Chyc v General Medical Council

An appeal from a professional disciplinary tribunal is technically a rehearing, but the court ordinarily reviews the evidence and material before the tribunal. It should respect findings based on the tribunal’s observation of witnesses and its professional expertise, while remaining ready to correct errors of law, fact or judgment. A tribunal’s sanction also warrants particular respect where its purpose includes maintaining public confidence in the profession. Findings must remain confined to charges proved to the required standard. A practitioner should not be found guilty of a precisely formulated charge where the evidence establishes only a different obligation or shortcoming.

Following an 18-day hearing, a Fitness to Practise Panel of the General Medical Council found Dr Anthony Chyc guilty of serious professional misconduct and directed that his name be erased from the medical register. The allegations concerned improper conduct towards two women, failures to refer patients for specialist treatment and failures to file patient documents.

Dr Chyc appealed to the Administrative Court under section 40 of the Medical Act 1983. The central issues were whether the Panel’s factual findings were adequately supported, whether the findings of failure to refer were sustainable on the evidence, and whether certain document-filing charges had been proved as formulated.

1. The appeal was allowed in part. The findings concerning Ms P and Mrs A, and most of the findings concerning failures to refer and filing documents, were upheld. Certain findings relating to patients 21 and 18 were set aside. Charges concerning documents that were confidential but not shown to require filing in patient records were also to be set aside or amended, including the related “sweep up” charge.
2. Under the applicable version of section 40 of the Medical Act 1983, the appeal was technically by way of rehearing, but in practice involved review of the evidence and material before the Panel. The court had power to dismiss or allow the appeal, quash or substitute the relevant direction, or remit the case to the committee.
3. The court should give appropriate respect to the Panel’s assessment of witnesses because it had seen and heard them. The Panel also possessed professional expertise in assessing evidence relating to medical practice and the gravity of professional shortcomings. Respect did not remove the court’s jurisdiction: an appellant still succeeds where an error of law, fact or judgment is established.
4. The Panel was entitled to accept Ms P’s consistent account despite delay, later contact with the doctor and matters affecting her reliability. It had observed her evidence and questioned her about the points raised. The court was not persuaded that the finding was wrong.
5. The Panel was entitled to reject the speculative possibility that Mrs A had mistaken a key fob for an erection. The weight of a witness’s concession that something is possible depends on its qualification, its relationship with the other evidence and the setting of the case.
6. Where a charge alleged a failure personally to refer a patient, the evidence had to support that personal failure. The finding concerning patient 21 was not sustained. In other cases, the Panel was entitled to infer that the doctor had received and seen referral requests where the documents were addressed to him and there was no evidence that another person had assumed responsibility.
7. Charges had to be interpreted relatively restrictively where the criminal standard of proof applied and the consequences of a finding could affect professional competence and sanction. A charge alleging failure to file documents was not proved merely by evidence that confidential documents should have been protected until shredded. The evidence had to establish the filing obligation alleged.
8. The Panel’s finding of serious professional misconduct and erasure remained appropriate notwithstanding the successful challenges to some subsidiary findings, because the principal findings were upheld.

• Fitness to Practise Panel of the General Medical Council: after an 18-day hearing, found Dr Chyc guilty of serious professional misconduct and directed erasure from the medical register.
• High Court (Administrative Court): appeal under section 40 of the Medical Act 1983 allowed in part. Findings relating to patients 21 and 18 and unsupported filing charges were set aside or amended; the remaining findings and the overall sanction were upheld.