Baby P: How should the GMC respond ?

[ipsiLoquitor]

What is an appropriate response from the GMC to these events ?

Those in charge of the local authority have now resigned or been forced out but who is the equivalent person in the case of doctors ?

Who runs the system that failed ? Or is it a personal failure only ?

Should someone resign (apart from the frontline staff) ? Or is the situation so different that venting all sadness on one doctor is appropriate ?

[James]

You are making a big assumption that one of the doctors looking after baby P made an error. From the little I have seen on the news the doctors looking after him identified that he was being abused and recommended to social workers that he was taken into care.

[northoftherriver]

Well the locum consultant who missed the broken back is up in front of the gmc...

[ipsiLoquitor]

Originally Posted by James

You are making a big assumption that one of the doctors looking after baby P made an error. From the little I have seen on the news the doctors looking after him identified that he was being abused and recommended to social workers that he was taken into care.

Yes, I am assuming that the doctor made an error and find myself wondering if the type of error she made will be classified as generic or simply a one-off. If it is generic (or systemic) who is the equivalent 'boss' - the person who hired her ? the consultant she worked with ? Or does being a doctor imply sole responsibility once the patient is 'through the door' ?

[ipsiLoquitor]

Will the GMC simply stop at punishing a doctor who may have behaved like many other doctors ? Will they look for an evidence base or is that only applicable when dealing with 'medicine' ?

Context:

Res Ipsi Loquitor:-

The Saudi-born doctor was working as a locum paediatrician at St Ann's Hospital in Tottenham when she examined Baby P on August 1 last year, just two days before his death.
By the time she saw him, the toddler had already had his fingernails ripped out and was likely to have been half-paralysed from injuries to his back and ribs .
She noticed bruises on his body but failed to spot the serious injuries he had suffered.
The doctor made a decision: not to carry out a full examination of Baby P because he was "miserable and cranky".
The 52-year-old, of Ilford, East London, was the first person to lose her job over the case, having her contract with Great Ormond Street Hospital terminated.
Last week the General Medical Council suspended her from practising while it investigates her conduct, having already banned her from working without supervision.
In a statement, she said: "Like everyone involved in this case, I have been deeply affected by the shocking and tragic circumstances of this young child's death.
Comment on Evidence Based Medicine:
The point is, how many other doctors would and indeed have done exactly the same- but with no evidence (i.e. death of a baby) no action will ever be taken.

[northoftherriver]

Originally Posted by ipsiLoquitor

Yes, I am assuming that the doctor made an error and find myself wondering if the type of error she made will be classified as generic or simply a one-off. If it is generic (or systemic) who is the equivalent 'boss' - the person who hired her ? the consultant she worked with ? Or does being a doctor imply sole responsibility once the patient is 'through the door' ?

Why does it have to be one of these things? Can it not be a bit of both?

Still, a Doctor has to take a degree of responsibility for their actions. She may or may not be found negligent depending upon the circumstances of the case.

[ipsiLoquitor]

Originally Posted by northoftherriver

Why does it have to be one of these things? Can it not be a bit of both?

Still, a Doctor has to take a degree of responsibility for their actions. She may or may not be found negligent depending upon the circumstances of the case.

Excellent post.

The negligence test, I believe, considers what other similarly trained professionals of the same rank/experience would have done. That is why it is either or (although I wouldn't usually like such a dichotomy).

If, what she did was not negligent, by definition that leaves the whole cohort of paediatricians in the dock. For obvious reasons most of them will not want to line up with this particular doctor, whatever the truth of their own practice.

If, on the other hand, she was negligent, the medical profession maintains its authority and other consultants are not 'at risk' of a lowering of their repute etc.

This is a dilemma for the GMC is it not? If her standards fell below those expected she is scapegoated in the context of other consultants behaving similarly. Many people know that her experience/decision is often repeated e.g. in GP settings.

That is why it is either or, not because of the truth of the matter, but because if it is a 'bit of both' this implies public self-criticism of doctors by doctors - a pretty rare thing. In addition, it means that people outside the medical profession may be viewed as having legitimately increased input to the process of recruitment/selection/training of doctors.

If you look at the other thread you will see that the gut instinct of most in medicine or wishing to be in medicine is to 'rule out' opinion on the basis of either not being a doctor or not having experience of medicine.

They would, in fact, on this basis rule out the High Court judges who so often decide on legal questions of negligence.