Krishnamurthy, R (On the Application Of) v General Medical Council

A professional performance committee need not give a fully reasoned judgment. It must explain briefly but clearly why it has reached its determination. It is entitled to assess the evidence independently and need not expressly reject every opinion, where its reasons make the basis of its conclusion clear. Delays in following a remedial programme may properly weigh against a practitioner, even if they are not culpable, because they may bear on whether deficiencies have been adequately addressed. A further performance assessment may be required after a lengthy suspension, provided the assessment takes account of the practical difficulties caused by the suspension.

The claimant, a general medical practitioner, brought a statutory appeal under section 40(1)(aa) of the Medical Act 1983 against a decision of the General Medical Council’s Committee on Professional Performance extending his suspension for 12 months.

He argued principally that the committee had failed to address sufficiently the evidence of Dr Adams, whose view was that he should be permitted supervised practice to develop his clinical skills. Other grounds challenged inferences drawn from delays in the claimant’s remedial programme, the treatment of his educational activities, and the prospect of a further assessment after suspension.

1. Appeal dismissed. The committee’s determination gave clear reasons for extending the suspension. Its duty was to explain briefly but clearly why it made the determination, rather than to provide a fully reasoned judgment.
2. The committee was entitled to assess Dr Adams’s evidence in the context of all the evidence, including the claimant’s answers in cross-examination and to questions from committee members. It was unnecessary expressly to state that Dr Adams’s opinion was rejected because the committee’s reasons showed why it had reached a different assessment.
3. The committee was entitled to treat the claimant’s failure to meet Dr Bailey within the suggested period, and the delay in preparing a personal educational plan, as factors weighing against him. Those delays could be relevant to whether he had adequately addressed his shortcomings, even if they were not culpable.
4. The assertion that the committee had ignored the claimant’s educational packages was unsustainable. The determination expressly recorded the efforts made to improve performance, and there was no basis for concluding that the material had been disregarded.
5. It was not unreasonable to require a further assessment before the end of the extended suspension. The assessor should take account of the difficulties faced by a practitioner who has been suspended, although the practitioner’s skills could still sensibly be assessed.
6. The appeal accordingly failed. Costs were awarded to the General Medical Council.

The judgment records a statutory appeal from the General Medical Council’s Committee on Professional Performance, which had extended the claimant’s suspension for 12 months. The High Court dismissed the appeal and awarded costs.