Siddiqui v The General Medical Council

On an appeal from a professional disciplinary tribunal, the court may examine factual findings as well as legal issues, but the appeal is not a rehearing. The tribunal’s decision is treated as correct unless the appellant shows objective grounds requiring a different conclusion. The intensity of review varies with the issue: statutory interpretation attracts limited deference, while findings based on oral evidence, case management, evaluative judgments and sanction attract substantial deference. The court will intervene on those matters only where the tribunal was plainly wrong or the process was seriously irregular or unjust. A tribunal may proceed in a practitioner’s absence where the governing rules are satisfied, provided it exercises that discretion cautiously and balances the practitioner’s interests against the public interest.

Dr Muhamad Siddiqui appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel decision erasing his name from the medical register. The Panel had found numerous charges proved concerning circumcision procedures performed on babies, including inadequate consent, examination, aseptic conditions and resuscitation arrangements, together with two findings of dishonesty. It found his fitness to practise impaired and concluded that erasure was proportionate. The appeal challenged the Panel’s procedure, fact-finding, treatment of expert evidence, alleged bias, dishonesty findings and decision to proceed in his absence. The central questions were whether the Panel’s decision was unjust because of a serious procedural or other irregularity, or was wrong.

Appeal dismissed on the merits. No ground disclosed a serious procedural or other irregularity, and the Panel’s decision was not shown to be wrong.

1. Scope of appeal. Under section 40 of the Medical Act 1983 and CPR rule 52.11(3), the court may examine factual findings and legal issues, but does not conduct a rehearing. The appellant must show objective grounds requiring a different view of the reasoning process or application of law, rather than merely showing that another view is reasonable or possible.
2. Deference. The appropriate degree of deference depends on the issue. It may be limited for statutory interpretation, substantial for disputed primary facts dependent on oral testimony, and significant for secondary factual inferences. Case-management decisions, open-textured evaluative judgments and sanction attract the greatest restraint, with intervention justified only where the Panel was plainly wrong.
3. Adjournment. The Panel had a broad case-management discretion under rule 29 of the Rules. The minor amendments, late expert material and unfinalised witness timetable caused no demonstrated prejudice. Refusal of the adjournment was therefore a legitimate exercise of discretion.
4. Absence. Rule 31 gave the Panel discretion to proceed where the practitioner was neither present nor represented and the required notice had been served. The Panel acted with due caution, considered whether the appellant had voluntarily absented himself, and balanced his interests against the public interest. It was entitled to proceed after proper notice, repeated unsuccessful attempts to contact him and the appellant’s acceptance that he chose not to participate further. His absence was not itself held against him.
5. Merits. The Panel was entitled to assess witness credibility, prefer the evidence of parents and experts, and reject the challenges to expertise, conflicts of interest, consent, clinical care, dishonesty and alleged bias. The sanction decision was not shown to be disproportionate or otherwise wrong. The appeal was dismissed on its merits, making it unnecessary to decide the GMC’s separate objections concerning lateness.

1. Fitness to Practise Panel: On 25 February 2015, the Panel found the appellant’s fitness to practise impaired and ordered erasure from the medical register.
2. High Court (Administrative Court): The appeal under section 40 of the Medical Act 1983 was dismissed on the merits. The court did not determine the GMC’s alternative objections that the appeal and additional grounds were out of time.