This is a story of a woman who dedicated her life to helping others. From the age of 13, she wanted to help people get better, so she set on a path to become a medical doctor. This is the story of a doctor who is black, Muslim and a woman, whose career has come to an abrupt end with a two-year imprisonment sentence.

This is the curious case of Dr Hamzid Bawa-Garba.

Dr Bawa-Garba is a well-regarded doctor amongst her peers; highly dedicated to her vocation, her record as a doctor had been exemplary. She is known for her charity work and being a mother who loves her children; it comes as no surprise that she specialised as a paediatrician (child specialist).

After a period of 14-months on maternity leave, Dr Bawa-Garba returned to work for the NHS, doing what she could for a national service which is widely known to be suffering from inadequate funding and a plethora of budget cuts, compounded by failed targets. The 18th of February 2011 was supposed to be like any other day as a member of the NHS frontline staff; however, that was the day that changed the life of Dr Bawa-Garba. The outcome of her case will have direct and indirect ramifications for her peers, the GMC, the NHS, and the wider public.

6-year-old Jack Adcock who was born with Down’s syndrome was admitted to Leicester Royal Infirmary Hospital at 10.15am. Jack was accompanied by his mother and grandmother who were concerned about him as he had been very unwell throughout the proceeding night. Dr Bawa-Garba was the Junior Doctor who was caring for the young soul. A series of unfortunate events led to Jack’s heart suddenly stopping, and despite efforts to restart it by the resuscitation team, Jack sadly died at 9.20 pm; may his soul rest in peace.

There is a certain level of care which all who rely on NHS expect, and this is what has now been called into question in this tragic case.

On the day in question, Dr Bawa-Garba had been working a double shift, which amounted to 13 hours with no break, which many Doctors have since reported to be commonplace. As well as her normal duties, she was also tasked with providing medical cover for the Children’s Assessment Unit. This meant she was now performing the role of four doctors. This is because the other members of her team; the registrar (specialised doctor) was away training, the consultant was away on teaching duties, and the only other junior doctor was tasked with sorting out IT errors which were interfering with the communication of important lab reports. Given this reduced level of staffing, Why were more doctors not employed on that day?

Here are some of the critical troubling facts which emerged following an inquiry into events on that day.

  • Dr Bawa-Garba was covering six wards, over four floors dealing with emergencies, while holding a crash bleep (the pager which alerts doctors to respond immediately to all cardiac arrest and trauma calls within the hospital).
  • The blood reporting systems were down, which meant that the blood tests ordered at 10.45 am were only received at 4.45pm.
  • Due to these IT failures, relevant information could not be communicated across on time. She was not made aware of X rays ready to be reviewed until much later. The senior house officer who would usually be providing clinical care was tasked with chasing the information. Hence she was not available to directly assist DR Bawa-Garba.
  • Jack’s Nurse on that day was not a trained paediatric nurse, she was trained only in adult care and had been working as a nurse for 17 years. She administered a heart drug NOT prescribed by DR Bawa-Garba.
  • There was a delay in the administration of antibiotics to Jack, as there was significant time between when they had been prescribed by the Dr and when they were given.
  • The patient was transferred to a different ward without the consent or knowledge of Dr Bawa-Garba which resulted in Jack briefly being mistaken for another child.

Questions we need to ask as members of the public.

Are these conditions safe for the public/patients? Are these conditions safe for our healthcare practitioners? How does the NHS and government expect their employees to offer a high level of care when they are not given the tools to enable them? Why weren’t the correct nurses employed?

“Research published in the Journal of the Royal Society of Medicine suggests that over 30,000 deaths were caused by cuts to the NHS in 2015.”

It is safe to assume that Dr Bawa-Garba was asked to captain a sinking ship safely across the Atlantic ocean. She was given a malfunctioning plane with no wheels, a non-existent copilot, strong communication interference with airport control, and after a non-stop 13-hour flight she was expected to land the plane with ease #NoProblem.

In 2015, Dr Bawa-Garba was charged with gross negligence and was given a suspended two years imprisonment sentence. Despite this, she continued to practice as a doctor for the NHS (with no complaints), but in June 2017, the medical tribunal suspended her for 12 months. The GMC then appealed to High Court to overrule her suspension with a complete removal from the medical register based on the precedent on the principles set by Sharp LJ in GMC v Jagivan (a case where a male doctor was wrongly acquitted of sexual misconduct).

Jack’s family have been awarded what they perceive to be justice; Dr Bawa-Garba has been struck off the medical register, which means she can no longer work as a doctor. This begs the question, what about other families who have lost loved ones in similar circumstances who did not have a scapegoat to pin their anger towards? While the continuous, systematic errors within the NHS are swept underneath the carpet, the GMC can hold their heads high as if it were just another day of upholding the notion of “maintaining the public confidence in the medical profession”. All this while being blissfully dismissive of the conditions doctors are forced to work in.

If she were not a woman would the verdict still be the same? If this human being’s skin was a different shade would she have been struck off the register? If she wasn’t a doctor who also happened to wear a hijab, would she still have been used as a scapegoat?

For “reasons unknown” to the GMC, studies show that black and ethnic minority doctors are 30% more likely to be reported to GMC and 2x more likely than white doctors to be sanctioned by the GMC. The GMC’s fourth annual state of medical education and practice report in 2014 found that complaints against black and ethnic minority doctors were 17% more likely to be investigated in comparison to white doctors and that 25% of these claims were more likely lead to a sanction or warning. The GMC have acknowledged the disparities, however, action to address the underlying issues that are affecting our doctors are yet to be seen.

The support for Dr Bawa-Garba is growing. The public has raised over £100K (click here to donate) and counting. Doctors from many different backgrounds and cultures have shared their ongoing support and there is a strong feeling that her race has played a factor in her treatment. If this is indeed a case of an isolated doctor’s performance being exceptionally low leading to the tragic death of this child, would she have garnished this amount of support from her peers?

#IAMHADIZA

Read the full case here – http://www.bailii.org/ew/cases/EWHC/Admin/2018/76.html

References

Dr Bawa-Garba hearing – https://www.gmc-uk.org/news/30730.asp – GMC statement

Dr Bawa Garba v General Medical Council – https://www.mpts-uk.org/A14_15_Dr_Bawa_Garba_v_General_Medical_Council_2015_EWHC_1277__QB____Circular.pdf_61529687.pdf
http://www.pulsetoday.co.uk/your-practice/regulation/gmc-not-to-blame-for-greater-likelihood-of-sanctions-among-uk-ethnic-minority-gps-says-report/20009451.article

Understanding the rise in Fitness to Practise complaints from members of the public –
https://www.plymouth.ac.uk/uploads/production/document/path/0/75/Archer_et_al_FTP_Final_Report_30.01.2014.pdf

Gassing Under the Sea: Thoughts on medical politics, the NHS, and the BMA – https://gassingunderthesea.wordpress.com/2018/01/25/i-am-hadiza – by James Haddock

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