Mohammad, R (on the application of) v Nursing Midwifery Council

In an appeal against professional disciplinary sanction, the court asks whether the decision was excessive and disproportionate or outside the range of reasonable decisions. A specialist professional tribunal’s assessment of professional standards deserves respect. Personal mitigation carries less weight than in ordinary criminal proceedings because disciplinary sanctions are not primarily punitive and must maintain public confidence in the profession. Where a tribunal has considered mitigation, followed the required staged approach, given adequate reasons and addressed honesty, integrity and public protection, the court should not interfere merely because it might have imposed a different sanction.

The claimant, a registered nurse, appealed under Article 38 of the Nursing and Midwifery Order 2001 against a Conduct and Competence Committee decision striking her off the register. She had been convicted of money-laundering offences and sentenced to a suspended term of imprisonment, with a confiscation order.

She argued that the Committee had given insufficient weight to her personal mitigation and that striking off was disproportionate. The central questions were whether the Committee had properly evaluated the mitigation and whether its sanction was excessive, disproportionate or outside the range of reasonable decisions.

1. Appeal dismissed. The applicable test was whether the striking-off order was excessive and disproportionate or outside the range of what could be regarded as reasonable, as stated in Gosh v General Medical Council [2001] 1 WLR 1915 and R (on the application of) Bevan v General Medical Council [2005] EWHC 174.
2. A professional disciplinary tribunal is a specialist body. Its understanding of the standards expected in the profession deserves respect: Meadow v General Medical Council [2007] QB 462. The weight given to personal mitigation is primarily for the tribunal. In this context, personal mitigation has less weight than in ordinary criminal proceedings because the sanction is not primarily punitive and does not address the essential need to maintain public confidence in the profession, following Bolton v The Law Society (1993) EWCA Civ 32.
3. The Committee had plainly taken the claimant’s mitigation into account and had carried out the necessary balancing exercise. It was entitled to attach limited weight to her circumstances while giving substantial importance to public protection and the reputation of the nursing profession.
4. The Committee had followed the step-by-step approach in the Indicative Sanctions Guidance. Its conclusion that suspension was inappropriate was based on the seriousness of the dishonesty, the claimant’s persistent lies during the criminal trial, concerns about her honesty and integrity, and the possibility that external influence could override those qualities. The reasoning was adequate. The decisions in Manzur v General Medical Council [2001] UKPC 55 and R (on the application of) James v Nursing and Midwifery Council [2008] EWHC 365 did not require a different result. Manzur involved materially different facts, while James turned on inadequate reasons and did not establish that striking off was impermissible.
5. The striking-off order was not excessive or disproportionate and was within the range of reasonable decisions. The claimant was ordered to pay the respondent’s costs in the sum of £2,500.

• High Court (Administrative Court): appeal under Article 38 of the Nursing and Midwifery Order 2001 dismissed. The Conduct and Competence Committee’s striking-off order was upheld.