George v The General Medical Council

An appeal under section 40 of the Medical Act 1983 is a rehearing, but the court must respect the specialist judgment of the professional tribunal. It corrects material errors of fact or law and assesses whether the tribunal’s conclusions were properly applied to the facts. It must not conduct a re-sentencing exercise.

In disciplinary proceedings, personal mitigation has limited weight because the overriding concern is the public interest. Insight may require acceptance of the seriousness of the underlying criminal conviction. Persistent lack of insight and failure to remediate may justify erasure where continued registration would undermine public confidence.

Dr George appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel’s decision to erase him from the medical register. The panel had found his fitness to practise impaired following his conviction for harassment under the Protection from Harassment Act 1997, arising from faxes sent to the General Medical Council about his son-in-law.

The appeal focused on the alleged failure to give proper weight to mitigation, the absence of repetition, Dr George’s partial acceptance of responsibility, and the fact that he had not attended the hearing. The central issue was whether the panel’s finding of impairment and decision to impose erasure were wrong, disproportionate or unjust because of procedural or other irregularity.

1. Appeal dismissed. The panel’s decision to erase Dr George from the register disclosed no material error of fact or law, procedural irregularity or disproportionate reasoning.
2. Under section 40 of the Medical Act 1983, the appeal proceeds by way of rehearing. The High Court exercises a secondary judgment. It gives special respect to the professional tribunal’s assessment of what is required to preserve public confidence in the profession, while correcting material errors of fact and law. It must not engage in re-sentencing: Raschid v General Medical Council [2007] EWCA Civ 46; [2007] 1 WLR 1460 (para 25–26).
3. The panel properly considered Dr George’s written evidence and legal submissions, and was entitled to assess the seriousness of the misconduct independently of the criminal sentence. Personal mitigation is of limited relevance in disciplinary proceedings because the overriding concern is the public interest (para 27–28).
4. The panel was entitled to find that Dr George lacked insight. A relevant aspect of insight is acceptance of the seriousness of the criminal conviction. Dr George had not accepted the findings that his conduct was malicious, had not made a real apology, and had identified only limited lessons: Karwal v General Medical Council [2011] EWHC 826 (Admin) (para 29–31).
5. The panel followed the sanctions guidance, considered sanctions from least to most serious, and rejected suspension because of the persistent lack of insight and absence of remediation. It was entitled to conclude that erasure was necessary to maintain public confidence (para 31–32). Comments made sotto voce during argument could not displace the reasoning in the Divisional Court’s final judgment (para 30).

The GMC was awarded costs of £10,557.04, payable within three months.

The judgment does not state a prior appellate decision in the present appeal. It records that the Fitness to Practise Panel ordered erasure in November 2015.