GMC chair’s reply to Nick Ross’s second letter regarding Hadiza Bawa-Garba
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k765 (Published 19 February 2018) Cite this as: BMJ 2018;360:k765
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Many doctors would disagree with the "discretionary decisions" of GMC in this matter.(1). But, on the other hand, one has to acknowledge that GMC is "between a rock and hard place" with Dr Bawa-Garba case. GMC is ultimately beholden to the political task-masters in the parliament. So it is no surprise that GMC weighs up how the issue might play out in the public arena. The BMJ rapid response section is no match for the comments section of widely read national newspapers. (1).
I would also go further and add that the recent actions of the GMC has been in fact brought more attention to Dr Bawa-Garba's legal case. For instance, there were no published rapid responses to the news of the original conviction in the BMJ in 2015. (2) .
I am also perplexed by the outrage which is disproportionately directed against GMC when in fact it should be predominantly directed against the legal system which seems to criminalise medical mistakes. As Terence Stephenson points out the legal systems in UK are adversarial in nature and it is the legal system that needs reform.(3). Criminalisation of medical errors can lead to defensive medicine and ultimately can make NHS financially unsustainable. We have to convince the public and parliament to urgently reform medical manslaughter laws or else the future of NHS is in peril (4).
References:
(1) Stephenson T. GMC chair’s reply to Nick Ross’s second letter regarding Hadiza Bawa-Garba. BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k765 (Published 19 February 2018).
(2) Senior doctor, 35, who was convicted of manslaughter over blunders that resulted in death of boy, six, can be struck off, High Court rules. Daily Mail. Published: 25 January 2018. http://www.dailymail.co.uk/news/article-5310161/Ruling-doctor-convicted-... (accessed 3/3/2018).
(3) Dyer C. Paediatrician found guilty of manslaughter after boy’s death from septic shock. BMJ 2015;351:h5969. doi: https://doi.org/10.1136/bmj.h5969 (Published 05 November 2015).
(4) Lacobucci G. Health secretary orders review into use of medical manslaughter. BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k592 (Published 06 February 2018).
(5) Sundar S. Legal case marks the beginning of the end for NHS. BMJ 2015; 351. doi: https://doi.org/10.1136/bmj.h5516 (Published 04 November 2015).
Competing interests: No competing interests
Letter to Charlie Massey Re: Hadiza Bawa-Garba
Dear Sir,
In response to the article in The BMJ, where you say
" If you think your working conditions are unsafe document (datix) the issue and escalate, but don't walk away."
Do you know how long it takes to do a datix that is initially going to be ignored? .. and follow it up?
I am not a Doctor, but my wife is, in a UK hospital setting. Two of her colleagues, one of them a senior nurse practitioner have got fed up of documenting and escalating and have done just that.. walked away. One of them ended up finding another job in another trust to escape the over work, which I believe was about 1.5 to 2.5 hours on a daily basis on an 8 hour day. The other one moved to another less stressful post in the same trust.
Reason....."you can't go home" "there is nobody to replace you"
My wife has been waiting for over a year for a job plan to use her qualifications properly, but no progress, patients being booked to inappropriate clinics just to get the seen by someone, even if that Dr is not qualified to always advise them and treat them safely. And whose fault will it be then?
My wife frequently comes home fatigued after doing extra hours several times a week. It is beginning to affect her health and well being too, but apparently that counts for nothing, and I now flatly refuse that she should do ANY locum shifts at all even when there are staff shortages as the problem becomes How to get time off in lieu! And the usual thing to do when there is a tired Doctor is to blame them and only them for any systemic failures. Where is my and our families quality of life meant to be in all this?
I am now retired, but when i worked as part of my job I held an HGV licence, and there are strict limits on working hours for drivers, and compulsory rest days and rest periods too, Which NHS employers can feel free to ignore.
I do not find it acceptable that any Dr, Junior, senior or Consultant should be told after doing 2 sessions (8 hours without a tea break even) to go home, get 3 hours rest and then come back and do a night shift (12.5 hours minimum) covering wards and emergency admissions.
The more the GMC accepts this sort of attitude from the managers, the GMC itself and the politicians, the more ingrained it will become.
And you might ask, why am I writing this? Not as a rant, but because I had a friend, a surgeon who died after a stroke on his way to a conference after a heavy workload.
I am tired of listening, (with much sympathy I add) to her friends and colleagues bemoaning the workload.
My wife wants to retire as early as possible to escape the sheer workload, pressure and paperwork involved as well as the hours and hours spent in what is supposed to be "our family time" doing more and more paperwork and reading more and more guff sent in emails.
All you will achieve with the continual sniping at Doctors and Health workers at all levels is that they WILL walk away, which is the opposite of what you are saying to do.
For fairly obvious reasons, I am not identifying her and not revealing our location.
Ben Thornton
Competing interests: No competing interests
The GMC Chairman claims that the organisation has to uphold UK law.
53% of its warnings imposed and published on its website include allegations that the GMC accepts there is “no reasonable prospect” of proving.
Section 43 of The Telecommunications 1984 makes malicious publication of allegations a criminal offence.
How does the GMC decide which laws to uphold and which to ignore?
Competing interests: The GMC has published false allegations about me for 5 years despite seeing contrary evidence.
Reading this letter is a breath of fresh air after all the criticism that has been levelled at the GMC that I have encountered recently. I think the key point is that there are mistakes and there are mistakes - but not all of them are forgiveable.
Competing interests: No competing interests
Re: GMC chair’s reply to Nick Ross’s second letter regarding Hadiza Bawa-Garba
Since 2016, Sir Terence Stephenson has "discussed with the Health Secretary the creation of a 'safe space' in healthcare and a form of legal privilege, akin to the airline industry....but parliament has chosen not to enact that. Until it does, we remain bound by UK law as it stands".
Parliament and its laws have clearly fallen flat on their face in relation to the vital principle that medical professionals and those working in the NHS cannot themselves practice safely, if the spaces in which they work are unsafe, unsound and unsupportive. This is an incovenient truth; yet, if parliamentarians cannot enact laws that ensure such spaces are mandated, then we are clearly all negligently served. The airline industry itself paid for a 10-year redesign that transformed air traffic control into the National Air Traffic Services (NATS) and flight safety across the UK for all those using flying through our airspace was rigorously optimised.
As doctors, we compulsorily pay the GMC to provide our 'ticket' to practise, so surely we should expect this organisation to key to ensuring that our interventional 'flights' and 'flight deck' working contexts are safe.
I am now looking to the GMC's officers to address that "but" in the Chairman's letter and give this issue its undivided and unremitting attention in the face of whatever objections our parliamentarians might throw.
And, for the record, doctors are members of the public too.
Competing interests: No competing interests