Abu-Romia v General Medical Council

An appellate court reviewing a professional disciplinary decision does not rehear the evidence or substitute its own view of credibility. It asks whether the tribunal reached conclusions open to it on admissible evidence, made an error of law, or denied the appellant a fair hearing under article 6.

Intervention in penalty is justified only where the sanction is wrong because it is disproportionate or falls outside the reasonable range. The profession is ordinarily best placed to assess appropriate sanctions for professional misconduct. A nine-month suspension was within that range in the circumstances.

Dr Abu-Romia appealed under section 40 of the Medical Act 1983, as amended by section 30 of the National Health Service and Health Care Professions Act 2002, against a Professional Conduct Committee decision finding serious professional misconduct.

The misconduct related to prescribing Diethylpropion at a slimming clinic. The Committee found inadequate history-taking, insufficient information about the medication, failure to attempt non-pharmacological management, prescribing when the product licence had been withdrawn, and failure to inform a general practitioner in one case. It imposed a nine-month suspension.

The central issues were whether the findings were supported by the evidence, whether the hearing was fair under article 6 of the European Convention, and whether the sanction was disproportionate.

1. Appeal dismissed. The court’s function was supervisory. It had not heard the witnesses, so credibility was primarily for the Committee. The court could intervene only if the Committee reached a conclusion not open to it on the evidence, made an error of law, relied on inadmissible evidence, or failed to provide a fair hearing.
2. The Committee was entitled to prefer the evidence of the two patients and the expert evidence to the appellant’s account. A tribunal’s rejection of a witness’s evidence does not necessarily mean that the witness was lying; the witness may be mistaken or have an unreliable memory. The findings of inadequate history-taking, insufficient advice, failure to attempt non-pharmacological treatment, inappropriate prescribing and failure to notify the general practitioner were properly open to the Committee.
3. The hearing was fair for the purposes of article 6. The appellant had legal representation, a full opportunity to challenge the GMC’s witnesses, and a proper opportunity to give evidence.
4. On penalty, the court could intervene only if the sanction was wrong because it was disproportionate. The Committee had considered the seriousness of the misconduct, the available sanctions, the appellant’s long and previously unblemished record, and the need to protect patients and maintain public confidence. A nine-month suspension was within the reasonable range. The court referred to McCoan v GMC [1964] 3 All ER 143, adapting its formulation to the modern language of proportionality.
5. The suspension was neither wrong nor disproportionate, and the court could not interfere.

• High Court (Administrative Court): dismissed the appeal against the Professional Conduct Committee’s decision of 5 June 2003.
• Professional Conduct Committee of the General Medical Council: found serious professional misconduct and directed suspension of the appellant’s registration for nine months.