Summary
On an application to restore a name to the medical register under section 41 of the Medical Act 1983, the question is whether the practitioner is now fit to practise having regard to the GMC’s over-arching objective. No separate requirement of exceptional circumstances applies to doctors. The five-year minimum is not a tariff after which remediation alone determines the outcome. Remorse, insight, remediation, future risk and passage of time must be assessed, but public confidence and proper professional standards remain independently important. The same underlying approach applies at sanction and restoration, although particular factors may carry different weight. A tribunal that focuses on remediation and asks only whether restoration would compromise the objective commits an error of principle.
Factual background
The GMC brought a second appeal after the Medical Practitioners’ Tribunal restored Dr Chandra’s name to the medical register following his erasure for sexual misconduct and dishonesty. Mrs Justice Moulder dismissed the GMC’s first appeal: [2017] EWHC 2556 (Admin). The appeal concerned whether solicitor restoration authorities required exceptional circumstances, and whether the Tribunal had properly applied the over-arching objective under section 41 of the Medical Act 1983, including public confidence and professional standards.
Held
The Court of Appeal announced its intention to allow the GMC’s appeal and remit the restoration application to the Medical Practitioners’ Tribunal for rehearing. No final order was made before a resumed hearing. Until then, Dr Chandra remained on the medical register.
Section 41 of the Medical Act 1983 gives the Tribunal a broad discretion, but the statutory question is whether the applicant is now fit to practise having regard to the over-arching objective. The statute does not require a preliminary finding of exceptional circumstances. The principles in Bolton v Law Society [1994] 1 WLR 512 apply to doctors as well as solicitors and to both sanction and restoration, although the weight given to particular matters may differ.
Remediation is essential and the passage of time is important, but the five-year period is not a tariff after which only public protection or remediation matters. The Tribunal must consider the original misconduct, insight, remorse, remediation, current competence and future risk, then stand back and balance those findings against all three limbs of the statutory objective: public health and safety, public confidence, and proper professional standards and conduct.
Dishonesty and sexual misconduct may be fundamentally connected with the doctor’s professional role. In such cases, the public’s confidence in the practitioner’s integrity and sexual probity can remain highly significant despite genuine remediation. The Tribunal must address whether restoration would promote and maintain public confidence and proper standards, rather than merely conclude that the objective would not be compromised.
The Tribunal had concentrated on Dr Chandra’s acceptance of wrongdoing, insight, remediation, competence and risk of repetition. It had not adequately addressed the effect of restoration on public confidence and professional standards. That was an error of principle. The appellate court accepted the Tribunal’s primary factual findings but was entitled to intervene on the legal and evaluative error.
The court’s approach to earlier authorities
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Appellate history
- Court of Appeal (Civil Division): Announced an intention to allow the GMC’s second appeal and remit the restoration application for rehearing. Formal orders were deferred.
- High Court of Justice, Queen’s Bench Division (Administrative Court): Mrs Justice Moulder dismissed the GMC’s first appeal from the Tribunal’s restoration decision: [2017] EWHC 2556 (Admin).
- Medical Practitioners’ Tribunal: Directed restoration of Dr Chandra’s name to the medical register in March 2017.
Appeal route
- Appealed from[2017] EWHC 2556 (Admin)This appealappeal allowed in due course; remitted for rehearing
- This judgment [2018] EWCA Civ 1898 Court of Appeal (Civil Division)
Key cases cited
22 authorities cited.
- Habib Khan v General Pharmaceutical Council [2016] UKSC 64
- Datec Electronics Holdings Limited and others (Respondents) v. United Parcels Services Limited (Appellants) [2007] UKHL 23
- Patel v The General Medical Council Privy Council Appeal No. 48 of 2002
- Gupta v General Medical Council [2001] UKPC 61
- Ghosh v General Medical Council [2001] UKPC 29
- Southall v General Medical Council [2010] EWCA Civ 407
- Fatnani & Anor v General Medical Council [2007] EWCA Civ 46
- General Medical Council v Meadow [2006] EWCA Civ 1390
- Assicurazioni Generali SpA v Arab Insurance Group (Practice Note) [2002] EWCA Civ 1642
- Bolton v Law Society [1994] 1 WLR 512
- General Medical Council v Bawa-Garba [2018] EWHC 76 (Admin)
- General Medical Council v Jagjivan & Anor [2017] EWHC 1247 (Admin)
- Solicitors Regulation Authority v Simon Kaberry [2012] EWHC 388 (Admin)
- Council for Healthcare Regulatory Excellence v Nursing and Midwifery Council & Anor [2011] EWHC 927 (Admin)
- Thobani v the Solicitors Regulation Authority [2011] EWHC 3783
- Yeong v The General Medical Council [2009] EWHC 1923 (Admin)
- Zygmunt, R (on the application of) v General Medical Council [2008] EWHC 2643 (Admin)
- Giele v General Medical Council [2005] EWHC 2143 (Admin)
- Council for the Regulation of Healthcare Professionals v General Medical Council & Anor [2005] EWHC 579 (Admin)
- Langford v Law Society [2002] EWHC 2802 (Admin)
- Jideofo v the Law Society (No 06 of 2006) Jideofo v the Law Society (No 06 of 2006)
- Azzam
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Cases citing this case
9 later cases · 6 positive · 2 neutral · 1 caution
Most senior citing decisions:
- Dr Thomas Plimmer v General Medical Council [2024] EWHC 3343 (Admin) followed
- General Medical Council v Nour Mohamed Magdy Aly Rezk [2023] EWHC 3228 (Admin) applied
- Dr Rinku Sengupta v General Medical Council [2023] EWHC 1302 (Admin) applied
- SEKINAT BAKARE v GENERAL MEDICAL COUNCIL [2021] EWHC 3278 (Admin)
- General Medical Council & Ors v Zafar [2020] EWHC 846 (Admin)
- General Medical Council v Walton [2019] EWHC 3537 (Admin)
- Professional Standards Authority for Health And Social Care v General Dental Council & Anor [2019] EWHC 2640 (Admin)
- Sastry v General Medical Council [2019] EWHC 390 (Admin)
- Solicitors Regulation Authority v James [2018] EWHC 3058 (Admin)
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