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

In reviewing a professional disciplinary sanction, the court must respect the specialist tribunal’s assessment unless the decision is wrong in principle. A fitness to practise panel must consider the practitioner’s offending as a whole when determining sanction. It may not retry the underlying criminal convictions, but it must allow the practitioner to explain the circumstances, provide mitigation and demonstrate insight. Maintaining public confidence and upholding proper professional standards are relevant public-interest considerations, alongside protection of patients. Proportionality requires consideration of lesser sanctions, but the availability of a lesser sanction does not make erasure unlawful. Interference with a sanction will ordinarily be rare where the panel has applied the relevant guidance and acted fairly.

The claimant, a doctor, appealed against a General Medical Council committee’s decision to erase him from the medical register. The sanction followed convictions for common assault and dishonesty offences involving sick pay and applications for medical employment. He accepted the convictions and that they amounted to serious professional misconduct, but argued that erasure was excessive, that the offences should have been considered separately, and that the committee had unfairly prevented him from explaining the convictions and presenting mitigation.

The committee had treated the convictions as establishing impaired fitness to practise and then considered the appropriate sanction under the Indicative Sanctions Guidance. The central issues were whether the committee had acted procedurally unfairly, whether it was entitled to consider the offending together, and whether erasure was disproportionate.

1. The appeal was dismissed. The committee was entitled to consider all the offending together. Separating the assault from the dishonesty offences would have been artificial because the sanction had to reflect the conduct of the individual practitioner as a whole.
2. The committee was not entitled to act as a criminal appeal court or to investigate whether the convictions were correct. It was, however, required to hear relevant mitigation. A practitioner may accept the conduct and explain the circumstances, motives or personal background in order to show that the criminal responsibility or professional seriousness is less than might otherwise appear. The committee was entitled to prevent attempts to dispute the factual correctness of the convictions.
3. The chairman’s interventions did not prevent a fair hearing. The claimant was able to explain his conduct, his cultural background, his previous career and his remorse. The committee was entitled to regard attempts to minimise the seriousness of the offences as showing limited insight, and to treat that as aggravating.
4. The applicable public-interest considerations included protection of patients, maintaining public confidence in the profession and declaring and upholding proper standards of conduct and behaviour. The committee also had to apply proportionality by weighing the public interest against the practitioner’s interests and considering mitigation and lesser sanctions.
5. The claimant’s competence, lack of danger to patients, financial hardship, suspension and personal circumstances could have justified a lesser sanction. They did not make the decision to erase him wrong in principle. The committee considered the lesser possibilities and was entitled to conclude that the dishonesty and violence represented a serious departure from professional standards and were fundamentally incompatible with remaining on the register.
6. It was recognised that successful appeals against disciplinary sanctions should be rare, having regard to the expertise of the GMC’s panels. Costs were summarily assessed at £5,000.

1. General Medical Council committee: The claimant’s convictions were accepted, impaired fitness to practise was found, and he was erased from the medical register.
2. High Court (Administrative Court): The appeal against erasure was dismissed. Costs were summarily assessed at £5,000.