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Reaction to Bawa-Garba’s reinstatement: “We urge doctors to keep reflecting”

President of the RCP, Professor Dame Jane Dacre

“The judgment of the court of appeal is a welcome step towards the development of a just culture in healthcare, as opposed to a blame culture. As we said in our evidence to the GMC review of medical manslaughter, focusing on blame serves nobody, least of all patients, families, friends and carers.

“But our thoughts today are first and foremost with the family of six-year-old Jack Adcock who died as a result of the errors that were made. While we understand the judgement is not what they hoped for, the RCP believes it will help us develop a culture in which families like them will be more likely to receive the support, clear explanations and apologies they need and deserve.

“While the primary aim of investigations into the deaths of patients is to apportion blame, it is less likely that systemic faults will be uncovered and future lives saved, which must be the priority. On 18 February 2011, Jack Adcock was not the victim of a truly, exceptionally bad doctor, but of an overstretched system that saw a competent trainee covering the workload of several doctors.

“As Dr Bawa-Garba’s counsel said, the decision of the Medical Practitioners Tribunal Service to impose a one year suspension was ‘humane and balanced’. It recognised that the actions of a doctor had contributed to the death of a patient, but also that the doctor in question was working under extreme pressure.

“As a result of its decision to take the case to the high court and have Dr Bawa-Garba struck off, the profession’s trust and faith in the GMC has been undermined. With this judgement, it is clear it has to immediately begin work to regain our respect. The RCP looks forward to working closely with its review to identify the steps it needs to take.

“We hope today’s judgement will provide some reassurance to doctors, particularly our trainees, that they will be protected if they make a mistake. We remain concerned at the impact this case has had on professional reflection, which is crucial to helping us improve our performance. We again urge all doctors to keep on reflecting.

“As a profession, we must now work together to avoid further deaths. We will achieve this by making sure the NHS has the financial and human resources it needs. By working with the GMC to make sure its focus is on the development of a just culture. And, above all, by collectively reflecting and learning from this tragic incident.”

Royal College of Paediatrics and Child Health, President Prof Russell Viner

“We welcome today’s verdict. The tragic death of Jack Adcock and the subsequent criminal and regulatory proceedings against Dr Hadiza Bawa-Garba have been difficult for all involved, but none more so than for Jack’s family. Our thoughts are with them today.

“The RCPCH respects the outcome of the legal process and now wishes to consider how we move on and learn from this case, which has shone a spotlight on the process of investigating serious errors and the doctors who make them.

“In particular, the role of the GMC in this matter has caused significant anxiety and anger amongst paediatricians and other medical professionals, as shown by a motion passed by our 2018 AGM recognising that this issue arose in the context of systemic failings within the NHS. The RCPCH has previously flagged the importance of fostering a culture of supporting doctors to learn from their mistakes, rather than one which seeks to blame.

“In particular, doctors should not be deterred from openly sharing, and thereby learning from, their reflections on errors.

“The RCPCH will consider the full ruling and its implications. In the meantime, 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.”

Professor Derek Bell, President of the Royal College of Physicians of Edinburgh

“We note today’s ruling and are pleased that Hadiza Bawa-Garba has won her Court of Appeal challenge. Looking ahead, it is vital that lessons are learned from this case.

“It is important to explore the wider issues that create the potential for patient harm, particularly understaffing. We must encourage an open and no-blame culture where the focus is on identifying and addressing risks and failures in systems of governance, and where all staff and patients are empowered to raise concerns over standards of care.

“Only by doing so can we ensure that we learn from cases such as this and prevent similar tragedies from occurring.”

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