Inayatullah v General Medical Council  All ER (D) 237 (Oct)
Medical practitioner - Professional conduct committee. The appellant doctor appealed against the decisions of the General Medical Council's Fitness to Practise Panel (the panel) that his fitness to practise was impaired and that erasure from the register was the appropriate sanction. The Administrative Court, in dismissing the appeal, held that the panel's legal assessor had provided proper guidance and a direction on the appellant's good character had not been required. In light of those conclusions, the challenge to the sanction had been unarguable.
The appellant doctor was the subject of a 'sting' by journalists. Actors presented symptoms in consultations with the appellant while wired with cameras. AC consulted the appellant twice. Following the second consultation, the appellant was recorded examining AC, which was not reflected in the film. In evidence before the respondent General Medical Council's (the GMC) Fitness to Practise Panel (the panel), the appellant repeatedly stated that, while he could not remember whether or not he had examined AC, he only recorded what he had done. Further, expert evidence was given on behalf of the appellant, from a colleague, B, and on behalf of the GMC. The panel received directions from its legal assessor concerning the expert evidence, probability, and the standard and burden of proof.
The panel found:
- that B's evidence was of questionable independence and the appellant's evidence was unreliable
- absent evidence that the film had been tampered with, the appellant had not carried out an examination of AC, but had recorded that he had done so
- the appellant was dishonest by the standards of reasonable people
- the allegations concerning clinical matters were proved
- the appellant's fitness to practise was impaired
- the only appropriate sanction was erasure from the register.
The appellant appealed, under ss 38 and 40 of the Medical Act 1983. The appellant contended that:
- the legal assessor's direction on the question of probability and the standard of proof had been insufficient;
- by analogy with the criminal law, a good character direction had been required;
- the panel should have grappled with why it had not accepted B's evidence; and
- the panel had erred in imposing the sanction of erasure.
The appeal would be dismissed.
(1) When read as a whole, the legal assessor's directions concerning probability and the standard of proof had been appropriate and shaped for the circumstances of the case. Fairness had not required anything further. The assessor had not been obliged to advise the panel on all possible conclusions and her summary of the case had been entirely fair. Therefore, the direction had dealt with the important points and had provided the panel with proper guidance.
Cheatle v General Medical Council  All ER (D) 281 (Mar) applied; B (children) (sexual abuse: standard of proof), Re  4 All ER 1 considered; Sharma v General Medical Council  All ER (D) 36 (Jun) considered.
(2) A direction on good character might not have been inappropriate, but the real question was whether fairness had required it. The analogy with criminal proceedings was not close fitting. The two limbs of the good character direction, namely, its impact and the appellant's credibility, were obvious without a direction being required to render the proceedings fair. Accordingly, the absence of the good character direction had not been a legal error and there had been no obligation on the legal assessor to have given one.
R v Moustakim  All ER (D) 176 (May) considered.
(3) The panel had rejected B's evidence as not always having been underpinned by impartiality and independence. Many of the allegations against the appellant had related to matters about which the panel had been entitled to reach its own opinion. It was a matter of its judgment within its province and its findings had been entirely reasonable.
Bolam v Friern Hospital Management Committee  2 All ER 118 considered; Bolitho v City and Hackney Health Authority  4 All ER 771 considered.
(4) In light of the court's conclusions, the challenge to the sanction had been unarguable. As the panel's findings on dishonesty and clinical matters stood, the conclusion on erasure was unimpeachable.
Reproduced with the kind permission of LexisLibrary.