Gage v General Chiropractic Council

An appeal from a professional disciplinary tribunal is allowed only where the tribunal’s decision was wrong or unjust because of a serious procedural or other irregularity. The court must give substantial weight to the tribunal’s professional expertise.

A disciplinary investigation committee was required to disclose significant expert evidence obtained under its investigation rules, but non-disclosure did not require a stay or dismissal where the practitioner later had a fair hearing and the irregularity did not make the final decision unjust. Professional misconduct is proved to the civil standard, with stronger evidence required for more serious allegations. Publicity breaching advertising and professional codes may constitute unacceptable professional conduct without proof of dishonesty or actual reliance by a member of the public.

Dr Warren Gage, a chiropractor, appealed under section 31 of the Chiropractors Act 1994 against findings by the General Chiropractic Council’s Professional Conduct Committee. The Committee found five allegations proved concerning testimonials and publicity which breached the CAP Code and the Chiropractors Code, and imposed a suspension order ending on 31 October 2004.

The appeal challenged non-disclosure of an expert report, alleged bias, the standard of proof, findings under the CAP Code and Chiropractors Code, the characterisation of the conduct as unacceptable professional conduct, and the penalty. The central issues included the consequences of procedural non-disclosure and the effect of the suspension order while the appeal was pending.

1. Appeal test. The appeal was a rehearing governed by rule 52.11.3 of the Civil Procedure Rules. The court would intervene if the Committee’s decision was wrong or if a serious procedural or other irregularity made the proceedings unjust. On professional competence and disciplinary judgment, substantial weight was due to the Committee’s expertise, following Moody v General Osteopathic Council [2004] EWHC 967 (Admin).
2. Expert report. Rule 5(2) of the investigation rules had to be read broadly enough to permit an expert report. That power carried an obligation to disclose significant evidence to the chiropractor, consistent with the disclosure provisions in rules 4(2), 4(5) and 4(6). The Committee was therefore wrong to hold that disclosure was unnecessary. However, the defect did not require a stay or dismissal. Dr Gage had later had a full and fair hearing, and the evidence made a disciplinary hearing inevitable. The irregularity was not sufficiently serious to make the final decision unjust.
3. Bias and proof. The pharmacist chair’s professional status did not give rise to a real possibility of bias, applying Porter v Magill [2002] 2 WLR 37. Under section 22(2) of the Chiropractors Act 1994, the applicable standard was the civil standard of proof. The seriousness of an allegation affected the strength of evidence required, but did not convert the test into the criminal standard.
4. Publicity and professional conduct. The Committee was entitled to find that testimonials implied that chiropractic could effectively treat serious conditions without the independent support required by clause 14.3 of the CAP Code. Breach of paragraph 8.4 of the Chiropractors Code did not require proof of deliberate dishonesty, actual exploitation, or actual harm. The heading “Honesty” was only a signpost; the substantive rule prohibited publicity abusing public trust or exploiting lack of knowledge. A claim that treatment had achieved long-term results where other chiropractors had achieved only temporary results breached paragraph 8.12, which prohibited claims of superiority.
5. Penalty and order. The five breaches were properly characterised as unacceptable professional conduct. The short suspension was not wrong, and the court gave proper weight to the Committee’s assessment of seriousness and protection of the public. The order was expressed to end on 31 October 2004, while section 31(2) postponed its operation until disposal of the appeal. The court could not rewrite it as a fixed 69-day suspension or impose a more adverse sentence absent a reference under the statutory scheme. The appeal was dismissed. Dr Gage therefore served no period of suspension. He was ordered to pay 80 per cent of the Council’s costs.

The judgment does not state any earlier appeal stage. This was an appeal to the Administrative Court under section 31 of the Chiropractors Act 1994 from the decision of the General Chiropractic Council Professional Conduct Committee.