Selim v General Medical Council

An appeal against a professional disciplinary sanction is a review, not a rehearing or resentencing exercise. The High Court may intervene where the tribunal was wrong or where serious procedural irregularity made the decision unjust. It must respect the tribunal’s specialist expertise, particularly on factual findings based on oral evidence, while correcting material errors of fact or law.

In cases involving serious, recurrent dishonesty, absence of insight and lack of remediation, erasure may be the only proportionate sanction. The relevant focus is protection of the public, maintenance of confidence in the profession and proper professional standards, rather than punishment of the practitioner.

Dr Magdi Selim, a general practitioner, appealed against the decision of a Medical Practice Tribunal Service panel to erase his name from the medical register. The panel had found proven misconduct involving dishonesty, misuse of medical records, improper pressure on staff, and a lack of compassion towards bereaved relatives. It also found deficient professional performance and concluded that his fitness to practise was impaired.

The panel took account of the seriousness and recurrence of the misconduct, previous disciplinary findings, lack of insight and absence of remediation. It rejected suspension as insufficient and imposed erasure. The central issues before the Administrative Court were whether the panel’s factual and procedural findings were flawed and whether erasure was disproportionate.

1. Appeal dismissed. The court found no material error, procedural unfairness or injustice in the panel’s findings or sanction decision.
2. The governing approach was that stated in Khan v General Medical Council [2015] EWHC 301 (Admin). Under CPR 52.11(3), an appeal may succeed only where the lower decision was wrong or unjust because of a serious procedural or other irregularity. The High Court must pay close regard to the specialist expertise of the fitness to practise tribunal. It may correct material errors of fact or law and conduct a secondary judgment on the application of legal principles, but must not substitute its own view of the merits or undertake a resentencing exercise.
3. The panel was entitled to prefer the evidence of the GMC’s witnesses. Its findings were based on live oral evidence and written evidence from witnesses whom the judge had not heard. The court therefore had no proper basis to revisit those credibility findings. The panel’s conclusions concerning manipulation of information, misuse of confidential medical records, improper pressure on staff and the letter to the bereaved parents were adequately reasoned.
4. The findings established serious misconduct involving dishonesty and deficient professional performance. The panel was entitled to conclude that Dr Selim lacked insight into the gravity of his conduct, had not demonstrated remediation, presented a risk of repetition and had undermined public confidence in the profession.
5. In those circumstances, and having regard to the recurrent nature of the dishonesty and the previous disciplinary history, the conclusion that suspension would be insufficient and erasure was proportionate fell within the panel’s judgment. The claim that the sanction was punitive or disproportionate was rejected.

1. Medical Practice Tribunal Service: On 17 November 2015 the panel determined the factual charges. On 1 December 2015 it found Dr Selim’s fitness to practise impaired. On 3 December 2015 it imposed erasure, followed by an interim suspension pending appeal.
2. High Court (Administrative Court): The appeal against erasure was dismissed.