Wentzel v General Medical Council

On an appeal by way of rehearing from a professional disciplinary tribunal, the court should respect the tribunal’s assessment of witnesses who gave evidence before it where the findings were reasonably open on the evidence. In determining sanction, the maintenance of public confidence in the profession is paramount. That interest may justify erasure even where the practitioner is competent, presents no identified risk of repetition, and erasure may end the practitioner’s career. The purpose of erasure is not confined to punishment or public protection from repetition; preserving confidence in professional standards is independently sufficient.

Dr Wentzel appealed under section 40 of the Medical Act 1983 against decisions of the Professional Conduct Committee of the General Medical Council. The Committee found that he had engaged in an emotional and sexual relationship with a vulnerable psychiatric patient, had misled his superiors about the relationship, and had continued it contrary to their instructions. It erased his name from the medical register.

The appeal challenged both the finding that sexual intercourse had occurred in January 1999 and the proportionality of erasure. The central issues were whether the Committee was entitled to accept the patient’s evidence and whether the competing interests of public confidence, the health service and the doctor justified erasure.

1. The appeal, which was by way of rehearing under section 40 of the Medical Act 1983, was dismissed.

2. The Committee was entitled to accept Ms X’s evidence concerning the January 1999 encounter. It had heard and observed the witnesses, and the evidence was supported by the surrounding emotional and sexual relationship, the doctor’s conduct before and after the encounter, and his statement that he would be struck off. The amendment limiting the charge to one occasion did not undermine her credibility, nor did the failure of other charges establish that her evidence on this charge was unreliable.

3. The Committee was entitled to find that Dr Wentzel lacked insight. Expert evidence was not necessary to enable it to conclude that his conduct contributed to Ms X’s subsequent breakdown, and a letter which did not mention him did not establish otherwise.

4. In determining sanction, the relevant interests included public confidence in the medical profession, the public interest in retaining a capable doctor, and the doctor’s own career. The maintenance of public confidence was the paramount interest. A doctor’s usefulness and the absence of an identified risk of repetition did not prevent erasure where the misconduct involved the sexual exploitation of a vulnerable patient by a psychiatrist and continued disregard of professional instructions.

5. Erasure was not imposed merely to punish or to protect against repetition. It was justified by the need to maintain confidence in the profession. The Committee was therefore entitled, and arguably bound, to order erasure notwithstanding the consequences for Dr Wentzel and the health service.

The appeal was brought to the High Court under section 40 of the Medical Act 1983 against decisions of the Professional Conduct Committee of the General Medical Council. The High Court dismissed the appeal.