General Medical Council v Hayat

A registrant seeking an adjournment of disciplinary proceedings on health grounds bears the onus of providing sufficiently particular medical evidence that the condition prevents effective participation in the hearing. A pro-forma certificate of unfitness for work does not, without more, establish unfitness to attend or participate.

The tribunal may assess the evidence in its full context, including prior engagement, other medical material, the public interest and the disruption caused by adjournment. Further medical enquiries are discretionary, not obligatory. An appellate court may intervene only where the specialist tribunal erred in principle or reached an evaluative decision outside the range reasonably open to it. A claimed procedural failure must also be material and make the decision unjust.

The Medical Practitioners Tribunal proceeded with a fitness-to-practise hearing in Dr Hayat’s absence after considering medical material, including a same-day sick note stating that he was unfit for work. It later found dishonesty and misconduct, found impairment, and erased him from the medical register.

Lang J allowed Dr Hayat’s statutory appeal in [2017] EWHC 1899 (Admin). She held that the Tribunal should have made further enquiries into his condition before proceeding and that the hearing had been unfair.

The General Medical Council appealed. The central issues were the required standard of medical evidence for an adjournment or for non-attendance, and the proper appellate approach to the Tribunal’s discretionary decision.

1. Appeal allowed. The Tribunal was entitled to proceed in Dr Hayat’s absence. Its decision not to adjourn was a discretionary and evaluative decision made by a specialist tribunal on the material before it.

2. The sick note did not establish that Dr Hayat was unable to attend or participate in the disciplinary hearing. It stated only that he was unfit for work, gave no sufficient explanation of how his condition prevented participation, and did not meet the requirements for medical evidence identified in Levy v Ellis Carr [2012] EWHC 63 (Ch). The Tribunal did not disregard the note. It considered it alongside the evidence from the treating doctors and was entitled to conclude that it added nothing material.

3. Following General Medical Council v Adeogba [2016] EWCA Civ 162, fairness includes fairness to the practitioner, the regulator and the public. A practitioner subject to regulation must engage with the process. The burden remained on Dr Hayat to provide adequate medical evidence. The Tribunal had a discretion, but no duty, to make further enquiries; no evidence showed that further enquiries would have produced material information or a different result.

4. Under Civil Procedure Rules 1998, rule 52.21(3), Lang J should not have reconsidered the adjournment application afresh. An appellate court may interfere only for an error of principle or an evaluative decision outside the range reasonably open to the tribunal. She also failed to give appropriate weight to the Tribunal’s specialist expertise, the earlier unsuccessful adjournment applications, and the public interest in completing the lengthy hearing.

5. Dr Hayat’s appeal was remitted to the High Court for determination of the remaining grounds identified by Lang J.

• Court of Appeal (Civil Division): Allowed the General Medical Council’s appeal and remitted Dr Hayat’s remaining grounds of appeal to the High Court.
• High Court, Administrative Court: Lang J allowed Dr Hayat’s appeal in [2017] EWHC 1899 (Admin) , holding that the Tribunal’s decision to proceed in his absence was unjust because of a serious procedural irregularity.
• Medical Practitioners Tribunal: Proceeded in Dr Hayat’s absence at the fact-finding hearing, made findings of dishonesty and misconduct, found impairment, and ordered erasure from the register.