Ujam v General Medical Council

On an appeal from a professional disciplinary panel, the court gives appropriate weight to the panel’s professional expertise, particularly in assessing a practitioner’s insight and presentation. Misconduct involving sexualised boundary violations may impair fitness to practise even where there is no risk to patients and the practitioner has taken remedial steps. The panel may place limited weight on remediation where the principal public-interest concern is maintaining confidence in the profession and upholding professional standards. Sanctions are not primarily punitive, but may have a punitive effect. A suspension is lawful where the panel has assessed the gravity of the misconduct, considered proportionality, and reasonably concluded that conditions would not adequately protect the wider public interest.

The appellant challenged determinations by a General Medical Council Fitness to Practise Panel following findings of sexual harassment and related misconduct towards three female colleagues. The Panel determined in December 2010 that his fitness to practise remained impaired, despite the passage of time, positive references and evidence of improved conduct. It later imposed a six-month suspension, rejecting conditional registration as insufficient to address the public-interest concerns.

The appeal concerned whether impairment continued at the conclusion of the Panel hearing and whether the sanction was wrong.

1. Appeal dismissed. The Panel was entitled to assess the appellant’s insight and the attitudes displayed in his evidence and presentation. The court should show a degree of deference to the experience and professional knowledge of a Fitness to Practise Panel: Cheatle v GMC [2009] EWHC 645 (Admin); Ghosh v GMC [2001] 1 WLR 1915.

2. The task in determining impairment is to take account of the misconduct and consider it with all other relevant factors known to the Panel: Cohen v GMC [2008] EWHC 581 (Admin). The Panel had considered the passage of time, insight, remediation, testimonials and oral evidence. Its conclusion that the misconduct remained relevant and that impairment continued was not one with which the court should interfere.

3. The significance of remediation depends on the nature of the misconduct. In cases of clinical error or incompetence, remedial action may be highly relevant. Where misconduct involves sexual or professional boundary violations undermining public confidence, remediation may carry considerably less weight because regulatory action may be required to reaffirm professional standards: Yeong v GMC [2009] EWHC 1923 (Admin).

4. The Panel was entitled to conclude that impairment continued principally because public confidence in the profession and proper standards of conduct required protection, notwithstanding the absence of a risk to patients.

5. In relation to sanction, the Panel was entitled to determine the gravity of the misconduct and the measures necessary to express disapproval and restore public confidence. Sanctions are intended to protect patients and the public interest rather than to punish, although they may have a punitive effect. The Panel reasonably concluded that conditions would be inappropriate and insufficient. The six-month suspension was therefore not wrong.

• General Medical Council Fitness to Practise Panel: determined on 17 December 2010 that fitness to practise remained impaired and, on 20 December 2010, imposed a six-month suspension.
• High Court (Administrative Court): dismissed the appeal. The court had previously given judgment on the factual background in [2012] EWHC 580 (Admin).