• Court of Appeal rejects GMC bid to strike-off junior doctor
  • Dr Bawa-Garba was convicted of gross negligent manslaughter
  • Court of Appeal judges said fitness to practise panel was right to consider systemic failings

The Court of Appeal has backed Dr Hadiza Bawa-Garba in her appeal against the General Medical Council’s bid to have her struck off the medical register following a conviction for gross negligence manslaughter.

In a ruling issued today judges said they rejected the GMC’s argument that the original fitness to practise panel was wrong not to strike off Dr Bawa-Garba in 2017.

The decision reverses a high court decision earlier this year that she should be struck off and reaffirms the position of fitness to practise panels as the correct venue for ruling on a professional’s ability to continue working.

Dr Bawa-Garba was convicted of gross negligence manslaughter in 2015 following the death of six-year-old Jack Adcock at Leicester Royal Infirmary in 2011.

The original criminal trial found Dr Bawa-Garba and nurse Isabel Amaro, were guilty of “truly exceptionally bad” care when they failed to spot signs of sepsis.

The GMC’s fitness to practise panel took into consideration wider systemic failings at the trust which included poor staffing levels which meant Dr Bawa-Garba was covering multiple wards, delays in tests results and IT failures and a lack of senior consultant presence.

Dr Bawa-Garba’s consultant on the day Jack Adcock died did not face criminal charges. He has since allowed his GMC registration to lapse and moved to Ireland.

Charlie Massey, chief executive of the GMC, told HSJ earlier this year he believed it was wrong for the fitness to practise panel “to go behind the criminal conviction.”

Documents obtained by HSJ in February from the Professional Standards Authority suggested then that the GMC case “had no merit” and was attempting to undermine an earlier supreme court ruling in 2016 which said fitness to practise tribunals should be treated with “diffidence” by criminal courts.

In the ruling today Lord Chief Justice of England and Wales Lord Burnett of Maldon said: “We reject the GMC’s contention that the tribunal made an error of principle in taking into account systemic failures on the part of the trust and personal mitigation of Dr Bawa-Garba, even if they formed part of the evidence presented to the jury in support of Dr Bawa-Garba’s defence in the criminal trial.”

They said it was appropriate for the tribunal to consider the “full context” of Jack Adcock’s death including multiple systemic failings adding: “Undoubtedly, there are some cases where the facts are such that the most severe sanction, erasure, is the only proper and reasonable sanction. This is not one of them.”

The judges said the GMC panel “accepted the evidence that [Dr Bawa-Garba] was honest and reliable and had reflected deeply and demonstrated significant and substantial insight, even though it was unable to conclude that she had complete insight into her actions as it did not hear from her directly. It found that her deficient conduct in relation to the care and treatment of Jack was neither deliberate nor reckless and that she did not present a continuing risk to patients.

“The tribunal was an expert body entitled to reach all those conclusions. Indeed, none of them have been challenged by the GMC.”

In a statement Charlie Massey, chief executive of the General Medical Council, said: “We fully accept the Court of Appeal’s judgement. This was a case of the tragic death of a child, and the consequent criminal conviction of a doctor. It was important to clarify the different roles of criminal courts and disciplinary tribunals in cases of gross negligence manslaughter, and we will carefully examine the court’s decision to see what lessons can be learnt.”

He added the regulator recognised the concern created by the case among doctors adding: “We have reflected on what we can do to address the concerns we’ve heard about this case. Doctors have rightly challenged us to speak out more forcefully to support those practising in pressured environments, and that is what we are increasing our efforts to do.”