Sultan v The General Medical Council

In professional disciplinary proceedings, sanction is directed principally to public protection, public confidence and professional standards, rather than retribution. Personal mitigation and the practitioner’s financial or career interests must be considered, but may carry less weight where serious misconduct or deficient performance creates an unacceptable public risk. A specialist fitness-to-practise tribunal is best placed to assess sanction. An appellate court should not substitute its own view or re-sentence unless there are proper grounds for intervention. Erasure may be proportionate where deficiencies are wide-ranging, insight is inadequate, and proposed retraining or supervision is impracticable.

Dr Mohammed Sabji Sultan appealed under Medical Act 1983, section 40, and CPR 52.11(3), against a Fitness to Practise Panel’s decision to erase his name from the Medical Register.

The Panel had found, following admissions, that his fitness to practise was impaired by misconduct involving insecure disposal of confidential patient records and deficient professional performance. The appeal challenged the proportionality of erasure, the Panel’s consideration of suspension and remediation, the treatment of personal mitigation, and the adequacy of its reasons.

1. Appeal dismissed. The Panel’s direction for erasure was neither unjustified nor disproportionate. The appellant was ordered to pay the respondent’s costs, summarily assessed at £6,276, within 28 days.
2. The statutory purpose of professional discipline is protection of patients and the wider public interest, including public confidence in the profession and the maintenance of proper standards. The exercise is not primarily punitive. Proportionality requires the available sanctions to be considered, beginning with the least restrictive, while giving proper weight to mitigation and the practitioner’s interests.
3. The court applied the principles in Raschid v the General Medical Council and Fatnani v the General Medical Council [2007] 1 WLR 1460. The specialist Panel had particular expertise in assessing the seriousness of professional misconduct, the risk to patients and the sanction required. The court should not undertake a re-sentencing exercise or substitute its own judgment merely because it might have imposed a different sanction.
4. The Panel was entitled to treat both misconduct and deficient professional performance as contributing to the sanction. It had considered the appellant’s personal circumstances, previous career, admissions, proposed retraining and evidence of mitigation. Its assessment that direct supervision would be required, that no workable conditions could be devised, and that retraining was impracticable was open to it on the evidence.
5. The Panel was also entitled to conclude that the appellant lacked sufficient insight and that his deficiencies covered a broad range of clinical skills. In those circumstances, suspension with a future review would not adequately protect patients or maintain public confidence.
6. The reasons were adequate. The Panel’s determination, read with the full transcript and evidence available to the appellant, sufficiently explained why erasure rather than suspension or conditions was selected.

1. High Court (Administrative Court): appeal against the Fitness to Practise Panel’s erasure decision dismissed. Costs summarily assessed at £6,276.