Lamming v General Medical Council

Fairness is an overarching requirement in professional disciplinary proceedings. An adjournment to obtain legal representation may be required where a respondent cannot fairly deal with the complexity of the case, but it is not automatically required when the tribunal reaches the sanction stage. The question is whether procedural unfairness is demonstrated and whether relevant material was thereby excluded.

On a section 40 appeal, the High Court must decide whether the tribunal’s decision was wrong. In doing so, it must accord particular respect to the specialist tribunal’s assessment of professional standards, public confidence and sanction. Serious dishonesty may justify erasure despite clinical competence, personal mitigation and the absence of direct patient harm.

Dr Christopher Lamming appealed against the decision of a Fitness to Practise Panel of the General Medical Council to erase him from the medical register under section 35D(2)(a) of the 1983 Act. The Panel had found that he dishonestly retained salary payments made in error, falsely represented the basis of the payments and had previously been found guilty of serious professional misconduct.

The appeal challenged the fairness of the sanction process, contending that the Panel should have adjourned to enable Dr Lamming to obtain legal advice and representation when erasure was being considered. It also challenged erasure as disproportionate. The central issues were whether the process was unfair and whether the Panel’s sanction was wrong.

1. Appeal dismissed. The Panel had to act fairly throughout the proceedings, in addition to complying with the detailed procedural rules. An adjournment to obtain legal representation may be required where a respondent is plainly unable to grapple with the complexity and detail of the case. That threshold was not met here. Dr Lamming had conducted his case ably over several days and had made detailed submissions on sanction, mitigation, health, references and his personal circumstances. No further material was produced on appeal showing that the Panel had been deprived of evidence which could have affected the result.
2. The appeal under section 40 was by way of rehearing under CPR PD Part 52, paragraph 22.3. The High Court’s task was to determine whether the appealed decision was wrong. In applying that test, the court had to give particular respect to the specialist Panel’s judgment on professional standards, public confidence and the appropriate sanction. The approaches in Meadow v GMC [2007] QB 462 and Fatnani and Raschid v GMC [2007] 1 WLR 1460 were substantially reconcilable.
3. The Panel had properly considered the public interest, the seriousness of dishonesty, the available sanctions and the personal mitigation. Dishonesty was particularly serious because it undermined public trust in the profession, even though the conduct did not directly affect patients. The amount retained, the lengthy period, the dishonest letter and the earlier serious misconduct justified the Panel’s assessment that erasure was necessary.
4. The earlier misconduct was not treated as a sequential repetition of dishonesty. Nevertheless, the Panel was entitled, and required, to take it into account when assessing the seriousness of the present conduct and the depth of the behavioural problem. Its balancing exercise was not wrong.
5. The GMC was awarded its costs, summarily assessed at £6,987.40.

1. High Court (Administrative Court) — appeal against the Fitness to Practise Panel’s decision dismissed. The Panel’s order for erasure was upheld.
2. Fitness to Practise Panel of the General Medical Council — found misconduct and impairment of fitness to practise, and ordered erasure under section 35D(2)(a) of the 1983 Act.