In February 2011, Jack Adcock, a six-year-old boy with Down’s Syndrome, was admitted to a hospital in the English city of Leicester with diarrhoea, breathlessness and vomiting. The boy, who died hours later from sepsis, was initially diagnosed with gastroenteritis by Hadiza Bawa-Garba, a specialist registrar in paediatrics at the hospital, who was solely in charge of the emergency department on that day.
Despite an investigation at the hospital identifying systemic failings and willingness on the part of Ms. Bawa-Garba to openly discuss what went wrong, a jury convicted her four years later for manslaughter and gave her a two-year suspended jail sentence. Following an intervention by the General Medical Council (GMC), her name was struck off the medical registrar in late January. The development, which comes amidst severe pressure on the National Health Service (NHS), has shocked the medical community. Practitioners are fearful that the case may set a precedent for individual doctors being scapegoated for systemic problems.
System under pressure
The severe pressure on the NHS was highlighted this winter, with scenes of patients waiting for hours in corridors outside accident and emergency departments and severely-pressured doctors and medical staff working well beyond their contracted hours. At one point in January, 50,000 hospital appointments were cancelled to relieve pressure on the system. Last weekend, thousands protested in central London to call for more funding for the NHS. Much to the chagrin of the campaigners, the protest was used as a pretext by U.S. President Donald Trump to make the case for a private health-care system.
“This ruling has also brought into sharp focus the difficult and pressurised environment in which doctors now work,” wrote Chaand Nagpaul, the chairman of the British Medical Association, to members of the organisation following the High Court ruling that stripped Ms. Bawa-Garba of her licence in January. “Like many of you, I believe that the greatest risk to patient safety is an under-resourced, understaffed NHS which is forcing doctors, nurses and all health-care staff to work under the most challenging of conditions...”
Ms. Bawa-Garba’s case has also attracted widespread support from the medical community, with a crowdfunding campaign for a legal challenge raising over £3,20,000, well over the targeted amount. “The case also has implications for patient safety across the U.K, because health-care professionals will henceforth be reluctant to share knowledge openly or reflect on clinical errors for fear of criminal prosecution,” warned the campaigners.
Some are fearful there is a racial element to this case. Dr. Ramesh Mehta of the British Association of Physicians of Indian origin (BAPIO) has long warned that doctors from an ethnic minority background face far harsher treatment than their white counterparts for errors. “We have no doubt it [race] is an element here,” says Dr. Mehta. BAPIO has written to the GMC, accusing it of reflecting an inherent bias that makes the body treat doctors from minority communities differently and harshly.
BAPIO is strongly backing Ms. Bawa-Garba, including through the Medical Defence Shield it established to help protect doctors in 2011. The body has attracted members from across the medical community, who are fearful of what they believe is an increasingly hostile atmosphere that fails to acknowledge systemic factors, and attempts to shift the blame on to individual medical professionals.
Vidya Ram works for The Hindu and is based in London
