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

An appeal from a Fitness to Practise Panel is by way of rehearing. The High Court must correct material errors of fact and law and serious procedural irregularity, while giving appropriate respect to the Panel’s judgment. It must exercise a distinct but secondary judgment on the application of legal principles to the facts.

A Panel may proceed in a practitioner’s absence where the governing rules are satisfied, but it must act with caution and consider the circumstances, evidence supporting the request for an adjournment, the seriousness of the allegations and the public interest. Erasure may be proportionate where dishonesty undermines public confidence, even if the misconduct does not concern clinical competence.

The claimant appealed under section 40 of the Medical Act 1983 against a decision of the General Medical Council’s Fitness to Practise Panel dated 16 November 2005. The Panel had erased his name from the Medical Register after finding proved his convictions for false accounting and deliberate misrepresentations in his CV concerning membership of the Royal College of Obstetricians and Gynaecologists.

The claimant challenged the refusal to postpone the hearing, the Panel’s factual findings, the proportionality of erasure and its failure to address adverse media reporting. The central issues were whether the Panel had acted lawfully in proceeding in his absence, whether its findings were open to it, and whether erasure was an appropriate sanction.

1. Appeal dismissed. The appeal under section 40 of the Medical Act 1983 was by way of rehearing. The court could set aside the Panel’s decision if it was wrong or unjust because of a serious procedural irregularity. Following Raschid [2007] 1 WLR 1460, the court had to respect the Panel’s judgment without deferring beyond what the circumstances warranted.
2. The Panel was entitled under rules 29 and 31 of the Fitness to Practise Rules SI 2004 No 2608 to refuse an adjournment and proceed in the claimant’s absence. It had considered the absence of significant medical evidence, the indefinite nature of the requested postponement, the seriousness of the allegations and the public interest. The claimant’s counsellor did not state that he was unfit or unable to attend. The Panel had acted within its powers and with the required caution.
3. The challenges to the factual findings sought to revisit matters that were for the Panel. The Panel was entitled to find that the CV entries were deliberate false representations rather than typographical errors. The complaints that specialist membership was unnecessary for the posts, or that clinicians had not been called, did not address the actual charges, which concerned dishonesty and the possible effect of the misrepresentations on employment.
4. Erasure was neither unlawful nor disproportionate. The claimant had been convicted of serious false accounting involving approximately £18,000, and the Panel had found a deliberate false representation. Protection of patients, the wider public interest and the reputation of the profession could justify erasure even where the conduct did not concern clinical competence. The Panel’s decision accorded with its guidance on dishonesty.
5. The failure to comment on extraneous media reporting was neither an error of law nor a procedural irregularity. The GMC was awarded costs assessed at £3,750, with the claimant given liberty to apply within 14 days of receiving notice of the order.

• High Court (Administrative Court): The appeal under section 40 of the Medical Act 1983 was dismissed. The decision of the GMC Fitness to Practise Panel dated 16 November 2005 was upheld.