Nursing A Grievance: Disparity Amongst Regulators?

Doctors and nurses, like so many professionals, are subject to regulation and oversight by their professional bodies. Part of that oversight includes the prospect of fitness to practise proceedings. Where a complaint before two separate regulators has the same factual background, is it to be expected that the committees' decisions would be the same?

A recent article1 explores the different approaches taken by the GMC and NMC in related cases arising from the death of Jack Adcock. The author considered the well-known case of Dr Bawa-Garba and the less well known case of nurse Isabel Amaro. The facts of Dr Bawa-Garba's case can be read here. What was not extensively reported was that while Dr Bawa-Garba retained her registration, Isabel Amaro was erased from the nursing register. Her failures were that she did not keep accurate records of Jack Adcock's observations and she did not escalate concerns appropriately.

In the paper, the author highlights the similarities between the two professionals. Both had unblemished careers. Both their failures could be ascribed, partly, to systemic issues at Leicester Royal Infirmary. Both were found to have caused the early death of Jack Adcock. Both were said to have departed from the requisite standard of care so much that it was criminal. Both were convicted of manslaughter by gross negligence and both received a suspended sentence of 24 months' imprisonment. Yet Ms Amaro was erased from the nursing register while Dr Bawa-Garba is able to return to work.

The paper's author concludes that the NMC erred by "'presuming erasure' in gross negligence manslaughter and by giving too much weight to Nicol J's sentencing remarks" in the criminal case. This alleged presumption of erasure was criticised by the Court of Appeal in Dr Bawa-Garba's case. The NMC's final reason for erasure was to uphold public confidence in the profession and the regulator. This reasoning is, in the view of the article's author, "tantamount to a presumption of erasure".

If it is accepted that the NMC panel misunderstood how much they should rely on the sentencing remarks and...