LMCs pass vote of no confidence in GMC after Bawa-Garba case

LMC representatives have backed a vote of no confidence in the GMC after its decision to strike off Dr Hadiza Bawa-Garba and called for the GPC to advise doctors to 'disengage from written reflection'.

Despite warnings from senior BMA GPs that the move could make it difficult for the union to work closely with the regulator, GPs voted strongly in favour of the no confidence motion.

LMCs also backed a vote for the GPC to 'advise GPs to disengage from written reflection in both appraisal and revalidation until adequate safeguards are in place'.

GPs also voted for the GPC to demand a review by the House of Commons health select committee into the GMC's handling of the Bawa-Garba case, and to establish a system 'whereby GPs can make collective statements of concern regarding unsafe care'.

Bawa-Garba case

The vote comes after RCGP chair Professor Helen Stokes-Lampard set out the implications for GPs of the Bawa-Garba case in a statement published on GPonline last week.

GPC chair Dr Richard Vautrey warned that the no confidence vote provided further evidence of the extent to which the Bawa-Garba case had rocked medicine.

GPC sessional subcommittee chair Dr Zoe Norris asked the conference if, after the handling of the case of Dr Bawa-Garba, they were confident that they could reflect honestly and openly.

'Can you trust the current process,' she asked. Many LMC representatives murmured 'no'. Comments from health secretary Jeremy Hunt about expressing concern about the case and his decision to implement a review of medical manslaughter cases were not enough, she said.

'The statements made so far do not constitute adequate safeguards in my mind and do not protect GPs. There hasn’t been much balance in the policies and rhetoric to date to lead GPs to believe that we are valued by Mr Hunt and his government,' she added.

'We are told to speak up, that we will be protected if we speak up. As a salaried GP or locum I can speak up if something concerns me. If you are a partner – what can you do? Conference, if you fail to raise a concern about an aspect of patient care you cannot deliver safely because your hands are tied, who do you think will be up before the GMC?'

GMC investigation

Dr Alicia Watts from Kent LMC highlighted data showing that doctors under investigation by the GMC often suffer ill health during the process. She warned that the current system 'may actually harm doctors' and warned: 'Unless we move away from blame towards an open culture, patients may also suffer.'

GPC member Dr David Bailey was critical of the current system, highlighting that the GMC could use reflection against doctors under current rules. But along with GPC executive committee member Dr Mark Sanford-Wood, he cautioned against a no confidence vote - warning that ripping up the GMC and starting from scratch was not an option.

Dr Sanford-Wood told the conference: 'This debate is being had against the backdrop of two families who are devastated – the Adcocks and the Bawa-Garbas.

'We are all concerned about aspects of the Bawa-Garba case and want to encourage an environment of shared learning.'

However, he warned: 'We can best do that if we are properly engaged with the GMC. A no confidence vote would make that more difficult and I would caution against it on basis of a single decision the GMC has made.'

However, delegates backed the no confidence vote after Dr Norris asked: 'Prior to the Bawa-Garba case, did you have confidence in the GMC?' She said she or anyone else in the room could be the next doctor in Dr Bawa-Garba's shoes - 'I am Dr Bawa-Garba', she said.

The motion passed by the UK LMCs conference reads 'That conference, following the recent case of Dr Bawa-Garba, has no confidence in the GMC as a regulatory body.'

Dr Vautrey said: 'We need a system that seeks not to scapegoat individuals, but recognises when workplace pressures have placed doctors in dangerous situations and commits to taking action to stop it happening again.

'We have already secured a commitment from the GMC that it will never ask a doctor to provide reflections during investigations, and we are continuing to apply pressure to ensure it works to improve the system so that doctors of all grades can raise safety concerns while working in an overstretched environment.'

GMC chief executive Charlie Massey said: ‘We are listening to what doctors are telling us about this case. We are sorry it has had such a significant impact on the profession, and that as a result, many doctors are feeling upset and unsure about their practice and their working environments. That was never our intention and we know that we have a huge amount to do to rebuild trust.

‘We have made a series of commitment with the BMA to work together to address those concerns. That includes reaffirmation that we do not ask for doctors’ reflective statements when investigating concerns, and confirmation that if doctors follow our guidance on raising concerns when working under pressure it will very much weigh in their favour if subsequent complaints are received about them.'

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