Dr Bawa-Garba is all of us

bawaOn the 25th of last month, a seven-year legal battle came to an end: Dr Hadiza Bawa- Garba was struck off the medical register. An ST6 paediatrics registrar, Dr Bawa- Garba was charged with gross negligence and manslaughter in connection with the death of Jack Adcock, a six year old boy with Down’s Syndrome. In what is now described as a ‘catalogue of errors’ she was said to have missed early signs of septic shock and mistakenly thought he was under a DNACPR order.

 

However, there is a whole lot more to the story. A failure in the IT system at the Leicester Royal Infirmary meant a delay in receiving blood test results. The hiatus in resuscitation of between 30 seconds to 2 minutes was not thought to have contributed to his death as his condition had deteriorated by then. She had also just returned from maternity leave to a new working environment, and the ward was severely understaffed – all too common a story in the NHS.

 

Dr Bawa- Garba was handed a 24-month sentence on the 14th of December 2015. The GMC later disputed this and took the Medical Practitioners Tribunal Service (MPTS) to court, arguing its own tribunal was wrong to have allowed Dr Bawa- Garba to continue to practice. The MPTS decision was subsequently overruled and she was struck off. This decision was seen as controversial, with Jeremy Hunt describing its implications as ‘damaging’ for a culture of transparency that needs to be cultivated in healthcare.

 

In days, over £200,000 has been raised by crowd funding to cover the legal fees involved in challenging the decision of the High Court. Over 800 doctors petitioned against the GMC ruling, arguing that the High Court hearing ‘criminalised clinical error’ and penalized doctors for ‘trust-wide issues’. The open letter to the BMA called for action against the ‘over-regulated and litigious culture’ of the NHS, which would inevitably set in motion a harmful trend of defensive medicine.

 

There is concern being raised that Dr Bawa- Garba’s e-portfolio and clinical reflection pieces were used as evidence against her in the trial, which would carry implications for future reflective practice. However, there is increasing evidence that this was not the case. As Dr Pallavi Bradshaw, an ophthalmologist and a prominent medico legal adviser argues, contents of e-portfolios ‘would not be provided for anything other than educational purposes’, and often information contained would be sufficiently anonymised so as not to contain any patient identifying data. Opponents of this view argue that her reflective pieces played a significant role in implicating her, and that documentation of any kind in the future should be avoided and replaced with one-to-one meetings. If it were the case that her personal reflections were used against her, it would seriously erode the process of learning from one’s own mistakes, one that is so essential to healthcare.

 

Dr Bawa –Garba could have been any one of us, now or in the future. She was said to have an ‘impeccable record’, a mother who had dedicated her life to the profession. If we want to promote a culture of transparency and openness in medicine, one in which we aim to learn from our mistakes rather than penalise and victimise, we need to get rid of the blame culture that is all too pervasive and easy to be embroiled in.

 

 

 

 

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