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'Until the NHS has a blame-free culture it will never learn from cases like Bawa-Garba'


The case of Dr Hadiza Bawa-Garba, who has won her appeal against being struck off the medical register, is legally, emotionally and practically complex.

On the one hand, you have medics arguing that a doctor was made the scapegoat for dangerous working conditions and on the other parents distraught at the death of their son.

While the case involves the tragic death of a child from sepsis, hopefully the lessons that can be learnt and the discussions generated will benefit both health professionals and patients.

Looking forward it is the culture of openness – or lack of it – that needs to be the beneficiary from the result of the appeal, regardless of which side you are on.

Professional and patient groups alike highlighted the need to encourage an open culture where the focus was on identifying and addressing risks, and where all were empowered to raise concerns.

As Peter Walsh, from the charity Action against Medical Accidents, rightly said: “There continues to be too much of a blame culture where individual health professionals are made scapegoats for systemic failures.”

Needless to say, short staffing was also repeatedly mentioned by those commenting on the case. And we know the dangers of failing to address staff shortages and lack of openness – there must never be another Mid Staffs.

But let us not forget that a nurse was also involved in the case. She was subsequently sentenced to a three-year suspended jail sentence in November 2015 and then struck off the nursing register.

Like the doctor, Isabel Amaro was also found guilty of manslaughter on the grounds of gross negligence, after her monitoring of Jack Adcock’s condition and record-keeping were criticised.

But unlike that of Dr Bawa-Garba, there has been little talk of her case or whether she should be reinstated – even though she was surely working in the same pressured situation as her medical colleague.

“Is this just another example of the lobbying power of the medical profession?”

Is this just another example of the lobbying power of the medical profession? Probably – though it’s hard to gauge as I’ve not heard any nursing organisation speaking out on behalf of Ms Amaro.

One for the Nursing and Midwifery Council to think about perhaps? Could the NMC proactively take another look at her case? In light of the successful appeal by her medical colleague this seems only fair.

Unfortunately, it also seems very unlikely. There was no trace of Ms Amaro in any of the press material I received about the case on Monday. She did get a brief mention on the BBC’s Panorama documentary, but that was it.

In contrast, over £160,000 was raised by medics to fund Dr Bawa-Garba’s appeal and more than 1,500 of them signed a letter expressing concerns about her treatment and arguing that it threatened a “culture of openness”.

My feeling on the fallout from the case is therefore twofold and harks back to the Speak Out Safely campaign run by Nursing Times in the wake of Mid Staffs.

Health professionals must be able to safely highlight concerns without fear of censure, but they must also see it as their responsibility to highlight concerns – as must the organisations representing them.


Readers' comments (7)

  • The lesson here is that doctors get off, nurses get crucified.

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  • This is sad for the nursing profession, how can this be? I do hope the nurse fight for her case and equally be given a chance.

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  • This is a sad day for our nursing profession. We must stop scapegoating individuals for systemic failures that are almost always a result of a chronic lack of recourses and funding cuts. Sadly nurses often try to make the best of awful situations and difficult choices inevitably mistakes happen, we can predict more unfortunately..
    Were is the RCN for this nurse?

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  • Not quite the same in the Nursing Home Sector Nurse Manager fined for not predicting Fire Doors with push bars are a Safety Hazard fined for £20K and struck off .Care Home Props. fined £1.5 million pounds and subsequently closed down through bankruptcy .
    Lets see what happens at Glosthorpe Hospital approx 600 people died (prematurely)

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  • Re Gerald Hudson's point above:
    WTF??? Surely designating a fire door safe or otherwise is the job of the local Fire Brigade's Safety Officer? Yet another case of nurses carrying the can.

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  • Some of us are trying to support Nurse Amaro as best we can but it is true - the situation has completely broken her and our profession must hold some responsibility for this. This case was tragic but there were multiple contributing factors. The Bawa case has shown the issues raised and those contributing factors - it is sad that the NMC has said they have no intention of reopening the case as clearly some facts have now emerged that if the case was heard today the outcome may have differed. Nurse Amaro was unrepresented at her hearing so attended alone. She was refused the ability to appeal the criminal conviction. The outcome for the NMC hearing seems almost pre determined. She was clearly a vulnerable adult and yet was not safeguarded so consequently was unable to present herself adequately due to the psychological impact that criminal proceedings had on her and the backlash of abuse she received as a result. The hearing notes that are available on the NMC website clearly state that nurse Amaro showed insight, remorse and remediation. They also show that this was a unique situation and the chances of repetition were low. Finally they report that the outcome is measured on public interest element alone. Did the pressure of the case and the need to make someone accountable override the key principles of our regulator? The new steps that the FtP are taking outlined in the letter from the new interim chief executive to all registrants gives the impression that they will look more globally rather than look to blame. Perhaps the interim CEO could commission a review and help to give this colleague some closure. She made mistakes but as the judge stated in her criminal case she was at the lower end of the hierarchy. What for the other two nurses involved in the case? Did they have NMC hearing? How can the NMC be sure that the evidence the Trust presented was complete and reliable? Were the facts presented solid? Or was it more that Nurse Amaro could not present her case appropriately? Dr Bawa Garba received a great deal of support both financially towards her case and professionally from her peers. It is sad that when a vulnerable adult is unable to promote herself to the public, the support stops.

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  • Dear John,
    Exactly ! just the point I was making, the Nurse was also the the Registered Manager at the Home. why was she not supported by NMC as you say by the way the Local Fire Brigade responsible for issuing the Fire Certificate for the Building wasn't even approached.

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