GMC readies gross negligence manslaughter review

The General Medical Council (GMC) has issued the terms of reference for its own review of gross negligence manslaughter cases following the prosecution of Dr Hadiza Bawa-Garba.

Led by Dame Clare Marx and covering the whole of the UK, the GMC’s review will examine what needs to be done to improve how existing law, procedures and processes are applied, while still protecting the public and maintaining confidence in the medical profession.

The review will also look at how the GMC should handle cases involving gross negligence manslaughter and the equivalent offence of culpable homicide in Scotland.

The work will be informed by the outcome of the Williams Review, a rapid policy review into the issues pertaining to gross negligence manslaughter in healthcare, ordered by health and social care secretary Jeremy Hunt in response to the prosecution of Bawa-Garba over the death of Jack Adcock.

He died from sepsis, which went undiagnosed due to her “catalogue of errors”. She was sentenced to two years in prison, suspended for two years, in 2015, and was struck off earlier this year.

The GMC’s review aims to support just decision-making and consistency in standards and processes where there are allegations of gross negligence manslaughter.

Some of the other issues outlined in the terms of reference include:

• The quality of local investigations and the distinction between errors and failings that amount to gross negligence manslaughter
• Equality, diversity and inclusion issues, including whether there is fair and consistent representation of particular groups of doctors with protected characteristics in allegations of gross negligence manslaughter
• The lack of corporate manslaughter prosecutions against healthcare organisations as compared to individual healthcare professionals within organisations facing gross negligence manslaughter prosecution, and any differences in approach between the UK countries and the possible reasons for this
• The role of medical expert evidence and its appropriateness in relation to the practitioners being investigated
• Whether sufficient regard is taken into all the circumstances in which the medical practitioner found themselves at the time of the fatality, such as system pressures, errors or failures
• Whether there could be more clarity in GMC guidance and communication around the role of reflective practice
• The extent of emotional, pastoral and other support available for medical practitioners who are the subject of an allegation or charge of gross negligence manslaughter

‘Vital that accountability is appropriately apportioned’

Dame Clare said of the GMC review: “Doctors are often working in an immensely pressurised system where mistakes can happen. This review aims to encourage a renewed focus on a just culture, reflective practice and individual and systemic learning.”

“It’s vital that accountability is appropriately apportioned between healthcare systems and individual doctors and that doctors are supported to act on concerns.”

The review will be undertaken by a working group that will be finalised and published shortly.

The working group will aim to report its findings to the GMC by the beginning of 2019.

Responding to the GMC’s announcement of the terms of reference for the gross negligence manslaughter review, Ian Barker, senior solicitor at the Medical Defence Union, said: “We welcome the GMC’s announcement of the terms of reference for the gross negligence manslaughter review and will contribute fully.”

“Too many doctors are being investigated and for those who are investigated, the process needs to be swifter and fairer. We believe there are a number of changes that could be made to the current law to achieve that.”

“We have given oral evidence to Sir Norman’s review panel and we will follow this with a full written submission.”

Mark Dugdale