Back in 2018, a landmark crowdjustice campaign saved the career of a young doctor who was scapegoated for systemic clinical and management failings in one of the UK’s largest NHS Trusts. The Bawa-Garba case exposed the serious internal rot which threatens the heart of NHS patient safety, but was diverted by the UK medical establishment into an “educational issue” about doctors’ reflective practice.
Now the Connolly Case – involving another young doctor – again calls into question the Government’s commitment to transparency and patient safety during COVID-19. Bearing in mind recent C-19 mortality, we ask, “In a climate of fear, who should be held responsible for avoidable deaths in the NHS?” 'The Connolly Case calls into question the Government's commitment to transparency and patient safety during COVID-19.' Click To Tweet
Bawa-Garba implicated politicians and executives at the very top of the NHS
The Bawa-Garba case was described as a case that “rocked medicine” because it showed that NHS workers on the front line take the blame, including criminal charges, when politicians and NHS executives create dangerous conditions in NHS Trusts.
Dr Hadiza Bawa-Garba was a paediatrics junior doctor convicted of medical manslaughter following her heartbreaking failure to save a young boy’s life in a hospital which was severely short-staffed and had multiple systemic failings.
This case caused an international outcry amongst the medical profession, for instance Australia’s national radio network presented an extensive radio discussion here and in the UK the story was covered by Panorama.
NHS doctors realised that Dr Bawa-Garba “could have been any one of us” – the case sparked an awakening that nurses and doctors would be in the firing line for avoidable deaths in an increasingly under-resourced and dangerous workplace.
What most people don’t know is that a BBC journalist reported allegations arising from a public health investigation that senior management from NHS England had known that there was increased mortality in Hadiza’s hospital at around the time of Jack Adcock’s tragic death, and they had covered up that evidence. This is not an isolated case. The Francis Inquiry detailed how NHS managers in Mid-Staffordshire had not only covered up risks to patient safety, but caused serious detriment to nurses, doctors and other healthcare professionals who spoke up for patient safety.
The Bristol Inquiry, the Gosport Inquiry, the Baby P Inquiry, the Morecambe Bay Inquiry, the Belfast Inquiry… the list goes on. This rot goes right to the top and has been responsible for thousands of avoidable NHS deaths – often of our most vulnerable patients, such as young children and the elderly. This is why transparency and accountability are essential during COVID-19.
'Given that corporate manslaughter legislation is so weak, the likely outcome of COVID-19 is that nurses and doctors on the ground will be held culpable for the failures of politicians and managers.' Click To Tweet
The desperate resource challenges of COVID-19 are likely to exacerbate this process of political and management failures leading to healthcare scandals involving vulnerable patients, for instance there are alarming reports about the management of patients with disabilities during the pandemic. Given that corporate manslaughter legislation is so weak in the UK, the likely outcome of COVID-19 is that nurses and doctors on the ground will be held culpable for the failures of politicians and NHS managers.
The Connolly Case – what happens when doctors speak up for patient safety?
Tragically, Hadiza did not speak up and ask for help in a dangerous environment which threatened the health of vulnerable children. She tried to “soldier on” like many NHS staff do. The important question is: What would have happened if Hadiza had spoken up? The case of Dr Claire Connolly suggests that Hadiza’s career may well have been terminated if she had raised concerns.
Claire Connolly had completed nearly 8 years of specialist training as a paediatrics junior doctor and was just a few months away from being appointed a consultant when she raised concerns about safety in a busy London hospital.
Following Claire’s concerns, she says that educational supervisors at her workplace reported her to Health Education England, a government executive body which controls the career progression of junior doctors, and this resulted in the termination of Claire’s career in paediatrics.
This again is not an isolated case. There are multiple cases of nurses and doctors who have suffered detriment for fulfilling their duty to speak up for the rights of their patients, documented extensively in Sir Robert Francis QC’s “Freedom to Speak Up” review.
Robert Francis’s review described “how staff who have sounded the alarm about dangerous practices have found themselves shunned, suspended and sacked by hospital bosses instead of having their concerns taken seriously”. 'What would have happened if Hadiza had spoken up? The Connolly Case suggests that Hadiza's career may well have been terminated if she had raised concerns.' Click To Tweet
The UK Government’s appalling response to Connolly
The factual evidence for Claire’s whistleblowing detriment will be tested by due process at a tribunal. However, the response of Health Education England to the Connolly Case is astonishing – it’s trying to avoid the factual evidence even coming to court, by arguing that trainee doctors are not protected in law from detriment caused by reports sent to HEE by educational supervisors. What did Claire’s supervisor do, and why does HEE want to hide that evidence so badly, that it’s prepared to argue 50,000 doctors should be deprived of whistleblowing protection from their educational supervisors?
Effectively, HEE seems to be constructing a mechanism where the careers of over 50,000 junior doctors can freely be destroyed by their supervisors if they speak up when they see patients in danger. Shockingly, HEE only recently wasted enormous amounts of tax-payers’ money constructing (and eventually losing) a similar legal argument against Dr Chris Day after he raised concerns about a dangerously understaffed ICU unit.'Effectively, the Government seems to be constructing a mechanism where the careers of over 50,000 junior doctors can freely be destroyed by their supervisors if they speak up when they see patients in danger.' Click To Tweet
It’s important to remember that HEE is directly responsible to the Health Secretary under the Care Act 2014, so this legal case directly implicates the Government in an effort to stop junior doctors on the front line speaking up for patient safety.
The Health Secretary says that the treatment of NHS whistleblowers is “morally abhorrent” but his own department is removing legislative whistleblowing protection from over 50,000 doctors!
Unsurprisingly, the medical establishment appears uninterested in this assault on doctors’ rights and patient safety.
The BMA has failed to take action to protect the employment rights of these 50,000 doctors, and the GMC has raised no concerns about the enormous threat to patient safety. Just as in the case of Dr Bawa Garba, it will fall on grassroots organisations to take action.
The cycle of independent inquiries followed by ineffective reports and empty platitudes has to stop. National tragedies resulting in hundreds of avoidable NHS deaths will keep on happening unless we empower clinical staff on the ground to speak up for patient safety. HEE’s legal arguments against Dr Claire Connolly threaten the employment rights of over 50,000 doctors and the safety of the millions of patients they treat every year.
NHS healthcare professionals are doing everything possible to keep vulnerable patients alive during COVID-19. Let’s support Claire’s legal battle for her right to keep her patients safe, and the rights of over 50,000 doctors to do the same.