Igwilo v the General Medical Council.

On an appeal against a professional disciplinary sanction, the High Court performs a secondary judgment. It corrects material errors of fact or law and reviews whether the sanction was properly applied to the facts, but it does not re-sentence or substitute its own view for that of the expert tribunal. Particular respect is due to the tribunal’s assessment where the purpose of the sanction includes maintaining public confidence in the profession.

An adjournment may properly be refused where purported appeals are only applications for permission, the practitioner is represented and able to present the case, and delay would conflict with the public interest in an expeditious determination. Serious, deliberate and sustained dishonesty, undertaken for professional advancement and undermining regulatory safeguards, may justify erasure and immediate suspension despite mitigation.

The appellant, a doctor, appealed under section 40 of the Medical Act 1983 against a Medical Practitioners Tribunal decision following findings that his fitness to practise was impaired. The tribunal refused an adjournment, imposed erasure from the medical register and ordered immediate suspension pending appeal.

The appellant challenged the refusal to adjourn, contended that erasure was excessive in light of mitigation, and argued that immediate suspension was unnecessary because he was no longer practising. The background included an earlier decision of Lang J, which had substituted a finding of impairment and remitted sanction to a freshly constituted tribunal. The central issues were whether the tribunal had erred in law or acted unfairly, and whether its sanction was wrong.

1. Fresh grounds and adjournment. The court refused permission to rely on fresh arguments served immediately before the hearing. No sensible reason had been offered for their lateness, and allowing them would have imperilled the listed hearing. The further application to adjourn was dismissed because the alleged challenges were applications for permission to appeal, not appeals then on foot. The appellant had been represented before the tribunal and had been able to make the submissions considered appropriate. The tribunal had properly balanced his interests against the public interest in resolving the sanction issue without undue delay.
2. Approach to sanction appeals. Applying Fatnani & Anor v General Medical Council [2007] 1 WLR 1460, the court’s task was to decide whether the sanction was wrong. It was not to re-sentence or re-administer the sanction. The court exercised a secondary judgment and afforded particular respect to the expert professional tribunal.
3. Erasure. The tribunal had considered the mitigating and aggravating factors. The dishonesty was large-scale, deliberate, sustained and elaborately planned, affected professional colleagues, was undertaken for personal gain, and had the potential to undermine patient protection and public confidence. Against the Sanctions Guidance, no lesser sanction adequately reflected the seriousness of the misconduct. The decision to erase the appellant was therefore open to the tribunal and contained no material error.
4. Immediate suspension. Given the gravity of the misconduct and the seriousness of erasure, immediate suspension was necessary and proportionate. The fact that the appellant said he did not intend to practise did not make the order unnecessary.
5. The appeal was dismissed.

• High Court (Administrative Court): [2017] EWHC 419 (Admin) — appeal dismissed.
• High Court (Administrative Court): Lang J had allowed the Professional Standards Authority’s challenge, substituted a finding that the appellant’s fitness to practise was impaired, and remitted sanction to a freshly constituted tribunal in [2016] EWHC 524 (Admin).
• Medical Practitioners Tribunal: refused an adjournment, imposed erasure and ordered immediate suspension pending appeal.