Patient safety

23.02.18

Marx to lead gross negligence manslaughter review following Bawa-Garba case

Dame Clare Marx is to lead a review into how manslaughter by gross negligence is applied to medical practice, spanning every step of the process from local investigations post-incident to diversity matters, the GMC has announced.

Marx, who is chair of the Faculty of Medical Leadership and Management and former Royal College of Surgeons (RCS) of England president, will lead the work that will bring together defence organisations and patient, legal and criminal justice experts from across the UK to analyse how existing processes can be improved.

The review, which will inform the Department of Health and Social Care’s urgent review ordered by health and care secretary Jeremy Hunt, will look at the pathway from reporting to investigation and prosecution, distinguishing between errors and exceptionally bad failings, the role of expert witnesses, and the need for reliable data to support a true understanding of incidence and trends.

The GMC says that the aim is to support doctors in raising concerns and to encourage reflective practice, as well as improving patient safety.

It comes following a High Court ruling that saw Dr Hadiza Bawa-Garba, who was found guilty of manslaughter by gross negligence following the death of a child in 2015, removed from the medical register – a decision that saw wide criticism from the profession and experts.

Dame Marx said that there is a “critical need” to examine the wider issues around the investigation of these cases, and the expertise and consistency applied to those investigations.

“Each step of the process will be explored from local investigations post incidents, to diversity matters surrounding the doctors subject to investigation and whether regulatory processes at the GMC could be improved in such cases,” she added.

“Doctors are often working in an immensely pressurised system where mistakes can happen. This work will be valuable for the medical profession and I am pleased the GMC has decided to take this work forward.”

Charlie Massey, chief executive of the GMC, said that Marx’s experience would be “extremely valuable” in the review.

“As well as addressing the issues with criminal prosecutions a further aim of this review is to encourage a renewed focus on enabling a learning, no-blame culture, reflective practice and provision of support for doctors in raising concerns,” he added.

An RCS spokesperson welcomed both reviews, which they argued could identify important learning points and reveal how cases are initiated and investigated.

Referring to the Dr Bawa-Garba case that has triggered the reviews, the spokesperson added: “The case of Dr Bawa-Garba has caused great concern among doctors. Our health and legal systems must protect patients from avoidable and unnecessary harm, while also providing clarity about the difference between gross negligence manslaughter and basic human error in medical practice. 

“Health professionals need to know where they stand in relation to criminal liability and professional misconduct.

“We also need an open, no-blame culture in the NHS – where clinicians feel able to talk about their practice so the whole medical team can learn from the experiences of others.”

The GMC aims to complete its review by the end of the year and will confirm more details about the work and professionals involved shortly.

Top image: fstop123

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