Al-Khayat, R (on the application of) v General Medical Council

When reviewing a professional disciplinary sanction, the court must accord appropriate respect to the specialist tribunal’s assessment of professional seriousness, public protection and the measures required to maintain standards. That respect does not prevent the court from examining whether the sanction is appropriate, necessary and proportionate. Where a tribunal finds repeated fundamental clinical failings, serious professional deficiency and a current risk of harm to patients, suspension may be necessary instead of conditional registration. The tribunal is also entitled to use its professional experience and expert evidence to determine the period required for retraining and risk reduction.

The claimant, a doctor, appealed against a decision of the General Medical Council’s Fitness to Practise Panel. The Panel had found serious professional misconduct arising from repeated failures in the treatment and assessment of a patient and imposed a 12-month suspension.

The appeal challenged only the sanction. The claimant argued that conditions on registration, allowing continued practice while undertaking retraining, would have been sufficient and that suspension risked loss of clinical skills. The central issue was whether the Panel’s choice and duration of suspension were excessive or disproportionate.

1. Appeal dismissed. The court found no error in either the nature or length of the suspension. The claimant was ordered to pay the Council’s assessed costs of £6,231.20.
2. The court applied the approach stated in Ghosh v General Medical Council [2001] UKPC 29; [2001] 1 WLR 1915. Appropriate respect must be given to the specialist tribunal’s assessment of the seriousness of professional misconduct and the measures needed to maintain professional standards and protect the public. The court must not defer more than the circumstances warrant and may consider whether the sanction is appropriate, necessary and proportionate.
3. The Panel had found repeated fundamental failings, widespread breaches of essential principles of good clinical care, serious professional deficiency and a current risk of harm to patients. In those circumstances, it was not appropriate to leave the doctor free to treat patients subject to conditions. Suspension was therefore an available and necessary protective sanction.
4. The length of suspension was also a matter for the Panel’s professional experience and judgment, informed by the expert evidence, particularly as to the danger presented and the period required to remedy it. The court found no evidential or legal basis for interfering with the 12-month period.

• Fitness to Practise Panel of the General Medical Council: found serious professional misconduct and imposed a 12-month suspension.
• High Court (Administrative Court): dismissed the appeal and awarded the Council assessed costs.