Bawa-Garba and why a sticking plaster approach to the NHS will not work

Writing in today’s Times, columnist and broadcaster Jenni Russell says wise doctors will retreat from the front line as overwork and the risk of negligence cases make safer specialisms preferable to acute medicine.

Her comments come after the decisions of the GMC and the High Court in pursuing the striking-off of Dr Hadiza Bawa-Garba after an error which led to a child’s death.
The doctor was under extreme pressure, covering for an absent registrar while overseeing six wards on four floors, on a relentlessly demanding twelve-hour shift. It was her first day back after maternity leave and she had had no induction training. The nursing rota was understaffed and the IT system was down for hours, meaning blood test results were critically delayed. Her consultant wasn’t present. All the evidence given testified to her being a committed, above-average doctor, and yet she has been thrown out of the profession.

Jenni Russell says the unintended consequences of this hardline decision by the GMC are going to damage the NHS, not protect it. Doctors across the country are aghast, feeling, as an editorial in the BMJ said, that “there but for the grace of God go I”. Furious senior doctors are reporting themselves to the GMC for long-ago errors, to make that point. Newer doctors are now afraid to admit to theirs in case it backfires on them. One doctor is quoted as saying: “I’m practising defensive medicine now.  We all are. I’m not taking risks. If someone turns up with a non-specific lump, I might before have used my judgment, said wait and see. Now I’m sending them for scans, second opinions, follow-ups, blood tests. Lots of that will be unnecessary, the NHS is already overloaded, and I’m adding to that. But I feel now I’ve got no protection, I’ve got to watch my own back.”

Jenni Russell also warns about the “cold legal danger doctors are now in” and says doctors need safer staffing levels and an absolute assurance that when they make mistakes their institutions will share responsibility too.

I have every sympathy for NHS staff on the receiving end of funding cuts and shortages. The NHS was never meant to cope with such high numbers of patients and radical changes need to be made in order to save it.  All professionals are open to claims if we fall below the standard required of society, lawyers included.

If under funding is the result of below par standards resulting in death, maybe a case of corporate manslaughter should be considered rather than pursuing the individual doctor?

What is increasingly clear is that the NHS is no longer fit for purpose, due to the high number of people using it.

One option is to means test those who use the service and rely on private medical care to assist the NHS.  Can employers also do more to provide staff with access to private healthcare and help relieve the pressure?

We are following the USA and becoming a more litigious society.   If hospital negligence results in injury, people are entitled to take action.   We cannot take away those rights away.

The time has come for radical change to the whole system.   We need to reduce the number of people using the NHS and put it back together again.  A sticking plaster approach will not work.

Hilary Meredith