French Resistance and Roman Fiction
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A World War 2 Trilogy
By FRED NATH (Novelist and Neurosurgeon)
Fred's Blog
Fred's Blog
Blog
Dr Bawa-Garba and Manslaughter
| Posted on 9 February, 2018 at 11:30 |
Many will have heard of this
terrible, tragic case. The doctor involved was tried for manslaughter and
convicted despite serious Trust flaws which led to the tragedy. My feeling here is rather different
to the majority. I do agree that a junior doctor, left unsupervised with two
juniors below her, each of whom had only a months’ experience of paediatrics,
and had herself just returned from 13 months maternity leave was particularly
vulnerable to a mistake being made. Where I depart from many people’s stated
views is that I do not think the registrar is culpable. After 32 years as a consultant, I
know that my duty working with junior doctors is to ensure they manage every
case with knowledge and insight. This is done by closely supervising the least
experienced ones and checking that all the right things have been done with
every case admitted under my care. Those patients admitted when I am on call
are my responsibility. The buck stops with the consultant. It has always been
so. If the registrar makes a mistake
then it seems clear to me that I am the one who should be held accountable, not
the junior who is following my instructions. I am the consultant and the
patient is my patient. If I leave a junior in charge, it remains my
responsibility and I have a duty of care. In this case, the clinical biochemistry
details were given to the consultant in charge of the case, by Dr Bava-Garba
before she went off shift. The matter is then his responsibility. Even had she
not imparted the correct information, it remains the responsibility of the
consultant to ensure the patient is safe and being treated properly. If I have a failing registrar one
must ask oneself who’s responsibility is that? Junior doctors are not a few
months out of the pram, they are qualified, responsible medical practitioners,
with medical and often post-graduate degrees. They are all capable of learning.
Those that do not learn, remain the consultant’s responsibility and the failure
is his and his alone with only rare exceptions. Consultants are at the top of the
clinical salary scale in the NHS for only one reason - because they take
responsibility in the end. The registrar in this case was scapegoated and was
not adequately backed up by her consultant who it seems, was elsewhere, teaching
at the time. I find this below a reasonable standard, in my opinion. A
consultant who knows the inexperience and limitations of the junior doctors
under him, and who is absent in any case, is not doing right by the patients or
staff. He should not have been allowed to be away from the hospital if he was
not immediately available for the patients being admitted under his care. He must
have planned the teaching, accepting that it was a commitment which once begun
could not be easily left. Did he arrange for another consultant to cover in his
absence? Apparently not. Accepting commitments away from work when you are on
call has always been regarded as wrong. This is especially true if the
consultant is engaging in private practice or other fee earning work. How is it
different to arrange a teaching session elsewhere? He was on call and therefore
responsible. If the registrar in the hospital
needs supervision, then that is the responsibility of the consultant. When I am
on call with any new registrar, I always check with them what experience they
have and what operations they have already done with and without supervision.
When I am called by them I always take their experience and ability into
account. Dr Bawa-Garba, in my opinion is
the victim of scapegoating to protect others who should stand up and accept the
responsibilities which they assume on appointment as a British consultant. I really hope the case is
appealed once more, and others are prepared to speak out in support of this
victimised and wrongly punished doctor. |
Categories: Grumbles
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8 Comments
Reply
Shuaibu Dambatta
10:47 on 12 February, 2018
I couldn’t agree more. And as someone has been your registrar, I can attest to the fact you do provide the optimum level of supervision your juniors need.
Reply
john benton
19:10 on 13 February, 2018
i agree, but notwithstanding, i also don't believe she did that much wrong either.
Reply
Sadequr Rahman
9:34 on 14 February, 2018
Thank you for taking the time to write such a thoughtful and intelligent blog. It has certainly been my opinion throughout this whole sad affair that when one assumes power (and therefore credit for successes), then responsibility for failure goes hand in hand. I have no doubt that system failures, background medical history and just plain bad luck played a major role in these events. But when we hold a senior position with the title, financial reward and responsibility that that position entails, just washing your hands of the responsibility part is not acceptable.
Unfortunately I feel that there have also been huge failings on the part of GMC (obviously), the CPS and the original legal defence team. I hope that there will be justice for Hadiza too. The future of our profession may depend on it.
Regards
Dr Sadequr Rahman
GP, South Wales
Unfortunately I feel that there have also been huge failings on the part of GMC (obviously), the CPS and the original legal defence team. I hope that there will be justice for Hadiza too. The future of our profession may depend on it.
Regards
Dr Sadequr Rahman
GP, South Wales
Reply
fgfdgfg
22:18 on 26 April, 2018
An amazing blog! What writing skills you have, must say I am real impressed by your work and appreciate it.
Reply
Lawrence Todd Maxwell
5:16 on 10 October, 2018
I admire people who keep sharing valuable stories through great writing. I'm glad to have read this blog. Thanks and hope to read more soon.
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