Abbas v General Medical Council

An appeal from a professional disciplinary tribunal is a review of whether the tribunal’s decision was wrong or unjust because of serious procedural or other irregularity. It is not a complete rehearing. Particular respect is owed to a specialist tribunal’s assessment of professional standards, witness credibility and primary facts. Persistent dishonesty, especially dishonesty towards the regulator or an interim orders panel combined with lack of insight, will ordinarily make erasure an available and often appropriate sanction. That principle remains subject to the circumstances of the individual case and does not create an inflexible rule.

The Medical Practitioners’ Tribunal Service found that Dr Ali Abbas had committed numerous clinical, behavioural and regulatory breaches. It concluded that his fitness to practise was impaired and ordered erasure from the medical register, with immediate suspension under Medical Act 1983, s 38.

Dr Abbas appealed, alleging procedural unfairness, inadequate disclosure, insufficient opportunity to cross-examine and obtain expert evidence, errors in factual findings, improper admission of videolink evidence, and disproportionate sanction. The central issue was whether the Tribunal’s decision was wrong or unjust because of a serious procedural or other irregularity.

1. Appeal jurisdiction. Under Civil Procedure Rules, r 52.21(3), the Court could consider fact as well as law, but the appeal was not an entire rehearing. The principles summarised in Gosalakkal v General Medical Council [2015] EWHC 2445 required appropriate respect for the specialist tribunal, its opportunity to hear witnesses, and its professional value judgments.
2. Findings and procedure. The Tribunal was entitled to refuse adjournments sought to obtain representation, disclosure and expert evidence. The Appellant had not shown that further time would serve a useful purpose. He had a fair opportunity to cross-examine the expert. The Tribunal was also entitled to rely on the evidence called, permit evidence by videolink, and reject explanations concerning missing documents and the alleged threat by a patient’s relative.
3. Findings of primary fact, particularly those based on witness credibility, were difficult to displace. The Court applied the approach in Meadows v GMC [2007] QB 462, Assicurazioni Generali SpA v Arab Insurance Group [2003] 1 WLR 577 and Southall v GMC [2010] EWCA Civ 407. The challenged findings fell within the range reasonably open to the Tribunal.
4. Regulatory conditions. The Appellant’s position at University Hospitals Coventry and Warwickshire was a post for which GMC registration was required. The Tribunal therefore correctly interpreted conditions 1 and 6 of the interim orders as requiring notification, contact details and prior approval. Its findings that those conditions had been breached, and that the Appellant had acted dishonestly, were unassailable or open to it.
5. Sanction. Persistent dishonesty and lack of insight made erasure an available sanction. The Court applied Naheed v GMC [2011] EWHC 702 (Admin) and recognised the qualification identified in Atkinson v GMC [2009] EWHC 3636 (Admin): erasure is not inevitable in every dishonesty case, and compelling evidence of insight or exceptional circumstances may justify a lesser sanction. The Tribunal was entitled to conclude that erasure was appropriate. The appeal was dismissed.

1. Medical Practitioners’ Tribunal Service: on 9 June 2016, found most allegations proved, determined that fitness to practise was impaired, and ordered erasure with immediate suspension under Medical Act 1983, s 38.
2. High Court (Administrative Court): dismissed the appeal on 20 January 2017.