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

A Fitness to Practise Panel may reject a practitioner’s undertaking where it considers that the undertaking would not sufficiently protect patients or the public interest, and may instead impose or extend conditions permitted by statute. On review, repeated non-compliance, lack of insight and failure to undertake required retraining may justify suspension. The primary purposes of professional sanctions are protection of the public and maintenance of confidence in the profession, rather than punishment. A sanction may remain proportionate even where age makes compliance more difficult, if public protection and professional standards justify it.

Dr Arzhangi appealed against a Fitness to Practise Panel decision suspending his registration for 12 months. The suspension followed breaches of conditions requiring supervised training and disclosure of those conditions when seeking work through an agency.

He argued that the Panel should have accepted his undertaking not to practise while he challenged an earlier adverse finding, and that suspension was disproportionate. The Administrative Court also considered the suggested application of the Employment Equality (Age) Regulations 2006.

1. Disposition. The appeal was dismissed. The Panel’s decision to suspend the appellant’s registration for 12 months was upheld. The appellant was ordered to pay the GMC’s assessed costs of £5,072.35.
2. The appellant had been properly notified of the hearing. He had failed to notify either the court or the GMC of any change of address, and the court was entitled to proceed in his absence without injustice.
3. Under rule 22(h) of the General Medical Council (Fitness to Practise) Rules Order of Council 2004, the Panel could take into account a written undertaking only if it considered it sufficient to protect patients and the public interest. Section 35D(2)(c) of the Medical Act permitted the Panel to impose conditions where fitness to practise was impaired. Sections 35D(11) and (12) permitted extension of an existing period of conditional registration, but did not give equivalent power where the Panel merely accepted an undertaking. The Panel was therefore entitled to reject the undertaking and reimpose conditions.
4. The undertaking was directed principally to the appellant’s challenge to an earlier finding, rather than to the conditions necessary for safe practice. The Panel was entitled to conclude that accepting it would leave the appellant outside its jurisdiction and would not protect patients or the public.
5. In deciding whether suspension was necessary, the Panel properly considered whether the appellant had appreciated the seriousness of the original misconduct, avoided re-offending, maintained his skills and knowledge, and could safely resume practice or comply with conditions. His prolonged absence from practice, failure to undertake supervised work, repeated breaches and lack of insight justified rejection of further conditional registration.
6. Following Rashid v the GMC [2007] 1 WLR 1460, the sanction’s principal purposes were public protection and maintenance of the profession’s reputation, rather than punishment. Suspension was therefore proportionate. The age-discrimination Regulations were not in force when the Panel decided the case; in any event, the same public-protection considerations would have justified suspension.

• Fitness to Practise Panel: On 18 August 2006, the Panel found breaches of registration conditions and suspended the appellant’s registration for 12 months with immediate effect.
• High Court (Administrative Court): The appeal against the Panel’s decision was dismissed. The appellant was ordered to pay the GMC’s costs.