Goodchild-Simpson v General Medical Council

On a statutory appeal from a professional fitness-to-practise panel, the High Court conducts a rehearing but does not retry the case de novo. Appropriate deference is given to the expert tribunal’s assessment of evidence, clinical judgment and witness credibility.

In performance assessments, the evidential sample need not be perfect. It must be relevant and the best reasonably available. Limitations may affect the weight of the evidence but do not necessarily make it inadmissible or worthless.

At the sanctions stage, public safety is the main consideration. Where a non-trivial risk to patients exists, the tribunal may adopt a cautious approach and has a broad margin of discretion in choosing between conditions and suspension. The High Court’s role remains supervisory and does not permit re-sentencing.

Dr Matthew Roger Goodchild-Simpson appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel determination suspending his registration for nine months.

He challenged the use of 50 case studies in a performance assessment, arguing that they were drawn from a short locum placement and were not representative. He also argued that the Panel should have imposed conditions instead of suspension, relying on evidence that supervised practice might be possible.

The central issues were whether the assessment evidence was fairly and properly obtained, and whether the Panel had lawfully exercised its discretion in selecting suspension as the appropriate sanction.

1. Appeal dismissed. The High Court’s jurisdiction under section 40 of the Medical Act 1983 is by way of rehearing, but it is not a de novo retrial. The court must recognise the expertise of the professional tribunal and its advantage in assessing witnesses and clinical evidence. The court’s judgment on appeal is secondary and supervisory.
2. The selection and evaluation of performance-assessment samples were matters of clinical judgment. The assessors sought the best available evidence, namely recent work performed by the appellant. Although an ideal sample would have been drawn from two sources, the available evidence supported using 50 cases from one recent posting. A sample need not be perfect to be admissible and probative. Its limitations may qualify the inferences drawn, but do not make the evidence worthless. The Fitness to Practise Panel independently considered the evidence and was entitled to accept it.
3. In determining sanction, the Panel was required to give primary weight to public safety. Section 1(1A) of the Medical Act 1983 identifies protection, promotion and maintenance of public health and safety as the General Medical Council’s main objective. The appellant’s professional interests were relevant but did not override patient safety.
4. The Panel was not bound by the recommendation or evidence of any individual expert. It was entitled to assess credibility and weight across the evidence and was not required to provide a forensic analysis of every piece of evidence. Its conclusion that the combination of serious mental-health concerns, deficient performance, lack of insight and risk to patients made conditions inadequate was reasonably open to it.
5. The decision to impose suspension rather than conditions fell within the Panel’s area of expertise and discretion. The High Court would not interfere merely because it might have reached a different view.

• Fitness to Practise Panel: determined on 22 August 2013 that the appellant’s fitness to practise was impaired by health and deficient professional performance, and suspended his registration for nine months.
• High Court (Administrative Court): dismissed the statutory appeal.