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

An appeal against a professional disciplinary sanction may succeed on later evidence showing that the appellant was unfit to conduct the original hearing. The evidence must establish more than retrospective assertions of illness. The court should assess its reliability, contemporaneity, independence, medical foundation and consistency with the hearing record. A disciplinary panel is not required to adjourn proceedings or obtain psychiatric evidence on its own initiative where the material before it gives no adequate reason to suspect that the practitioner is unable to defend himself. Where the evidence establishes that the hearing was fair and the practitioner was fit to participate, remission for reconsideration is unnecessary.

The claimant, a doctor, appealed under section 40 of the Medical Act 1983 against the General Medical Council Fitness to Practise Panel’s decision to erase his name from the Register. The sanction followed admitted criminal convictions and findings of serious professional misconduct.

He contended that the Panel should have adjourned to allow legal advice and representation and should have obtained psychiatric evidence. He relied on later evidence that depression had made him unfit to conduct the hearing. The central issues were whether the Panel had acted unfairly and whether the subsequent evidence justified allowing or remitting the appeal.

1. Appeal dismissed. The court was satisfied that the claimant had received a fair hearing and that remission for reconsideration was unnecessary.
2. The Panel had no legal obligation to adjourn or obtain psychiatric evidence on its own initiative. The information before it indicated that any previous depression had ended by 2002. The claimant denied current mental illness, appeared articulate and focused, and did not request an adjournment, representation or medical assessment.
3. Following Sai Baba v General Medical Council (Privy Council Appeal No: 16 of 2000), later evidence may justify allowing an appeal where it establishes that the appellant was not fit to defend himself at the original hearing. The court considered the principles in Ladd v Marshall together with the substantive issue rather than as a separate preliminary question.
4. The later psychiatric report did not establish unfitness. The psychiatrist had not seen the claimant near the relevant date, had little contemporaneous medical material, relied substantially on retrospective accounts, and did not rigorously analyse the applicable fitness question. The report also contained material outside the psychiatrist’s expertise. The claimant’s own evidence required independent expert support.
5. The evidence was inconsistent with the contemporaneous material, including the claimant’s presentation at the hearing and a later near-contemporary psychiatric assessment. The court therefore rejected both the claim that the claimant had been unfit and the fallback submission that the matter should be remitted because of uncertainty.
6. Permission to appeal was refused. The defendant was awarded costs, subject to detailed assessment and the claimant’s public funding protection.

The judgment records an appeal under section 40 of the Medical Act 1983 from the Fitness to Practise Panel’s sanction decision. The Administrative Court dismissed the appeal and refused permission to appeal.