Appeal court rules in favour of Bawa-Garba appeal

A court has ruled in favour of Dr Hadiza Bawa-Garba in her appeal against the controversial High Court case, which saw her struck off the medical register in January.

The ruling quashes the High Court’s decision in favour of the GMC to declare Dr Bawa-Garba unfit to practise earlier this year.

The GMC had taken its own tribunal to court to overturn its decision to allow Dr Bawa-Garba to remain on the medical register following her 2015 manslaughter conviction relating to the death of six-year-old patient Jack Adcock.

But the Court of Appeal said in today’s ruling that the Medical Practitioner Tribunal Service (MPTS) decision to suspend rather than erase was more appropriate.

Following the ruling, Dr Bawa-Garba is being restored to the GMC register and the MPTS will decide if further action needs to be taken.

The judgment read by Sir Terence Etherton, master of the rolls, said the decision ‘was not a decision of fact or law but an evaluative decision based on many factors’.

He said: ‘The Court of Appeal sets aside the order of the divisional court that Dr Bawa-Garba should be erased from the medical regulations and restore the order of the tribunal that she be suspended from practice for 12 months subject to review.’

Commenting on the verdict, 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 learnt.

‘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.’

He added that the 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’.

And said: ‘It has also been a lightning rod for the profession, highlighting issues that have gone unaddressed for far too long. While the GMC is not responsible for decisions to prosecute gross negligence manslaughter cases, we have reflected on what we can do to address the concerns we’ve heard about this case. Doctors have rightly challenged us to speak out more forcefully to support those practising in pressured environments, and that is what we are increasing our efforts to do.’

BMA chair Dr Chaand Nagpaul said today’s verdict ‘raises serious questions over the GMC’s ill-judged handling of the case’ which ’caused widespread alarm amongst doctors and undermined the role of the MPTS’.

He said: ‘We know that doctors going through MPT hearings find it stressful enough and the perception of a risk of double jeopardy can only exacerbate this problem.

‘Today’s judgement vindicates the BMA’s position that the MPTS is the right body to determine a doctor’s future in these complex and difficult cases, in which wider systemic pressures affecting patient safety need to be considered. It demonstrates that our call, acted upon by the Government, to remove the GMC’s right of appeal of MPTS decisions, was the right one.

‘It also raises serious questions over the GMC’s ill-judged handling of the case. As a regulator it has lost the confidence of doctors and must now act to rectify their relationship with profession.

‘Lessons must be learnt from this case which raises wider issues about the multiple factors that affect patient safety in an NHS under extreme pressure rather than narrowly focusing only on individuals.’

He added that the judgement is ‘a wake-up call for the Government that action is urgently needed to properly resource the NHS and address the systemic pressures and constraints that doctors are working under and which compromise the delivery of high-quality, safe patient care’.

Dr Chandra Kanneganti, BMA GP Committee member and chair of the British International Doctors Association, told Pulse that ‘patient safety is the winner here’.

He said: ‘The judge said that the [MPTS] tribunal looked at all the issues. It looked in detail about systemic failures, how to support Hadiza, how to get her back to training – they looked at everything – so they could not understand why she should not be back on the GMC register.’

He added that the verdict will promote a ‘good culture where everybody can reflect on the things that go wrong and try to learn from their errors, not blame each other for that’.

Dr Bawa-Gaba’s appeal case

Dr Bawa-Garba was struck off the medical register after the High Court ruled in favour of the GMC in the case against its own fitness-to-practise tribunal in January this year.

James Laddie, the QC representing Dr Bawa-Garba, claimed at her appeal hearing last month that there were ‘systemic failings which contributed to the environment in which Dr Bawa-Garba came to make the mistakes which led us to this court’.

Dr Bawa-Garba had originally diagnosed Jack Adcock with gastroenteritis and failed to spot from blood tests that Jack had sepsis, or review chest X-rays that indicated he had a chest infection.

Following the initial High Court ruling, which caused an uproar from the medical profession, the Government has announced its intention to strip the GMC of the power to appeal MPTS decisions. However the GMC has said it will continue until legislation changes.

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