‘Watershed’ manslaughter verdict raises doctors’ fears over scapegoating

Medical politics

By Mardi Chapman

30 May 2018

When patients die due to healthcare system errors, should individual doctors be subject to criminal court action for the consequences?

Doctors at the recent AMA National Conference have voted overwhelmingly in support of a motion to clarify any Australian implications from the UK case of Dr Hadiza Bawa-Garba – a paediatric trainee convicted of manslaughter and struck off the medical register following the death of a six-year old patient.

The motion, proposed by AMA (NSW) councillor Dr Andrew Pesce and seconded by Professor Brad Frankum, was carried with a yes vote from 97% of voting delegates.

The motion has requested that the AMA:

  1. Notes the case of and its implications for doctors in Australia, particularly in light the similar health care systems and stressors;
  2. Take legal advice on the implications of the case for Australian doctors; and
  3. Adopt a position statement that informs doctors of their protections should a similar situation arise in Australia, particularly around the use of personal learning journals.

Background material provided to delegates said the case has resonated with Australian doctors, many of whom work in similarly stressed hospital systems.

“As widely reported in the media, Dr Bawa-Garba was a fourth-year paediatric trainee in the UK. On her first day back from maternity leave in a new hospital, she was involved in the care of a six-year-old boy named Jack. On this particular day, Dr Bawa-Garba was called upon to cover for absent colleagues. To add to the day’s confusion, the IT system went down. The result of this complete system meltdown was the tragic death of Jack.”

“Such a death anywhere in the world would result in legal processes and disciplinary proceedings. However, what happened next in the Dr Bawa-Garba case was completely unexpected and a watershed case in medicine. Dr Bawa-Garba and a nursing colleague were charged and then convicted of manslaughter.”

“Following that conviction, the British medical tribunal imposed a one-year suspension on Dr Bawa-Garba’s practice. The General Medical Council appealed this suspension and the High Court found that as a result of the manslaughter conviction, she should be removed from the register permanently.”

Discussion at the AMA National Conference focussed on why Dr Bawa-Garba was ever charged with manslaughter or convicted when systemic issues were obviously at play.

And there was a clear indication in the room that Australian doctors-in-training have felt unsupported, that there was an element of ‘scapegoating’ and that something similar could happen here.

Visiting British Medical Association representative Dr Andrew Deardon told the Conference only six doctors had been convicted under the gross negligence manslaughter provisions between 2006 and 2013.

He said Dr Bawa-Garba had been given the right of appeal and the BMA was supporting her as an interested party.

One issue of concern he raised was that courts do have, but rarely exercise, the right to request documentation such as reflective learning portfolios. However Dr Bawa-Garba’s reflections were not considered in the criminal court proceedings.

The motion now goes to the AMA Federal Council meeting in August.

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