Sheill v The General Medical Council

On an appeal under section 40 of the Medical Act 1983, the High Court conducts a review within its appellate jurisdiction and may correct material errors of fact, law or judgment. It gives appropriate respect to a professional tribunal’s assessment of witnesses, professional practice and the gravity of misconduct.

A serious allegation, particularly dishonesty, must be properly formulated, specific and fairly ventilated. Where the allegation’s factual and temporal focus is unclear, the resulting finding may be set aside. A sanction will not necessarily be reduced merely because one finding is removed if the remaining misconduct independently makes erasure proportionate.

The appellant, a general practitioner and medical director of private clinics, appealed under section 40(7) of the Medical Act 1983 against findings and the sanction imposed by a Fitness to Practise Panel of the General Medical Council. The Panel found misconduct impairing his fitness to practise and directed erasure from the Medical Register.

He challenged findings that he had falsely claimed that a patient requested that her general practitioner not be informed, and that he had misled another patient by failing to disclose his suspension. He also argued that erasure was disproportionate. The central issues were whether the disputed allegations had been fairly formulated and proved, the proper approach to appellate review, and whether the remaining misconduct justified erasure.

1. Appellate approach. The appeal was technically by way of rehearing but in substance involved review of the evidence and material before the Panel. The court had full jurisdiction to correct material errors of fact, law or judgment, while recognising the Panel’s advantage in seeing and hearing witnesses and its professional expertise. Sanction required particular respect because its principal purposes included public protection and maintaining confidence in the profession.
2. Miss KL. The dishonesty allegation concerned the appellant’s claim that the patient had requested that her general practitioner not be informed. The charge did not identify clearly when or in what document the alleged false claim was made. The issue was not sufficiently focused before the Panel, and the direction on dishonesty did not ensure that the Panel addressed the appellant’s state of mind when the alleged claim was made. A serious allegation of dishonesty requires a properly formulated and specific allegation that is fully and fairly ventilated. Findings under charges 26(b) and 27(b) were therefore set aside.
3. Mrs ES. The Panel was entitled to accept the patient’s evidence that her status as a doctor was important to her decision to proceed. Although the appellant was entitled to provide the cosmetic treatment and had not made an expressly untrue statement, failing to disclose his suspension could amount to misleading conduct in the particular circumstances. The finding was upheld, though the conduct was characterised as an error of judgment rather than deliberate untruthfulness warranting significant censure by itself.
4. Sanction. Removing the dishonesty findings did not undermine the Panel’s carefully structured reasons for erasure. The remaining misconduct included persistent disregard of regulatory requirements, inappropriate prescribing and storage of medicines, failures concerning patient information and consent, rude and unprofessional conduct, and lack of insight. Those matters independently made conditions or suspension insufficient and erasure proportionate.
5. The appeal was allowed only in respect of findings 26(b) and 27(b); it was otherwise dismissed.

1. Fitness to Practise Panel of the General Medical Council: found misconduct impairing fitness to practise and directed erasure from the Medical Register.
2. High Court (Administrative Court): allowed the appeal in respect of findings 26(b) and 27(b), but dismissed the appeal against the remaining findings and sanction.