Boodoo v General Medical Council

On a statutory appeal from a professional disciplinary committee, the court should give appropriate respect and weight to the committee’s assessment of measures required to maintain professional standards and protect the public. A decision may be upheld where the evidence clearly establishes the relevant medical attributes, even if the committee uses a diagnostic label that was not specifically identified in the notice or evidence. Fairness is concerned with whether the practitioner had a proper opportunity to address the substance of the case and whether any procedural omission caused prejudice. Medical assessors may explain the medical significance of information before the committee and advise on questions referred to them or on potential medical misunderstanding, but they must not act as unsworn witnesses supplying independent evidence.

Dr Stephen Boodoo appealed under section 40 of the Medical Act 1983 against a Health Committee decision of the General Medical Council. The Committee made his continued registration conditional for 24 months, including a requirement to limit alcohol consumption in accordance with his medical supervisor’s advice and to abstain if required.

The appellant argued that the Committee had unfairly found alcohol dependence syndrome under ICD F10.2 when the case had been presented as harmful use of alcohol under F10.1, and that the medical assessors had exceeded their permitted function under the applicable Rules. The central questions were whether the diagnostic classification caused procedural unfairness or prejudice and whether the Committee’s decision was wrong or unjust under CPR Part 52.

1. The appeal was dismissed. Under section 40 of the Medical Act 1983 and CPR Part 52, the appeal could succeed only if the Health Committee’s decision was wrong or unjust because of a serious procedural irregularity.

2. The Committee was entitled to find the three features corresponding to F10.2: a strong desire to consume alcohol, difficulty controlling intake, and persistent use despite clear harmful consequences. Those matters were established by the unchallenged reports of three consultant psychiatrists. The diagnostic label was no more than a description of those attributes. The appellant therefore had sufficient notice of, and opportunity to address, the substance of the case. In any event, no prejudice was shown.

3. The medical assessors’ function under rule 16 and Schedule 2 paragraph 5 of the General Medical Council Health Committee (Procedure) Rules Order of Council 1987-1997 was to advise on the medical significance of information before the Committee, answer questions referred to them, and warn of a possible medical misunderstanding. The material did not establish that they had supplied independent evidence or exceeded that function.

4. Assuming, without finally deciding, that fairness required the assessor’s advice to be disclosed so that the parties could comment, the omission could not justify allowing the appeal. The evidence supporting the relevant findings was clear, concerted and unopposed. Nothing advanced for the appellant had any realistic prospect of changing the Committee’s decision to impose the alcohol-consumption condition.

5. The court accorded appropriate weight to the Committee’s professional judgment concerning public protection. It was at least strongly arguable that a different conclusion on the established features would have been Wednesbury unreasonable or perverse. The Committee’s decision was neither wrong nor unjust.

The judgment does not state the earlier procedural history of the Health Committee decision beyond the appeal to the Administrative Court. The appeal against the General Medical Council Health Committee’s decision of 19 May 2004 was dismissed, with agreed costs of £5,000 inclusive of VAT.