Sharief v General Medical Council

On an appeal from a fitness to practise determination, the High Court should respect the specialist tribunal’s assessment of evidence, particularly where credibility is important, but must quash findings that depend on a material misunderstanding of the evidence. The court conducts a rehearing but does not substitute its own factual assessment merely because another view is possible. A Fitness to Practise Panel may admit evidence that would not be admissible in criminal proceedings where its procedural rules make admission fair, relevant and desirable for due inquiry; it need not first determine how a criminal court would rule. Allegations must be considered separately, although findings on one allegation may inform another. An apparently authorised signature may still be dishonest where it is intended to make a document appear personally signed.

Dr Mohammad Sharief appealed under section 40 of the Medical Act 1983 against findings by a General Medical Council Fitness to Practise Panel. The Panel found numerous allegations proved, concluded that his fitness to practise was impaired, and suspended his registration for 12 months.

The appeal challenged the factual findings, the admission of a patient’s witness statement, the alleged dishonesty involved in asking a colleague to sign on his behalf, and the alleged forgery of a sub-investigator’s signature. The appellant accepted that impairment and sanction depended on the underlying findings. The central questions were whether the Panel had applied the correct approach to evidence and whether its findings were wrong or unjust because of procedural irregularity.

1. The appeal was allowed in part. The findings concerning the alleged forgery of Dr Douglas’s signature were quashed. The appeal was dismissed in respect of all other challenged findings, subject to consequential submissions concerning impairment and sanction.
2. The statutory framework separates fact-finding, impairment and sanction. Under section 40(7) of the Medical Act 1983, the court could dismiss, quash, substitute a direction, or remit the case. Applying GMC v Meadow (2006) EWCA Civ 1390 and Gupta v General Medical Council (PC) (2002) 1 WLR 169, the court conducted a rehearing but gave appropriate weight to the specialist Panel’s expertise, its opportunity to see and hear witnesses, and its assessment of credibility. A different view of the evidence was insufficient.
3. The Panel was entitled to reject the appellant’s explanations concerning patient eligibility, clinical reclassification, dishonesty and the fabricated letter. The absence of patient complaints, the Panel’s lack of specialist medical expertise, and competing expert evidence did not require intervention. The circumstances did not call for a Bolam direction; Maynard v West Midlands Regional Health Authority (1984) 1 WLR 634 was materially distinguishable.
4. Under rule 34 of the General Medical Council (Fitness to Practise) Rules Order of Council 2004, the Panel could admit relevant evidence if fair, and could admit evidence inadmissible in criminal proceedings where its duty to make due inquiry made admission desirable. It was not required first to decide whether a criminal court would admit the evidence under section 114 of the Criminal Justice Act 2003.
5. The Panel’s forgery findings could not stand. It misunderstood Sister Soudain’s evidence as an admission relating to the representations and warranties document, whereas her evidence concerned a different FDA 1572 form. Once that error was corrected, the remaining circumstantial evidence was insufficient.
6. The finding that the appellant dishonestly asked Sister Soudain to append a signature purporting to be his own was sustainable. The document falsely appeared to have been personally signed, and the request was not merely to sign it on his behalf using an appropriate “p.p.” notation.

The judgment records an appeal under section 40 of the Medical Act 1983 from a General Medical Council Fitness to Practise Panel determination. The Panel found impairment and directed suspension for 12 months. The High Court quashed only the findings concerning the alleged forgery of Dr Douglas’s signature and dismissed the appeal concerning the remaining findings.