Professional Standards Authority for Health And Social Care v General Pharmaceutical Council & Anor

On an appeal under National Health Service Reform and Healthcare Professions Act 2002, the court asks whether the disciplinary sanction was wrong, applying a secondary judgment while giving appropriate respect to the specialist regulator. A sanction is unduly lenient where no reasonable disciplinary tribunal, having regard to the relevant facts and the protective and reputational purposes of regulation, could have imposed it. Removal from the register may be required where serious criminal conduct involves dishonesty or lack of integrity, continuing lack of insight, serious potential harm, and conduct fundamentally incompatible with registration. A panel must address those matters coherently and explain how its sanction protects the public, maintains standards and sustains public confidence. A period of suspension cannot properly be justified by allowing a registrant to develop insight where the registrant continues to deny the essential facts and seriousness of the misconduct.

The Professional Standards Authority appealed under section 29 of the National Health Service Reform and Healthcare Professions Act 2002 against a Fitness to Practise Committee decision concerning a pharmacist convicted of two offences of wilful neglect of her infant daughter. The Committee found impairment but imposed 12 months’ suspension rather than removal from the register. The General Pharmaceutical Council did not resist the appeal and supported substitution of removal. The central issues were whether the Committee had misdirected itself about insight, failed to assess fundamental incompatibility and relevant sanction factors, and imposed a sanction that was wrong or unduly lenient.

1. Appeal allowed. The court proceeded in the registrant’s absence because the appeal documents had been properly sent to her registered address and she had not engaged with the proceedings. The Committee’s 12-month suspension was quashed and an order for removal from the register was substituted.
2. Under section 29, the question was whether the Committee’s decision was wrong. Applying Ruscillo v Council for Regulation of Healthcare Professionals [2004] EWCA Civ 1356, a sanction is unduly lenient where a disciplinary tribunal, having regard to the relevant facts and the object of disciplinary proceedings, could not reasonably have imposed it. The court’s task remained a secondary judgment, with appropriate respect for the specialist regulator, but intervention was required where the sanction was manifestly inappropriate.
3. The Committee’s finding at the impairment stage was that the registrant had shown no insight, had engaged in deliberate concealment and lacked integrity. Its later finding that she had taken some steps towards understanding insight was inadequately explained and inconsistent with the earlier findings. Insight required acceptance of the facts, recognition of the seriousness and wrongfulness of the conduct, and proper reflection on future conduct. The registrant’s continued denial and failure to explain the injuries gave no assurance that suspension would protect the public.
4. The conduct directly engaged clinical practice, professionalism and the protection of vulnerable persons. The Committee had failed adequately to consider the effect of the lack of integrity on public trust and confidence, and had not properly applied the relevant removal factors in the Indicative Sanctions Guidance, including continuing risk, serious potential harm, dishonesty, lack of insight, serious departure from professional standards and the need to maintain public confidence. Those matters made the conduct fundamentally incompatible with continued registration.
5. The Respondents were ordered to pay the Authority’s costs equally, in the total sum set out in the statement of costs.

1. High Court (Administrative Court) — The Authority’s appeal under section 29 of the National Health Service Reform and Healthcare Professions Act 2002 was allowed. The Committee’s suspension decision was quashed and removal from the register substituted.
2. Fitness to Practise Committee, General Pharmaceutical Council — The Committee found impairment but imposed 12 months’ suspension rather than removal.