Attorney General Reference No 79 of 2004

When sentencing grave sexual offences committed by a professional against patients, the court must assess the harm caused, the offender’s culpability, the risk of further offending and the need to deter others. A gross abuse of professional trust, vulnerable victims, recorded examinations and serious lasting harm are powerful aggravating features.

The sentence should reflect the appropriate overall criminality. Where an unduly lenient sentence is increased on an Attorney-General’s reference, the revised custodial term should nevertheless reflect the double jeopardy of sentencing the offender for a second time.

A general practitioner pleaded guilty at Leeds Crown Court to 23 offences. They included indecent assaults on female patients, making indecent photographs of children, and possessing indecent photographs of children.

The assaults involved unnecessary or improper intimate examinations of adult and child patients. Some examinations were covertly recorded. The offender’s home computer also contained a substantial number of indecent images of children.

The Recorder imposed an extended sentence of five and a half years, with a custodial term of three and a half years. The Attorney-General referred the sentence under section 36 of the Criminal Justice Act 1988 on the ground that it was unduly lenient.

1. The court granted leave and held that both the extended sentence of five and a half years and its custodial term of three and a half years were unduly lenient.

2. The correct sentencing assessment required regard to the harm to the victims, the offender’s culpability, the risk he posed and the need to deter others. The court accepted that the Recorder was right to determine an appropriate overall sentence.

3. The offending involved a grave breach of the trust inherent in the doctor-patient relationship. Several victims were vulnerable through age or impairment. The conduct was repeated, some examinations were recorded, some assaults involved penetration, and at least three victims suffered serious consequences. The reports assessed the risk of reoffending as medium, increasing if the offender obtained access to children or vulnerable adults. Deterrence of doctors and those professing to be doctors was also required.

4. An extended sentence of eight years was appropriate. The court substituted custodial terms producing a total of four and a half years’ imprisonment. Although the proper custodial term at first instance would have been at least five and a half years even after the guilty pleas, the reduced substituted term reflected the double jeopardy of a second sentencing. The remaining concurrent sentences were left unchanged.

• Court of Appeal (Criminal Division): Granted the Attorney-General leave under section 36 of the Criminal Justice Act 1988, held the sentence unduly lenient, and substituted an eight-year extended sentence with a custodial term of four and a half years: [2004] EWCA Crim 2722.

• Leeds Crown Court: On 17 May 2004, the Recorder imposed an extended sentence of five and a half years, comprising a custodial term of three and a half years, following guilty pleas to 23 counts.