Campbell, R (on the application of) v Birkin

In reviewing a professional disciplinary decision, the court asks whether the decision is unlawful on traditional public-law grounds. A professional conduct committee must distinguish professional misconduct from serious professional misconduct and must consider all relevant circumstances, including mitigation, before deciding whether the serious threshold is met. The committee need not analyse every factor separately or give elaborate reasons. General reasons are sufficient where the basis of the decision is clear from the findings and the decision read as a whole. A court must not adopt a pedantic or nit-picking approach to the committee’s reasoning. A series of culpable acts may nevertheless be described as isolated or exceptional when contrasted with an otherwise unblemished professional career, and relevant professional or geographical circumstances may properly be taken into account.

The claimant sought judicial review of the Professional Conduct Committee of the General Medical Council’s dismissal of a charge of serious professional misconduct against a consultant paediatrician. The committee had found numerous serious failings in his treatment of two children but concluded, after considering his professional record, testimonials and the relative medical isolation of his practice, that the charge was not proved.

The challenge alleged failure to assess the seriousness and similarity of the failings, irrational use of the description “isolated incidents”, and irrational reliance on the medical isolation of the practice. No challenge was made to the factual findings. The central issue was whether the committee’s conclusion was legally irrational or inadequately reasoned.

1. Application refused. The claimant had standing, but the challenge could succeed only on traditional judicial-review grounds. The court’s task was not to decide whether it agreed with the committee’s conclusion.
2. Under Medical Act 1983, section 36, the committee had to decide whether the registered doctor was guilty of serious professional misconduct. Misconduct involves conduct falling short of what would be proper in the circumstances. The qualification “serious” requires more than ordinary professional misconduct; gross professional negligence may suffice, without moral turpitude, but more is required than negligence giving rise only to civil liability.
3. The committee had to determine seriousness as a global question after considering all relevant circumstances, including mitigating factors. It was not required to isolate the seriousness of the clinical failings as a separate issue. The committee’s detailed findings, its description of the treatment as substandard and unprofessional, and its statement that the facts were capable of supporting serious professional misconduct showed that it had properly addressed seriousness.
4. The committee’s reasons were adequate. It was enough that, read fairly and in context, they identified the serious breaches, referred to the applicable approach, considered the doctor’s record and mitigation, and explained the conclusion. Professional disciplinary reasons need not be elaborate or lengthy.
5. The descriptions “isolated incidents” and “relative medical isolation” were inept or capable of improvement, but not irrational. The first could refer to the exceptional nature of the two episodes against an otherwise unblemished career. The second could reflect the practical pressures of maintaining a single-handed paediatric service separated from neighbouring medical services.
6. The claim was therefore refused.