Uddin v General Medical Council

Findings of dishonesty in professional disciplinary proceedings require more than proof that information was inaccurate, misleading or negligently presented. The decision-maker must distinguish dishonesty from innocent mistake, unreasonableness and negligence, and give adequate, intelligible reasons linking the evidence to the required state of mind. An appellate court hearing an appeal by way of rehearing should respect primary factual findings and the expertise of a specialist tribunal, but may scrutinise evaluative conclusions, especially where the issue falls outside the tribunal’s professional expertise. In complex cases, reasons must make clear why the losing party failed and identify the essential reasoning supporting adverse credibility or dishonesty findings.

The appellant, a general practitioner, appealed under section 40 of the Medical Act 1983 against findings by the General Medical Council’s Fitness to Practise Panel. The Panel had found that she acted dishonestly in referring allegations about a former care-home manager to the Protection of Vulnerable Adults process. It found misconduct, impairment of fitness to practise and imposed erasure.

The appeal focused principally on five findings of dishonesty concerning alleged failures to send criminal-record checks, failure to provide supporting evidence, misleading letters and witness statements. The central issues were whether the Panel’s reasoning adequately established dishonesty and whether the findings could stand.

1. Appeal allowed. The five findings of dishonesty at paragraphs 7(d), 10, 11 and 12(a) and (c) of the charges were quashed. The matter was remitted to a differently constituted Panel for reconsideration of misconduct, impairment and sanction. The respondent was ordered to pay the appellant’s costs, subject to detailed assessment if not agreed.
2. The appeal was by way of rehearing. Under rule 52.11 of the Civil Procedure Rules 1998, the court may intervene where the Panel’s decision was wrong or unjust because of serious procedural error or other irregularity. Appropriate weight must be given to a specialist tribunal and to its assessment of live witnesses. Greater caution is appropriate where the issue is evaluative and outside the Panel’s clinical expertise.
3. The Panel’s reasons were flawed. An inaccurate or misleading statement does not, without more, establish dishonesty. Conduct may instead result from an innocent mistake, unreasonable judgment or negligence. The Panel repeatedly moved from findings about inaccurate content, responsibility to check documents, or failure to provide adequate evidence directly to dishonesty without identifying a sound basis for the necessary state of mind.
4. The reasons were also inadequate because they relied on matters outside the charges, failed to specify which parts of documents were misleading, and did not explain why the evidence established dishonesty. A professional facing serious findings is entitled to proper, adequate and intelligible reasons showing why she lost.
5. The court made tentative observations that care is required when applying the criminal-law two-stage approach in R v Ghosh to civil or professional proceedings. The ordinary civil standard applies, and in many criminal cases no separate direction on dishonesty is required unless the defendant’s awareness of the ordinary standards is genuinely in issue.
6. The court rejected the suggestion that the matter was merely an employment dispute. Non-clinical conduct may raise serious issues of probity and public confidence for professional regulation. The defects identified concerned the Panel’s reasoning and the dishonesty findings, while the position on other grounds remained neutral.

• Fitness to Practise Panel: Following a 23-day hearing, the Panel found facts proved, determined that the appellant’s fitness to practise was impaired by misconduct, and ordered erasure from the register. Its reasons were set out in a letter dated 21 March 2011.
• High Court (Administrative Court): The appeal under section 40 of the Medical Act 1983 was allowed. The five dishonesty findings were quashed and the matter remitted for reconsideration by a differently constituted Panel.