Caiach, R (on the application of) v General Medical Council

On an appeal from a professional disciplinary decision, the reviewing court must determine whether the tribunal applied the correct principles and reached a decision open to it on the evidence. It must not substitute its own view merely because it might have exercised a discretion differently. An adjournment application may be refused where the party seeking it fails to provide persuasive evidence of a proper reason for postponement. Where the tribunal has properly considered the available medical and other evidence, and its decision is supported by that evidence, appellate intervention is unwarranted. An application to extend time may be refused where the proposed appeal has no substantial merit, even if there is a reasonable explanation for procedural delay.

The claimant, a consultant orthopaedic surgeon, appealed against a Fitness to Practise Panel decision of the General Medical Council. The Panel had imposed conditions on her registration for 18 months, principally requiring education, supervision or retraining. The claimant had not attended the hearing and sought, by implication, a further adjournment on compassionate and health grounds. The Panel refused the adjournment, proceeded on the evidence before it and found deficiencies in practice competence and educational performance.

Before the Administrative Court, the claimant challenged the refusal to adjourn, the Panel’s assessment of the evidence and its treatment of certain documents. The Council also argued that the appeal was out of time. The central issues were whether the Panel had erred in principle, whether its decision was supported by the evidence, and whether time should be extended.

1. Adjournment. The Panel had been accurately advised on the relevant principles. The burden of establishing a proper ground for an adjournment rested on the claimant. It was open to the Panel to conclude that there was insufficient substantive evidence concerning her father’s illness and that the medical reports did not establish that her own mental health prevented attendance. The Panel was entitled to treat her non-attendance as voluntary and to refuse a further adjournment.
2. Approach on appeal. In reviewing the exercise of a discretion, the court had to examine the matter as one of principle. It could not substitute its own assessment of the material for that of the inferior tribunal merely because it might have reached a different conclusion. No error of principle had been shown.
3. Merits and evidence. The Panel was entitled to rely on the Assessment Panel’s report and the explanations given by its members. Those witnesses had not been challenged by cross-examination or otherwise. The claimant had not demonstrated that the Panel lacked evidential justification for imposing conditions on her registration. The Panel’s decision to exclude documents whose authors could no longer be cross-examined was also understandable and disclosed no error.
4. Extension of time and disposition. The court accepted that the claimant had initially attempted to lodge an appeal and had been distressed when procedural defects were identified. If delay had been the only issue, an extension might have been granted. Since the proposed appeal had no substantial merit, the application for an extension of time was refused and, so far as necessary, the appeal was dismissed.
5. The claimant was ordered to pay the General Medical Council’s costs, assessed in the sum of £4,750.

The claimant appealed to the Administrative Court from the Fitness to Practise Panel’s decision of 26 April 2005, which imposed conditions on her registration for 18 months. The Administrative Court refused an extension of time and, so far as necessary, dismissed the appeal.