Julien Warshafsky: how this doctor died and what it tells us about the system that failed himBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2564 (Published 14 June 2018) Cite this as: BMJ 2018;361:k2564
All rapid responses
Dr Bawa Garba and now Dr Julien Warshafsky and what a human tragedies for hard working sincere doctors! But these are not just two stories. I can tell many such stories of injustice to hard working sincere doctors. It saddens me that even GMC or FMLM or BMA has taken my concerns seriously over the last 15 years!
I have had meetings with 3 GMC Presidents, 3 BMA Chairman and many more NHS leaders. I have met Mr Jeremy Hunt, Simon Stevens in NHS England and anyone who is willing to meet me and listen to me. I even started Tweeting about NHS and also now use Lindkden.
What really saddens me is that most of the leaders I have met have been very good to me and they all gave me their valuable time and listened to me. I have been GMC Adviser for BME doctors issues for 10 years! We did make some changes and most of them are marginal changes but what I really wanted GMC to do has not been done. I suggested to GMC leader nearly 3 years ago to look at the impact of racism in NHS and the plight of Whistle Blowers. GMC did a lot for Whistle Blowers but failed to do anything about BME doctors plight and 'Institutional racism' of our NHS!
BMA failed to do anything. I met many of BMA leaders and told them the impact of poor leadership, poor accountability, poor governance and lack of support for doctors when they make mistakes or when they start showing bad behaviour!
27 doctors have committed suicide and 85 have died within a year of referral to GMC and 80 to 90% of referral to GMC are either unnecessary or can be prevented or can be dealt early and harm to patients can be prevented!
Hopefully now things will change. The New BMA Chairman Dr Chaand Nagpaul gives me hopes. He listens and he cares and he is determined to change the culture. Last week, we had an excellent conference to look at the impact of racism, bullying and discrimination and he has promised lot of action
There is Clare Marx review by the GMC and also there is research being carried out by Roger Kline and others.
Sadly poor support for doctors, and fear of referral to GMC has created lot of fear amongst doctors. Some Trust are using this to threaten hard working sincere doctors who speak up or stand up for their rights or rights of patients.
Dr Chris Day, Dr Edwin Jesudasan and many such stories are coming out. BMA's failure to support these doctors is also coming out in open. We as doctors can not and must not turn a blind eye when innocent patients suffer.
GMC has to look at its own internal process, policies and procedures. I have collected many cases of BME doctors and expert reports of GMC experts which are simply shocking. Innocent BME doctors have been scapegoated when consultants, clinical directors made the mistake! In many cases GMC experts have said 'Doctors' fitness to practice is impaired' just with one case! Many experts are not trained in looking at systems failures or human factors.
Martin Luther King Jr who said 'Injustice anywhere denies justice everywhere.! Of course, GMC has one of the most challenging job and it is only a tip of the iceberg. Vast majority discrimination takes place locally at Trust and CCG level.
Having said all these, NHS and UK is simply grate. I have had amazing career and vast majority of patients get good care. However when things go wrong, when doctors get in difficulty, most of them are not supported and GMC has been used as a threat! It is not just BME doctors who get in difficulty but many juniors, whistle blowers also get in difficulty.
We must create kind caring compassionate NHS where there are good systems and process, good culture to prevent harm to patients. Good culture, good team is what provides good care to patients.
Most doctors who get in difficulty need help, support and not blame or punishment. Of course bad doctors who sexually molest patients, steal drugs or wilfully put patients lives at risk must be disciplined.
Patient safety must not be compromised but blaming individual doctor or a nurse when there are systems failures is not the way to improve patient safety
Happy staff - Happy patients and NHS must promote staff happiness as the way to make sure patients get the best care.
Competing interests: I was Medical Director of NHS for 15 years and always been honest and sincere and hence this email may upset some of the leaders.