Rumbold v The General Medical Council

On an appeal under section 40 of the Medical Act 1983, the Administrative Court must respect the specialist expertise of the Fitness to Practise Panel, its opportunity to assess witnesses, and its evaluative judgment. The court retains responsibility to correct material errors of fact or law and to exercise its own, distinctly secondary, judgment.

In sanction cases, the Panel’s purpose is protection of patients, the public interest and confidence in the profession, rather than punishment. The seriousness of child pornography offences and continued registration as a sex offender are material considerations. A further suspension was justified where the Panel reasonably concluded, on the evidence as a whole, that the doctor lacked sufficient understanding of his offending to return to practice.

Dr John Rumbold appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel decision dated 12 February 2007. The Panel found that his fitness to practise remained impaired and imposed a further 12-month suspension.

The appeal concerned the proper intensity of review on a section 40 appeal, the relevance of the seriousness of his convictions and continuing sex-offender notification requirements, and whether the Panel had a proper evidential basis for concluding that he lacked sufficient understanding of his offending to return to medical practice.

1. Appeal dismissed. The Panel’s decision to impose a further 12-month suspension was wholly justified.
2. On a section 40 appeal, the court must give appropriate weight to the Panel’s specialist understanding of professional standards, its advantage in hearing and seeing witnesses, and the fact that primary and secondary factual assessments and overall value judgments may reasonably admit of different answers. The court may correct material errors of fact or law and exercise its own judgment, but that judgment is distinctly secondary.
3. The court identified a possible difference of emphasis between Meadow and Raschid and Fatnani, but declined to resolve it because the appeal failed under either formulation. The court applied both approaches.
4. Sanction is directed principally to protecting patients, maintaining public confidence and preserving the reputation and standards of the profession. The seriousness of convictions for internet child pornography and continued registration under the sex-offender notification requirements were material considerations. The Panel was entitled to regard the offences as extremely serious and to consider suspension rather than conditions.
5. The conclusion that the doctor lacked sufficient understanding of his offending was supported by the evidence taken as a whole, including the post-treatment report, the psychiatric evidence, the doctor’s answers in evidence and the Panel’s own assessment. The Panel was best placed to make that evaluative judgment, and there was a proper basis for it.
6. The Panel was also entitled to consider the doctor’s failure to make specific enquiries about feasible future training or employment. Those matters, taken together with the other factors, justified further suspension.

The judgment does not state a separate lower-court decision in this litigation. The appeal was brought directly against the Fitness to Practise Panel’s decision dated 12 February 2007.