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BMA responds to rapid review into gross negligence manslaughter

Response comes in the aftermath of the Dr Bawa-Garba ruling

Jo Carlowe

Tuesday, 17 April 2018

The British Medical Association has today published its response to a rapid policy review into the issues pertaining to gross negligence manslaughter (GNM).

The review was commissioned by health and social care secretary Jeremy Hunt in the aftermath of the Dr Bawa-Garba ruling and will report back at the end of the month. 

Sir Norman Williams Review aims to explore the issue of where and how the line is drawn between gross negligence manslaughter (GNM) and negligence, and what processes are gone through before initiating a prosecution for GNM. 

In addition, it will look at how the role of reflective learning, openness and transparency can be protected where the healthcare professional believes a mistake has been made to ensure that lessons are learned and mistakes not covered up. The Review will also consider what lessons need to be learned by the General Medical Council (GMC) and other healthcare professionals’ regulators in relation to how they deal with professionals following a criminal process for gross negligence manslaughter. 

In its response, the BMA reiterated the significant and wide-ranging impact of the ruling against Dr Bawa-Garba on doctors in general and provided evidence of its concerns and recommendations across the whole pathway of GNM. It issued the following key recommendations:

  • That any GNM cases in healthcare are referred only after consultation with the Chief Coroner.
  • That a national police unit is established to investigate GNM cases in healthcare.
  • The test for bringing a prosecution is a difficult balancing act and to introduce consistency in a relatively small number of cases, it should be for the Director of Public Prosecutions to personally authorise all prosecutions involving accusations of GNM in a healthcare setting.
  • That only experts who are in active clinical practice and hold a licence to practise are instructed in GNM cases.
  • That it should be compulsory for all expert witnesses to go through core training including report writing, courtroom skills, cross examination and criminal law and procedure.
  • That a mandatory human factors training programme is developed for everyone involved in the prosecution process for GNM in healthcare.
  • That the exception reporting process is standardised, extended to all doctors and a national database for exception reports is established so that data can be properly analysed and used to improve training and working experiences for doctors and outcomes for patients.
  • That legal protection is provided to reflections in all education and training documents.
  • That Section 35A (1A) of the Medical Act 1983 is amended so it excludes information provided for the sole purpose of education and training.
  • That the GMC should lose its right to appeal Medical Practitioners Tribunal Service (MPTS) decisions.

The BMA’s full response can be read here.

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