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Tuesday, 14 August 2018

Doctor pays tribute to six-year-old after successful appeal against striking-off

Written by Jan Colley & Sally Wardle

A paediatrician convicted of gross negligence manslaughter over the death of six-year-old Jack Adcock said she was "very pleased" after winning her bid to be reinstated to the medical register.

Hadiza Bawa-Garba (pictured) fought a decision made in January by two High Court judges to substitute erasure for the lesser sanction of a year's suspension imposed by the Medical Practitioners Tribunal (MPT) in June last year.

The ruling followed a successful appeal by the General Medical Council (GMC), which argued that suspension was "not sufficient" to protect the public or maintain public confidence in the medical profession.

On Monday, the Court of Appeal unanimously allowed her challenge and said her name should be restored to the medical register forthwith.

Her case was remitted to the MPT for review of the suspension, which will remain in place in the meantime.

Dr Bawa-Garba told the BBC's Panorama programme: "I'm very pleased with the outcome but I want to pay tribute and remember Jack Adcock, a wonderful little boy that started the story.

"I want to let the parents know that I'm sorry for my role in what has happened to Jack.

"I also want to acknowledge and give gratitude to people around the world from the public to the medical community who have supported me. I'm very overwhelmed by the generosity and I'm really grateful for that."

Jack, from Glen Parva, Leicestershire - who had Down's syndrome and a heart condition - died at Leicester Royal Infirmary in 2011 after he developed sepsis.

In 2015, at Nottingham Crown Court, Dr Bawa-Garba was sentenced to two years in prison suspended for two years.

The judge said neither she nor a nurse who was on duty "gave Jack the priority which this very sick boy deserved".

Jack's mother Nicola branded the ruling "an absolute disgrace".

She told ITV News: "It makes a mockery of the justice system. If she'd (Dr Bawa-Garba) have done what she should have done that day I know my son would still be here 99.9% and I will never budge from that."

Giving the appeal court's ruling, the Master of the Rolls, Sir Terence Etherton, said: "Undoubtedly, there are some cases where the facts are such that the most severe sanction, erasure from the medical register, is the only proper and reasonable sanction. This is not one of them.

"Once it is understood that it was permissible for the tribunal to take into account the full context of Jack's death, including the range of persons bearing responsibility for that tragedy and the systemic failings of the hospital, as well as the other matters relied upon by Dr Bawa-Garba, and that the tribunal plainly had in mind its overriding obligation to protect the public for the future, it is impossible to say that the suspension sanction imposed by the tribunal was not one properly open to it and that the only sanction properly and reasonably available was erasure."

He added: "The present case is unusual.

"No concerns have ever been raised about the clinical competence of Dr Bawa-Garba, other than in relation to Jack's death, even though she continued to be employed at the hospital until her conviction.

"The evidence before the tribunal was that she was in the top third of her specialist trainee cohort.

"The tribunal was satisfied that her deficient actions in relation to Jack were neither deliberate nor reckless, that she had remedied the deficiencies in her clinical skills and did not present a continuing risk to patients, and that the risk of her clinical practice suddenly and without explanation falling below the standards expected on any given day was no higher than for any other reasonably competent doctor.

"The tribunal was an expert body entitled to reach all those conclusions, including the important factor weighing in favour of Dr Bawa-Garba that she is a competent and useful doctor, who presents no material continuing danger to the public, and can provide considerable useful future service to society."

KEY QUESTIONS ABOUT DOCTOR'S BATTLE WITH GMC OVER DECISION TO STRIKE HER OFF

Dr Hadiza Bawa-Garba has won an appeal over the decision to strike her off after she was convicted of gross negligence manslaughter over the death of a six-year-old boy.

Here are some key questions and answers relating to the case and the impact the judgement could have on the medical profession.

- Who is Dr Bawa-Garba?

The paediatric specialist was found guilty of gross negligence manslaughter in 2015 over the death of six-year-old Jack Adcock, who died from sepsis at Leicester Royal Infirmary in 2011.

A tribunal ruled in June last year that she should remain on the medical register despite her conviction, but issued a one-year suspension.

The General Medical Council (GMC) took the case to the High Court to appeal against the sanction, saying it was "not sufficient" and Dr Bawa-Garba was struck off in January.

- How did the medical community respond to the case?

The actions of the GMC angered many doctors who said important issues raised by the case - including dangerous levels of understaffing, failures of IT systems and staff working in inappropriate conditions - had been ignored.

Jeremy Hunt, who was health secretary at the time, ordered an urgent review to clarify the line between gross negligence manslaughter and human error for healthcare workers.

Accepting the findings by Professor Sir Norman Williams, Mr Hunt said doctors and nurses who make "honest mistakes" while treating patients would receive greater support.

- What are the implications of Dr Bawa-Garba's successful appeal?

Organisations representing healthcare workers said the GMC would have to work to regain their trust, and hope the ruling will signal a move away from "blame culture".

Professor Dame Jane Dacre, president of the Royal College of Physicians, said the judgement is "a welcome step towards the development of a just culture in healthcare".

She said: "We hope today's judgement will provide some reassurance to doctors, particularly our trainees, that they will be protected if they make a mistake."

Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, said: "We stand willing to continue working with the GMC to address the issues raised by this case.

"Our members are committed to delivering high-quality, safe care for children and avoiding errors; but when one-off errors do happen, doctors are owed a duty of care and support, not blame."

Dr Chaand Nagpaul, British Medical Association (BMA) council chair, said the regulator has "lost the confidence of doctors and must now act to rectify their relationship with the 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.

- How has the GMC responded?

Charlie Massey, GMC chief executive, 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."

The case has "exposed a raft of concerns, particularly around the role of criminal law in medicine" and the GMC has commissioned an independent review as a result, Mr Massey said.

He added: "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.

Copyright (c) Press Association Ltd. 2018, All Rights Reserved. Picture (c) Leicestershire Police / PA Wire.