Goodchild-Simpson v General Medical Council [2014] EWHC 1343 (Admin)

Posted on
The fitness to practice panel (FPP) of the Medical Practitioners Tribunal Service of the General Medical Council decided to suspend the appellant's registration as a doctor for a period of nine months. In coming to the decision, the FPP had not considered that erasure was proportionate. Nor had it considered that the imposition of no sanction at all was appropriate. The FPP considered therefore that some in-between sanction was necessary. The appellant appealed, as of right, pursuant to s 40 of the Medical Act 1983.

The grounds of appeal were: (i) that the procedure used by the assessors in relation to the selection of sample cases was unfair; and (ii) the choice made by the FPP when it came to sanction as between suspensions a remedy and the imposition of conditions was unlawful. First, as regards the procedure adopted by the assessors it was submitted that the process was flawed because the case studies used by the assessors had not been a fair representation of the work the appellant had carried out over a number of years. In relation to the second ground it was submitted that the FPP had failed to take his own professional interests into sufficient consideration.

The appeal would be dismissed.

(1) A decision as to the adequacy of a sample to be used in a performance assessment was not, in any traditional sense, an issue of fairness, which was more habitually concerned with principles of natural justice and procedure. In the context in which it arose, in the instant case the challenge was to the adequacy of the sample cases selected by the assessors. That was an area that involved the exercise of medical judgment, which the experts were best placed to exercise, the court would be loathe to second-guess that judgment in the absence of some clear and material error. In any event it was not possible to identify any such errors in the approach that had been taken. Further, the samples had been only one part of the evidence and the FPP had been entitled to place them in the evidential balance and form views (see [24], [26], [29] of the judgment).

(2) In deciding a sanction, the starting point had to be public safety. Once an FPP had concluded that there was some material, non-trivial, risk to the public then that was a factor of great weight. Other factors played a part, including the interests of the doctor. There was a clear public interest in ensuring that in an overworked NHS all medical staff were deployed and that the investment made in such staff was not wasted. The FPP was entitled to adopt a precautionary and cautious approach to remedy where any non-trivial issue as to public safety arose and that would serve to confer upon them a broad margin of discretion (see [34], [35] of the judgment).

In coming to its decision on sanction, the FPP had started by emphasising its primary role in public protection. It then set out a careful synthesis of the facts and matters relevant to whether it should impose conditions upon registration or suspension. It decided in favour of the latter. The decision of the FPP had fallen four square within the centre of its area of expertise and it was not credible that the High Court should interfere in that decision (see [41], [42] of the judgment). 

Reproduced with kind permission of LexisLibrary.