MDDUS supports findings of Hamilton review

PUBLICATION of an independent review into how the laws on gross negligence manslaughter and culpable homicide are applied to medical practice has been welcomed by MDDUS – and in particular its support for the removal of the GMC’s right of appeal in Medical Practitioners Tribunal Service (MPTS) decisions.

The GMC commissioned the review following the death of Jack Adcock and the subsequent prosecution and conviction of Dr Hadiza Bawa-Garba for gross negligence manslaughter, leading to her suspension and then erasure (on GMC appeal) from the medical register.

The review was established to consider gross negligence manslaughter and culpable homicide in relation to the “perceived vulnerability” of the medical profession to these criminal charges – and the possible effects on the notion of a "just culture", reflective practice, and individual and systemic learning.

Commenting on some of the main findings, MDDUS joint head of medical division Dr John Holden said: "We welcome the findings of Leslie Hamilton’s independent review and the recommendations that aim to encourage a just and fair culture for patients and doctors.

"We welcome endorsement of the Williams review recommendations to reform the Medical Act including removal of the GMC’s right of appeal of Medical Practitioners Tribunal Service (MPTS) decisions. Such reform is a far better use of scarce parliamentary time than current plans to regulate the medical defence organisations (MDOs) and will improve the fitness to practise process and ensure consensual disposal.

"Removing double jeopardy on appeals is an important step in rebuilding relationships between the profession and regulator and we support recommendations to put legislation that would remove the GMC’s right of appeal in place as soon as possible.

"We also strongly support the recommendation that doctors’ reflections should be given legal protection as this would prevent defensive practice and ensure an ongoing learning culture.

"We stressed in our consultation response that referral of gross negligence manslaughter cases by coroners should be made through the chief coroner. There must at all stages be genuinely independent accredited expert advice before any decision is made to make a regulatory referral or to trigger a police investigation, let alone to prosecute. Prosecution decisions need to follow the Scottish example and be made at a very senior level indeed, recognising the exceptional nature of the offence and the public interest issues.

"We are encouraged by the importance of education and training being highlighted within the review. We welcome the recommendation for a Scotland-wide approach to learning from fatal accident inquiries and board’s SEARs as well.

"Finally, we are pleased to see recognition of the role MDOs play in supporting doctors through the investigative process. MDDUS continues to supports members through these difficult and stressful processes, providing peace of mind and representation from our team of expert medical advisers and lawyers."

The GMC has acknowledged that the Bawa-Garba case has "undoubtedly affected" its relationship with the medical profession. Charlie Massey, Chief Executive of the General Medical Council, said: "The report says we must rebuild trust with the profession, and we fully accept this challenge. Having reflected as an organisation, we are committed to acting on that and taking forward all the recommendations in this report directed to us.

"We share this report’s desire for a just culture in healthcare, and acknowledge that we have a crucial role in making that happen. We are already making progress. Work is underway to address some of the key issues raised in this report but there is plenty more for us to do."