Paediatrician convicted of manslaughter must be erased from register, rules High CourtBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k417 (Published 26 January 2018) Cite this as: BMJ 2018;360:k417
A trainee paediatrician who was convicted of gross negligence manslaughter over the death of a 6 year old boy must be struck off the UK medical register to maintain public confidence in the profession, the High Court has ruled.1
A medical practitioners tribunal decided in June 2017 to suspend Hadiza Bawa-Garba for 12 months rather than erase her from the register, after taking account of system failures that contributed to Jack Adcock’s death.2
But two senior judges have substituted the sanction of erasure, after the General Medical Council appealed against the tribunal’s decision.
Mr Justice Ouseley, giving the leading judgment, said, “I have come firmly to the conclusion that the decision of the tribunal on sanction was wrong, that the GMC appeal must be allowed, and that this court must substitute the sanction of erasure for the sanction of suspension.” Lord Justice Gross agreed, “with sadness but no real hesitation.”
Jack, who had Down’s syndrome, died of sepsis at Leicester Royal Infirmary in February 2011. Bawa-Garba was given a two year suspended jail sentence in December 2015 after being convicted of manslaughter.3
Ouseley said that the tribunal’s decision to suspend rather than erase her contradicted the jury’s findings that her failings were “truly exceptionally bad.” He added, “The holes in the patient’s safety net cannot reduce her personal culpability.”
He went on, “There was no suggestion, unwelcome and stressful though the failings around her were, and with the workload she had, that this was something she had not been trained to cope with or was something wholly out of the ordinary for a year 6 trainee, not far off consultancy, to have to cope with, without making such serious errors. It was her failings which were truly exceptionally bad.”
He acknowledged that Bawa-Garba “before and after the tragic events was a competent, above-average doctor,” and that “for many years afterwards she has practised safely and competently.” But “this misconduct by manslaughter by gross negligence involved a particularly serious departure from the principles of [the GMC’s] Good Medical Practice, and the behaviour was fundamentally incompatible with being a doctor,” he added.
But the judges rejected an argument by the GMC that there must be a presumption that a conviction for gross negligence manslaughter should be followed by erasure, in the absence of exceptional or truly exceptional circumstances. They said that each case would turn on its own facts.
Rob Hendry, medical director of the Medical Protection Society, Bawa-Garba’s defence organisation, said that the society was considering “all options in the interests of our members and the wider profession,” which means that an appeal is possible. “The outcome of the GMC’s appeal against the tribunal decision on this case is disappointing, and its implications will understandably be of concern to the healthcare community. This appeal decision may jeopardise an open, learning culture in healthcare at a time when the profession is already marred by low morale and fear,” he added.
The GMC’s chief executive, Charlie Massey, said, “The ruling clarifies that tribunals cannot go behind the jury’s verdict when a doctor is convicted in a criminal court.” But he added, “We know the strength of feeling expressed by many doctors working in a system under sustained pressure, and we are totally committed to engendering a speak-up culture in the NHS. Doctors should never hesitate to act openly and honestly if something has gone wrong.”
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