This case has been festering, and playing in the minds of many reflective doctors. The principal that we should be completely open in our reflection will not hold water for those doctors who have made mistakes – Is this a form of official gagging? Dr Vaughan’s comment at the end of this report reads: “You can’t learn from errors in a climate that threatens individuals with criminal sanctions and lets the system off. The hospital hasn’t been held to account.” The Official BMA response (30th Jan 2018) is here.
Back to blame: the Bawa-Garba case and the patient safety agenda. Is there any Dr who will not stop putting any form of patient identifiers in their portfolio now? Medical errors may now be hidden for fear of litigation.
Doctors have been warned that they risk disciplinary action if they carry out threats to stop recording mistakes in writing.
They fear that any admissions could be used against them, after a junior doctor was struck off last week for errors that led to the death of a six-year-old boy. Hadiza Bawa-Garba was convicted of manslaughter by gross negligence in 2015 over the death of Jack Adcock from sepsis in 2011.
Her case has provoked anger among thousands of doctors, who believe that she was a scapegoat for systemic failings and may have been the victim of racism. Jack was admitted to Leicester Royal Infirmary in 2011 with diarrhoea and vomiting. Bawa-Garba failed to follow up tests quickly, did not call in a consultant and told a crash team to stop resuscitation after mistaking him for a patient with a “do not resuscitate” order. She was covering the work of two doctors after return from maternity leave, with no induction into the role.
Last year the Medical Practitioners Tribunal Service decided not to strike her off but the General Medical Council appealed and won last week.
Kaanthan Jawahar, a junior doctor specialising in geriatric psychiatry in Nottingham, wrote on Twitter: “Your employer will scapegoat you for systemic failures . . . Your seniors will throw you under the bus.”
Doctors must keep an eportfolio as part of their annual appraisal process, in which they should reflect on how they could improve their practice.
Rob Hendry, medical director at the Medical Protection Society, which represents doctors in legal cases, said: “One particular area of concern has stemmed from reports that Dr Bawa-Garba’s eportfolio reflections were used against her at the criminal trial. In fact, her eportfolio did not form part of the evidence before the court and jury.
“We also advise doctors to bear in mind that not disclosing an incident or reflection during appraisal may lead to a greater risk of allegations of probity and referral to the GMC.”
Terence Stephenson, chairman of the GMC, said that although the court had ruled that the tribunal “had no powers to unpick the criminal conviction”, there was a “critical need” to examine how gross negligence manslaughter cases were initiated and carried out.