Dr Waney Marian Valerie Squier v General Medical Council  EWHC 2739
This was an appeal against the MPT's decision to erase Dr Squier from the Medical Register.
Dr Waney Marian Valerie Squier had been a consultant paediatric neuropathologist at the Oxford University John Radcliffe Hospitals since 1984. She practised as a registrar in neuropathology in 1975 and was appointed senior registrar in paediatric pathology at Great Ormond Street Hospital in 1978, where she worked until taking up her post as consultant at the John Radcliffe.
Since the late 1980's Dr Squier had developed a medico-legal practice, providing reports as an expert neuropathologist in the civil, family and criminal courts. A significant and growing part of her medico-legal practice concerned cases where babies had died as a result of suspected non-accidental head injury (NAHI).
This case concerns the reports she provided and the evidence she gave between 2007 and 2010 involving six babies, of whom five died soon after allegedly sustaining NAHI, and in which she challenged the diagnosis of shaken baby syndrome. The charges brought by the MPT did not relate to Dr Squier's stance on this syndrome, but rather whether the evidence she gave went beyond the proper boundaries of expert evidence.
On 1 April 2010 a complaint was made to the General Medical Council (GMC) by the National Policing Improvement Agency. On 14 August 2014 a Notice of Hearing before the Fitness to Practise Panel was given by the GMC to Dr Squier. Following a preliminary hearing on 15- 26 September 2014, the FTPP gave directions for the substantive hearing. They were successfully challenged by judicial review proceedings before Ousely J in January and February 2015.
On 23 February 2015 Ousely J ordered that the Notice of Hearing of 14 August 2015 be quashed and that the GMC serve a revised notice, which set out, with adequate particulars, the disciplinary charges of which Dr Squier was accused. This was done and the substantive hearing took place between 5 October 2015 and 21 March 2016.
On 17 March 2016 the MPT determined that Dr Squier's fitness to practise was impaired and on 21 March 2016 they ordered that her name be erased from the medical register. Dr Squier appealed against this decision under s40(1)(a) of the Medical Act 1983.
The High Court re-examined every charge originally brought before the MPT and the basis for each finding.
Mitting J upheld a number of the findings of the MPT, and in considering whether this conduct amounted to serious misconduct or serious professional misconduct found that Dr Squier had "repeatedly" breached her obligations as an expert and that her conduct was aggravated by the "deliberate miscitation of research papers in two of her cases."
It was submitted on Dr Squier's behalf that her insight had now "changed" and that having reflected on the judgment she accepted the need for greater accuracy in her citation of literature.
The court imposed a Conditions of Practice Order, in place of Dr Squier's erasure.
The court, whilst critical of Dr Squier for cherry picking material and brushing-over contrary research, reserved its main criticisms for the MPT, who it said: "revealed a disturbing lack of understanding and over statement about what had occurred" in relation to one particular finding of dishonesty. (paragraph 135). It also condemned the MPT's reliance on evidence they had previously reassured Dr Squier would not be relied upon, resulting in a "serious irregularity" which resulted in an "unjust conclusion on a critical question".
In paragraph 138 Mitting J concluded that it would have been "desirable" for the panel to have been chaired by a lawyer with judicial experience:
"This was a lengthy and complex case. Its principal focus was the preparation and giving of expert evidence in family and criminal proceedings. Both for reasons of case management and of understanding the context in which expert evidence is given in such proceedings, it would have been desirable for this MPT to have been chaired by a lawyer with judicial experience. The Medical Practitioners’ Tribunal Service is obliged to maintain a list of tribunal members, including lay members, under Rule 4 of the General Medical Council (Constitution of Panels, Tribunals and Investigation Committee) Rules 2015. A “lay” member means a person who is not and has never been registered: rule 2. A lawyer with judicial experience falls within this definition. The MPTS is required by Rule 6(4) to maintain a list of persons eligible to serve as chair of a tribunal, including “lay” members. There is, therefore, nothing in the 2015 rules to prevent a lawyer with judicial experience from being appointed to chair a complex case requiring an understanding of the context in which expert evidence is given in a court. It would, in hindsight, have been better if that power had been exercised in this case."
This recommendation lends gravitas to the move towards the imposition of legally qualified chairs in complex GMC hearings.
This case raises two significant issues. It consolidates guidance on the approach to be taken when calling expert evidence, as well as reiterating the core duties of an expert when citing the works of others (paragraph 34). It also raises the question of the need for qualified legal chairs in complex cases where expert evidence is given.