Satya v General Medical Council

On an appeal against a professional disciplinary sanction, the court should accord particular respect to the specialist tribunal’s assessment, especially where the sanction’s purpose includes maintaining public confidence in the profession. Repeated dishonesty by a medical practitioner may justify erasure where suspension would be insufficient to protect patients, maintain confidence and uphold professional standards. Material concerning professional performance may properly be considered where it forms part of the context of the misconduct, including dishonesty in performance appraisals, provided the tribunal does not treat uncharged performance allegations as a separate disciplinary case. The tribunal’s assessment of remorse and potential risk to patients is primarily a matter for it.

The claimant, a doctor, appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel decision finding his fitness to practise impaired by misconduct and directing erasure from the Medical Register.

The misconduct consisted of four admitted incidents involving failure to disclose earlier medical study and repeated misrepresentation of educational, examination and appraisal information. The central issues were whether erasure was disproportionate and whether the Panel had taken irrelevant or prejudicial performance material into account when deciding sanction.

1. The appeal was dismissed. The court held that erasure was proportionate and that the Panel was entitled to reach that decision.
2. Under section 35C of the Medical Act 1983, fitness to practise may be regarded as impaired by reason of misconduct. Section 35D permitted the Panel, where impairment was found, to direct erasure, suspension or conditional registration. Under section 40(7), the High Court could dismiss or allow the appeal, substitute or vary the direction, or remit the case with directions.
3. Following Fatnani and Raschid v General Medical Council [2007] EWCA Civ 46, particular respect had to be given to the Panel’s judgment because the sanctions jurisdiction was directed principally to protecting patients and preserving public confidence in the profession, rather than retributive justice.
4. The Panel was entitled to find that the repeated dishonesty created a potential risk to patients. It was also entitled to reject the claimant’s remorse as unconvincing and to conclude that his account showed insufficient insight. Those assessments were particularly matters for the Panel, which had heard the claimant’s evidence.
5. Performance material was not irrelevant merely because performance itself was not charged. Two of the dishonest statements had been made in the context of performance appraisals, so performance formed part of the context in which the dishonesty occurred. The transcript showed that the Panel understood that it was determining conduct issues and did not ultimately rely on performance allegations as an independent reason for erasure.
6. In light of four incidents of dishonesty concerning educational or medical attainments, the Panel was entitled to conclude that suspension would be insufficient and that the misconduct was fundamentally incompatible with continued registration. Erasure was proportionate.
7. The defendant was awarded its costs.

• Fitness to Practise Panel: On 25 September 2007, found impairment by reason of misconduct and directed erasure from the Medical Register.
• High Court (Administrative Court): The appeal under section 40 of the Medical Act 1983 was dismissed. The erasure direction was upheld and the defendant was awarded its costs.