Razak v General Medical Council

On a statutory appeal from a professional disciplinary tribunal, the court reviews whether the tribunal acted reasonably and lawfully. It does not rehear the evidence or determine witness credibility afresh. The court considers all evidence placed before the tribunal, including evidence from the respondent, when deciding whether the tribunal could properly find the allegations proved. Inconsistencies in a witness’s evidence do not necessarily invalidate other evidence accepted by the tribunal. A tribunal may rationally accept some parts of a witness’s evidence and reject others. Appellate interference is justified only where no reasonable, properly directed tribunal could have reached the decision. Serious sexual misconduct by a psychiatrist towards a vulnerable psychiatric patient may justify erasure from the medical register.

Dr Ali Abdul Razak appealed against findings and an erasure direction made by the Professional Conduct Committee of the General Medical Council after a hearing in July 2003. The Committee found proved various allegations concerning an improper relationship with a psychiatric patient, including inappropriate personal contact, sexual conduct, provision of unprescribed medication and failures to document interventions. It also found serious professional misconduct.

The appeal challenged the Committee’s acceptance of the principal witness’s evidence, alleged inconsistencies between proved and unproved charges, and the refusal to stop the case at half-time. The appellant also challenged erasure as excessive. The central issues were the proper scope of the statutory appeal and whether the Committee’s factual findings and sanction were reasonably and lawfully available to it.

1. Appeal dismissed. The court upheld both the findings of serious professional misconduct and the direction erasing Dr Razak’s name from the Medical Register.

2. The jurisdiction was primarily regulatory. Unlike a criminal trial, its purpose included protecting the public and maintaining confidence in the medical profession. On appeal, the court therefore had to consider all the evidence before the Committee, not merely the evidence at the close of the GMC’s case. Evidence given by the respondent could materially support the case against him.

3. The court could not rehear the evidence or reassess credibility. The Committee was the tribunal of fact. The question was whether a reasonable Committee, properly instructed as to the law, could have reached the findings made.

4. Inconsistency in a witness’s evidence did not require wholesale rejection of that evidence. A tribunal could accept particular statements as reliable while rejecting others, having regard to surrounding circumstances, corroborative evidence, improbabilities, concessions and the manner in which the witness answered questions. The inconsistencies concerning the alleged assault at Drax Power Station were capable of being explained by confusion and did not make the finding unavailable.

5. The Committee was entitled to consider the charges and evidence cumulatively. The admitted failure to keep contemporaneous records was relevant to whether there had been an improper relationship, and the evidence concerning the admitted visits, the Scarborough hotel and the other conduct could support the findings on the more serious allegations. There was no necessary inconsistency between the charges found proved and those rejected.

6. Erasure was not excessive. The misconduct involved pursuing a sexual relationship, including sexual intercourse, with a vulnerable psychiatric patient. The Committee had considered the relevant personal circumstances, professional references and sanctions guidance. Protection of the public and confidence in the profession justified the severe sanction.

7. The GMC was awarded its costs, summarily assessed at £7,868, subject to a 14-day period for written submissions concerning the appellant’s funding position.

• Professional Conduct Committee of the General Medical Council: following a hearing between 28 and 30 July 2003, found specified allegations proved, found serious professional misconduct and directed that Dr Razak’s name be erased from the Medical Register.
• High Court (Administrative Court): dismissed the statutory appeal and upheld the findings and erasure direction.