Hayat v General Medical Council

A professional disciplinary tribunal must exercise its powers to adjourn or proceed in a practitioner’s absence consistently with common-law fairness and article 6 of the European Convention on Human Rights. Unchallenged medical evidence that a practitioner is unfit to work will not automatically establish inability to attend a hearing, but it requires careful investigation of whether the practitioner can participate effectively in the particular proceedings. Relevant circumstances include the length and demands of the hearing, the need for self-representation, and the need to give and challenge evidence. Proceeding in the absence of a practitioner without properly evaluating such evidence may amount to a serious procedural irregularity.

The appellant, a registered doctor, appealed under section 40 of the Medical Act 1983 against a Medical Practitioners Tribunal decision finding misconduct, impairment of fitness to practise and imposing erasure. The allegations concerned dishonest and misleading conduct in support of a critical illness insurance claim.

The Tribunal initially refused to proceed in the appellant’s absence, but later allowed the hearing to continue when he did not attend. It relied on medical evidence indicating that he had been fit for discharge and that no significant cardiac pathology prevented the proceedings. A later general practitioner’s certificate stated that he was unfit for work because of dizziness, chest pain and post-angiography complications. The central issue was whether the Tribunal had acted fairly in refusing a further adjournment and proceeding in his absence.

1. The appeal was allowed. The Tribunal’s decision was unjust because of a serious procedural irregularity, and the matter required a rehearing before a fresh panel.
2. The appeal under section 40 of the Medical Act 1983 was governed by CPR Part 52. The appeal was by way of rehearing, but without hearing the evidence again, as explained in Fish v General Medical Council [2012] EWHC 1269 (Admin).
3. The Tribunal’s powers to adjourn and to proceed in a practitioner’s absence under the General Medical Council (Fitness to Practise) Rules Order of Council 2004 were discretionary, but constrained by common-law fairness and article 6 of the European Convention on Human Rights. The principles in Mahmood v GMC [2007] EWHC 474 (Admin), including the guidance derived from R v Jones [2003] 1 AC 1, were correctly identified by the Tribunal.
4. Those principles were not properly applied. The evidence relied on by the Tribunal assessed the appellant’s condition as at 4 November, whereas the GP’s certificate recorded a new condition following his discharge and medical examination on 7 November. The Tribunal was not entitled simply to disregard the certificate because it stated that he was unfit for work rather than expressly unfit to attend the hearing.
5. The Tribunal should have evaluated whether the appellant could conduct a lengthy disciplinary hearing, potentially without representation, give evidence and withstand cross-examination on serious dishonesty allegations. The unchallenged medical evidence generally required an adjournment unless exceptional public-interest considerations justified proceeding.
6. The appellant was deprived of the opportunity to give evidence and challenge the regulator’s witnesses at the critical fact-finding stage. The court therefore did not determine the remaining grounds, since doing so could unfairly influence the fresh panel.

• High Court (Administrative Court): allowed the appeal against the Medical Practitioners Tribunal’s findings and sanction, and directed a rehearing before a fresh panel.