RCP responds to independent review of gross negligence manslaughter and culpable homicide

The GMC has published the report of the independent review of gross negligence manslaughter and culpable homicide. The GMC commissioned the review following the death of Jack Adcock and subsequent conviction of Dr Hadiza Bawa-Garba for gross negligence manslaughter.

In response, Professor Andrew Goddard, RCP President and the co-chairs of the RCP Trainees Committee, Dr Michael Fitzpatrick and Dr Matthew Roycroft, said:

'This report provides a welcome and necessary step in repairing the relationship between doctors and their regulator. While unnecessary strain has been placed on that relationship, we commend the GMC for demonstrating its desire to learn by commissioning the review and pledge to work with other Royal Colleges, employers, HEE, and the GMC in implementing its wide-ranging recommendations.

'We are glad the chief executive of the GMC, Charlie Massey, has accepted the challenge of rebuilding trust with the profession and committed to taking forward all the recommendations. We will openly and robustly hold the GMC to account to ensure the recommendations pertinent to them are delivered. We strongly believe that the changes that this report recommends will improve the investigative and regulatory framework in medicine, to the benefit of patients, families, and doctors. 

'It is unclear to many of our fellows and members if the GMC has apologised for any part it played in the breakdown of the relationship. A clearer apology would be a positive step.

It is imperative now that we work to collectively understand exactly what needs to be done, and how we are going to do it. We know the GMC is already taking action to reduce the timescales for progressing fitness to practise cases to Medical Practitioner Tribunals.

Professor Andrew Goddard, RCP President and the co-chairs of the RCP Trainees Committee, Dr Michael Fitzpatrick and Dr Matthew Roycroft.

'It is imperative now that we work to collectively understand exactly what needs to be done, and how we are going to do it. We know the GMC is already taking action to reduce the timescales for progressing fitness to practise cases to Medical Practitioner Tribunals.

'We trust the government will take on the recommendation of this review and the Williams review, so that the GMC’s right of appeal of Medical Practitioners Tribunal Service (MPTS) is removed. And we agree the Medical Act should be reformed to give the GMC more discretion over which cases it investigates. 

'Many doctors have told us they are concerned about the role of coroners in the process that leads to a prosecution for gross negligence manslaughter. We hope the Chief Coroner and his Deputies respond positively to the report and support coroners to make consistent decisions.

'But there is much more that can be done in the meantime. First and foremost, we must begin moving from a blame culture to a learning culture. As we said in our evidence to the review, if the primary aim of an investigation is to apportion blame it provides a perverse incentive to obfuscate.

'Criminalising error reduces patient safety, and militates against families, friends and carers receiving the support, clear explanations and apologies they need and deserve. We therefore welcome the report’s confirmation that improvements in patient safety are most likely to come through local investigations into patient safety incidents which are focused on learning not blame.

'The report’s recommendation that investigating authorities scrutinise the system, including the education and training environment for trainees, must be heeded. As we said previously, Jack Adcock was the victim of an overstretched system that saw a competent trainee covering the workload of several doctors.

'Dr Bawa-Garba’s prosecution was a source of great anxiety for trainees; the report sums up their feelings well when it says, Many questioned why an individual trainee working under pressure should carry the blame for what they considered to be wider systemic failings within her working environment.

'We agree with the focus on increased support for those returning to training or work after a break, and recognise the recent work of Health Education England to put that in place. We also strongly support the recommendation for better training and support with regard to investigation processes, which can be a source of great stress to doctors asked to testify.

'Doctors also need to look to themselves and the part they play in fostering an unjust culture. We agree they should only provide expert opinion on matters which occurred while they were in active and relevant clinical practice. We urge all doctors to read the guidance recently published by the Academy of Medical Royal Colleges on acting as a professional or expert witness.'