Nandi v General Medical Council

Serious professional misconduct requires conduct falling seriously below the standards expected of medical practitioners. Negligence may constitute serious professional misconduct, but only where it is of a high degree. A technical breach committed in good faith, without dishonesty, may be relevant to the overall assessment but will not necessarily amount to serious professional misconduct. A disciplinary committee’s expertise attracts respect, but the court must independently assess whether the threshold is met. Undertakings are not a proper substitute for a final finding where the evidence establishes serious professional misconduct, although they may exceptionally be relevant to interim orders.

Dr Nandi appealed under section 40 of the Medical Act 1983 against the Professional Conduct Committee’s finding that he was guilty of serious professional misconduct. The allegations concerned the temporary registration of one patient, the handling of requests for care for another patient, and failures relating to the assessment and referral of a third patient.

The Committee imposed conditions on Dr Nandi’s practice. The appeal challenged both the factual findings and the conclusion that the established conduct amounted to serious professional misconduct. The central issue was whether the Committee had applied the proper threshold to the facts it found proved.

1. Appeal allowed. The finding of serious professional misconduct was quashed, and the related sanctions fell away. Dr Nandi was awarded the costs of the appeal.

2. Findings of fact made by the Professional Conduct Committee should not ordinarily be disturbed unless clearly wrong. The Committee had heard the evidence and seen the witnesses. Although the appeal provisions referred to a re-hearing, that did not require the Administrative Court to hear fresh evidence or reconsider evidence as on an appeal from a magistrates’ court. The ordinary appellate approach applied.

3. Professional misconduct involves a falling short, by omission or commission, of the standards expected among medical practitioners, and the falling short must be serious. Negligent conduct can amount to serious professional misconduct, but the negligence must be of a high degree. There are no closed categories, and the assessment is for the Committee by reference to objective professional standards.

4. The court must accord an appropriate measure of respect to the Committee’s expertise in assessing professional standards and seriousness. That respect is not deference. The court must still decide whether the statutory threshold has been crossed.

5. The temporary registration of Mr M was a technical breach of the applicable regulations, but the Committee had rejected dishonesty and found that Dr Nandi acted to ensure that the patient received necessary medication. That matter should therefore have carried no weight in deciding whether the conduct was serious professional misconduct.

6. The findings concerning Mrs H and Mr R could justify criticism and, at most, findings of misconduct. They did not establish conduct sufficiently serious to cross the relevant threshold. In assessing the matter, the Committee had taken too harsh a view, treated falling below guidance standards as effectively sufficient, and failed to give proper weight to Dr Nandi’s long professional record and the limited number of incidents over approximately 30 years.

7. Undertakings could not properly replace a final finding of serious professional misconduct where the evidence warranted such a finding. They might exceptionally be appropriate in relation to an interim order, but that was not the position here.

This was an appeal to the Administrative Court under section 40 of the Medical Act 1983 from the finding and sanctions imposed by the General Medical Council’s Professional Conduct Committee. The appeal was allowed, the determination was quashed, and the conditions imposed on Dr Nandi’s registration ceased to have effect.