Rajkumar v General Medical Council

In an appeal against a professional disciplinary sanction for dishonesty, the court must respect the expertise of the tribunal, but that respect is more limited where dishonesty is involved. A suspension is proportionate where the tribunal has properly considered the seriousness of the misconduct, the risk of repetition, the practitioner’s insight and remediation, and the purposes of protecting the public and maintaining confidence in the profession. The absence of concerns about clinical practice does not mean that maintaining public confidence is the sole permissible purpose of sanction.

Dr Rajkumar appealed against a 12-month suspension imposed by a medical practitioners tribunal after it found that he had practised without indemnity insurance and had dishonestly concealed that fact from his partners. He accepted that suspension was appropriate but argued that the period should be shorter.

His grounds concerned the effect of an earlier warning, the purposes of sanction, remediation, reasons, and proportionality. The court considered whether the tribunal’s decision was wrong.

1. Appeal dismissed. The tribunal’s reasons were sufficient and its assessment of the effect of suspension was adequately explained. The sanction was proportionate in light of the dishonesty.
2. Appropriate respect was due to the tribunal as an expert professional body, but that respect was more limited in a dishonesty case: General Medical Council v Jagjivan & PSA [2017] EWHC 1247 (Admin), paragraph 40(vi).
3. The earlier warning was not, in itself, a significant factor. It was not a sanction, did not restrict practice, and followed an incorrect finding that Dr Rajkumar had not been dishonest. The salutary effect of the proceedings had nevertheless been taken into account in his favour.
4. The tribunal was entitled to consider the absence of repetition over the two years since the misconduct, while also finding that some risk remained because Dr Rajkumar’s insight was poor. His continued denial, attempts to minimise responsibility, and limited steps towards remediation supported that assessment.
5. The purposes of sanction under section 1(1)(a) to (c) of the Medical Act 1983 include protecting public health, safety and wellbeing, maintaining public confidence in the medical profession, and maintaining proper professional standards. The absence of concerns about clinical practice did not make maintaining public confidence the sole relevant purpose. The risk of repetition and lack of insight were also relevant.
6. Taking the circumstances in the round, the tribunal’s decision was not wrong. The 12-month suspension and review direction were appropriate.

The judgment describes an appeal from a medical practitioners tribunal’s decision dated 6 October 2017 imposing a 12-month suspension. The appeal was dismissed by the High Court (Administrative Court).