Clearer guidance can reduce gross negligence manslaughter investigations, says MDU

Clearer guidance for coroners, the police and the Crown Prosecution Service is needed to prevent doctors being needlessly put through a gross negligence manslaughter investigation, the Medical Defence Union (MDU) has said.

The MDU has provided oral evidence to the rapid review by Sir Norman Williams into gross negligence manslaughter in healthcare, and followed up with a written submission that further illustrates its recommendations following the prosecution of Dr Hadiza Bawa-Garba over the death of Jack Adcock.

The MDU has supported 34 medical members with manslaughter investigations since 2014. According to the union’s submission, there is only one or fewer prosecutions for every 10 investigations, indicating a significant level of over-investigation of doctors.

There should be far fewer investigations and prosecutions of healthcare practitioners for gross negligence manslaughter, said MDU senior solicitor Ian Barker of the union’s recommendation on guidance. “It should be about identifying and prosecuting only those cases that are the medical equivalent of deliberately driving down the motorway on the wrong side.”

“Coroners are currently responsible for passing most cases to the police for investigation and they should get greater support and clearer guidance about the law. There should be a far more robust referral process, to help to achieve greater consistency and clarity and ensure only appropriate cases are investigated.”

Barker continued: “In Scotland we are not aware of a case where a doctor has been successfully prosecuted for the similar offence of culpable homicide. We believe the same approach should apply in England and that investigation and prosecution of healthcare practitioners should be reserved for only the worst cases.”

“We are advocating straightforward changes that can be made quickly without practical difficulty. Given the clear distress that investigations cause for doctors involved and the fear and concern this generates more widely among healthcare practitioners, the MDU urges swift and decisive action.”

The General Medical Council issued the terms of reference for its own review of gross negligence manslaughter cases earlier this month. Health and social care secretary Jeremy Hunt ordered the rapid review after Bawa-Garba was struck off in January.

It was her “catalogue of errors” that left Jack Adcock’s sepsis undiagnosed. She was sentenced to two years in prison, suspended for two years, in 2015 over his death.

Mark Dugdale