Doctors rally behind struck off registrar

Posted by Julie Lambert

Australian doctors are rallying to support a British registrar who has been struck off over the death of a child, saying she was used as a scapegoat for staffing and systems failures at a UK hospital.

Former AMA President Dr Mukesh Haikerwal and RACGP President Dr Bastian Seidel are among many Australians speaking out against last week’s ruling that Dr Hadiza Bawa-Garba be stripped of her registration. They say the outcome is not only unfair but could damage medical culture.

“It’s about inadequate systems and inadequate support with manifest faults, and the smallest cog in the wheel is pilloried and drummed out of the business,” Dr Haikerwal told The Medical Republic.

Dr Seidel took to Twitter yesterday, saying: “How can one demand excellence from a doctor working in a broken system that only ever allows compromised care. It’s incomprehensible that the regulator does not take the context into account. Wake up #NHS and take note Australia.”

In less than a week, colleagues have raised more than £200,000 to fund a new legal battle to have Dr Bawa-Garba reinstated.

Thousands of doctors, in Britain and abroad, have put their names to a letter spelling out concerns about the dangers of punishing doctors for admitting mistakes.

“Patient safety is paramount and a culture of openness is critical,” the letter says.

“Doctors frequently take on the work of two or more in order to keep our hospitals open. We have seen doctors punished for whistleblowing about unsafe staffing levels.

“We now see them being held criminally responsible for mistakes made whilst working under these pressures, which, with chronic staff shortages, prolonged underfunding and low morale now occur with worrying frequency.”

According to reports, Dr Bawa-Garba,  a fifth-year registrar, was on her first day at a new hospital after 13 months’ maternity leave and covering four wards on six floors, when a six-year-old boy died of sepsis brought on by pneumonia under her watch in 2011.

In a string of errors and complications detailed in evidence, Dr Bawa-Garba’s consultant was absent, as was another rostered registrar, leaving her to do their jobs. The IT system at Leicester Royal Infirmary was down, requiring test results to be checked by phone.

The child, who had a heart condition, went into arrest after a parent gave him an ACE inhibitor at the hospital. Dr Bawa-Garba called off efforts to revive him because she mistook him for another child subject to a do-not-resuscitate order who had been in the same bed, although the action did not determine his fate.

In a court, the registrar was found guilty of manslaughter by gross negligence and given a two-year suspended prison sentence.

Subsequently, a medical tribunal under the General Medical Council, the UK equivalent of AHPRA, decided in June last year she should be allowed to return to work after a year.

But the council appealed the decision in the High Court, arguing in part that the suspension would not be enough to satisfy the public.

Dr Haikerwal, who trained at the same Leicester hospital in the 1980s, said Dr Bawa-Garba’s predicament could happen to any doctor struggling against the odds in a rundown health system.

The case touched a particularly raw nerve among young doctors.

“Nothing in the story – at least the facts available publicly – seems far fetched or unbelievable except the consequences for this doctor, who was set up to fail,”  Dr Tessa Kennedy,  a paediatric doctor and chair of the AMA/ASMOF NSW Doctors-in-Training Committee, said.

“I think the sense of being powerless, in control of very little yet accountable for everything, is what resonates… and it’s a real worst case scenario. Could it happen to me? Anxiety, fatigue, burnout, all fed by these fears.”

Queensland GP and emergency doctor Dr Minh Le Cong said many Australian doctors saw the outcome as a miscarriage of natural justice and were concerned it could damage the medical culture of open disclosure and admitting mistakes.

“What happened in this case is counter to everything in medical defence teaching in the last 10 years. It is counter to an open, just culture of dealing with medical errors,” he said.

“Put simply, I believe most Australian doctors see ourselves in the plight of Dr Bawa-Garba and would not want to see this happen here in Australia.”

The GMC’s Chief Executive, Charlie Massey, said last week’s High Court ruling that Dr Bawa-Garba should be struck off “confirmed that the tribunal was simply wrong to conclude that public confidence in the profession could be maintained without removing the doctor from the medical register”.

‘The ruling clarifies that tribunals cannot go behind the jury’s verdict when a doctor is convicted in a criminal court,” he said.

Dr Bawa-Garba has indicated she will accept the funds raised by colleagues to fight the ruling.