Ariyanayagam v General Medical Council

An appellate court reviewing a fitness-to-practise determination should respect the tribunal’s assessment of witnesses and intervene only where the decision was wrong or unjust because of serious procedural irregularity. A panel need not analyse every item of evidence separately. In a straightforward factual dispute, it is enough that the determination identifies the facts found proved and makes clear why the unsuccessful party lost. Electronic attendance data may properly support a finding of absence when the panel recognises its limitations and assesses it together with witness evidence and other records. Persistent dishonesty involving an abuse of professional trust may justify erasure where lesser sanctions cannot protect patients, the public interest and confidence in the profession.

The appellant, a consultant physician, appealed under section 40 of the Medical Act 1983 against a Fitness to Practise panel’s findings that he had been absent from hospital on 91 days, had acted dishonestly, had impaired fitness to practise and should be erased from the medical register.

He challenged the panel’s treatment of witness evidence, swipe-card access data and the adequacy of its reasons. He also contended that erasure was disproportionate. The central issues were whether the panel’s factual findings and reasons were legally sustainable and whether the sanction fell outside the range of reasonable sanctions.

1. Appeal dismissed. The appeal was governed by section 40 of the Medical Act 1983 and CPR Part 52. Under CPR 52.11, the court ordinarily conducts a review and allows an appeal only if the lower decision was wrong or unjust because of serious procedural or other irregularity.
2. The court should be slow to interfere with a Fitness to Practise panel’s assessment of oral evidence. The panel is particularly well placed to assess credibility and the standards expected of the profession, while the appellate court retains jurisdiction to reach a secondary judgment on the application of legal principles to the facts.
3. The panel’s reasons were adequate. This was a straightforward credibility case. It was unnecessary for the panel to reach an individual conclusion on every piece of evidence, provided its determination stated the facts found proved and explained why the appellant’s case had failed. The panel acknowledged limitations in the swipe-card evidence, treated indications of professional activity in the appellant’s favour, and relied on the overall pattern together with witness evidence, electronic records and the absence of a convincing explanation.
4. The panel was entitled to prefer the corroborative evidence of the GMC’s witnesses and reject the appellant’s account. Its conclusions were not plainly wrong, irrational or inadequately reasoned. The finding of impairment therefore stood.
5. Erasure was proportionate. The dishonesty was persistent, prolonged and involved an abuse of a position of trust. The panel considered the available sanctions and the indicative sanctions guidance, correctly bearing in mind that the purpose of sanction was protection rather than punishment. In the circumstances, erasure was inevitable to maintain public confidence and uphold proper professional standards.

The judgment records an appeal to the Administrative Court from a General Medical Council Fitness to Practise panel determination dated 20 July 2015. The panel had found 91 instances of absence proved, dishonesty established, fitness to practise impaired and erasure appropriate. The Administrative Court dismissed the appeal.