Williams v General Medical Council

An appellate court hearing a statutory appeal from a specialist disciplinary panel should show appropriate respect for the panel’s expertise, but must intervene where its decision is wrong or unjust because of serious procedural or other irregularity. The degree of respect varies with the issue.

Serious professional misconduct may arise from gross or culpable negligence even without bad faith. Professionals must be judged by the standards and circumstances existing at the time, without hindsight. Potential consequences may form part of the context. Personal mitigation cannot reduce conduct that otherwise establishes serious professional misconduct, although it remains relevant to sanction.

Dr Alan Williams appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel’s finding of serious professional misconduct and its imposition of a three-year condition preventing him from undertaking Home Office pathology or coroners’ cases.

The charges concerned the post-mortem examinations of two infants, the accuracy and documentation of findings, and the failure to report or disclose microbiological and biochemical material relating to one death. The appeal challenged delay, procedural fairness, legal advice, factual findings, the finding of serious professional misconduct and sanction.

The central issues were whether the Panel’s decision was wrong or unjust because of serious procedural or other irregularity, and how the High Court should approach an appeal by way of rehearing from a specialist disciplinary tribunal.

1. Appeal dismissed. The Panel’s decision was neither wrong nor unjust because of serious procedural or other irregularity. The Panel was entitled to refuse a stay despite delay and late service of the Notice of Inquiry. No material prejudice preventing a fair hearing was demonstrated.
2. The division of the hearing into three sessions, the timing of closing submissions and the arrangements for written submissions did not make the hearing unfair. The Panel controlled its procedure within the Conduct Rules and had sufficient material to determine the issues.
3. The Court of Appeal judgment in the criminal proceedings could properly be considered as part of the evidential and legal context, including its observations about disclosure. It was not binding on the Panel as a determination of Dr Williams’s misconduct. The Panel had to make its own assessment, and the Legal Assessor’s advice sufficiently made that clear.
4. The approach in R (Campbell) v General Medical Council [2005] EWCA Civ 250 was binding. Matters exclusively relevant to personal mitigation could not be used to downgrade conduct otherwise sufficient to establish serious professional misconduct. Evidence may be relevant both to culpability and mitigation.
5. The factual findings were open to the Panel. It was entitled to find serious errors and omissions in the post-mortem examinations and reports, and that the unusual microbiological results concerning Harry raised a potential possibility of natural death which should have been considered, reported and disclosed.
6. The Panel was entitled to find serious professional misconduct. The case involved a sustained catalogue of uncorrected errors and omissions over a prolonged period, in circumstances where Dr Williams had accepted a high level of forensic responsibility. Gross or culpable negligence could constitute serious professional misconduct despite the absence of bad faith.
7. The sanction was proportionate and did not prevent Dr Williams continuing his principal practice as a consultant histopathologist. Any credit for the undertaking given during the appeal could be considered on an application to vary the sanction under Rule 37.

• High Court (Administrative Court): appeal under section 40 of the Medical Act 1983 dismissed. The Fitness to Practise Panel’s finding of serious professional misconduct and three-year registration condition were upheld.