The Bawa-Garba Case

Those who still do not know about Bawa-Garba case can refer to the news, in order to disclose the details.

In few words – you can add or take below, if you consider mine inadequate –: Hadiza Bawa-Garba, resident paediatrician in the UK, Nigerian, Muslim, hiyab-dressed. 2011. On-call in terrible conditions. A kid dies. Five years after, Hadiza Bawa-Garba considered guilty by GMC and HC. Sacked from the profession in the UK for life. We’ve just known it. The rest: a wave of words.

You could simply say that it is the United Kingdom and its rarities. Then, I stop here. There’s a Channel between us. In one year’s time, they’ll be no longer a member of our EU. They’ve got different rules for driving and different units to measure distance or weight. A world apart. But still I think that we should not take the case so frivolously.

Some decades ago, their NHS was the inspiring force to build ours. Their current difficulties have a kind of parallelism here in Spain. This is not the correct place – neither one has the capability – to accomplish the task to see the degree of resemblance between both systems. But I must confess that I’ve followed their difficulties, as well as I’ve followed ours. So, I consider appropriate to take some lessons from the case under evaluation.

First of all, budgetary and staff restrictions have been suffered both there in the UK and here in Spain. Clinical tasks in unsafe – but not overtly recognized – conditions have been allowed both there and here. Likewise, the both of us have been suffering from overcrowding, underfunding, understaffing, cyberbreakdowns and so many other problems that I’ve been denouncing along these years. I will put aside the health cost we professionals are paying – for the public is not interested in that issue -. The main problem ensues when the System itself becomes dangerous. A no-return point.

A dangerous system. That’s the point, as evidenced by the case Bawa-Garba. Spaniards and Britons are equal in that issue. You bet your life in an Emergency Room. Budgetary cuts put the System to a limit, or so can be concluded from a careful analysis of Bawa-Garba case. It’s the the situation we live in Andalusia. A similar situation we are living every day in our GP offices, where patients are to be seen every four minutes. That’s the ideal culture for bulky medical mistakes. Mistakes that will be blamed to the health professional.

The British judiciary has acted rigorously, putting every mistake that could be found for that unhappy case heavily and individually upon the wretched resident. They did not consider the organizing chaos in which the unfortunate paediatrician had to do her job. No mitigating circumstances were considered for her. Expelled from the profession for ever in the UK. A real scapegoat to cover politicians’ shame for not being able to proportionate citizens a safe NHS. The maximum stress point, as always: emergency room or primary care. A flank that is usually covered by means of immigrant staff. The weakest part of the chain, certainly: a resident, specially if immigrant, above whom uncertainty always flies.

Notwithstanding, English GMC and HC have gone all too far with this issue, in this era of social network. Today, every physician feels at stake, and not only in the UK. Every time that a medical doctor sits in front of a patient, every time that he or she considers an analysis or radiograph, every time that they take a decision, they will feel the weight of a long period of study and work, and they will see them at stake. Everything at stake, because of a mistake, a wrongdoing, a bad day, a miscalculation.

The British decision, today, has put fear in the souls of hundreds of thousands of medical doctors around the world. And this very fact has got two repercussions: first of all, the inevitable surge of defensive medicine. That is not, as many people think, a deliberate practice for legal protection. Instead, it is only a fearful practice, inevitable consequence of considering that, today, being on call or simply in office, you’ll be a fatal victim of Murphy’s Law. Therefore, should that happen, for the cynical governing system, you are only a screw to replace.

Medical governing cynicism – and this is the second repercussion – will probably lead to the blocking of the most sensitive points of the Health System, where fatal events will multiply, in a difficult-to-mend vicious circle. All of which will probably accentuate System budget difficulties, leading it to a critical point. A medical profession too scared by trials will slow down a System-already-shocked with more tests that will generate more incidental findings, extra costs and extra iatrogenic effects. Imagine a near future in which terrified staffs are reluctant to discharge patients from hospitals upon the basis of risks of complications that could be attributed – at least in part – to their responsibility.

The price to confuse the diagnosis is too high to pay for any nation. If, confronted before the unfortunate case, the diagnosis made by the powerful is «poor individual praxis» instead of «cynicism, poor organisation, underfunding or understaffing», a great wave will be created whose consequences will be irreversible erosion of the System and the suffering of millions. But we may be sure that the wave will not touch those who helped to created it.

Federico Relimpio




Libros de Federico Relimpio


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