to establish the reasons why the GMC receives a higher proportion of complaints about BME doctors, which is due to be published in February 2019.

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