Ahmed v The General Medical Council

On an appeal under section 40 of the Medical Act 1983, the High Court should respect a specialist tribunal’s assessment of evidence and credibility. Findings of primary fact are virtually unassailable and should be disturbed only on compelling objective grounds.

Dishonesty is assessed under Ivey v Genting Casinos (UK) Ltd: the tribunal first determines the individual’s actual knowledge or belief, then applies the objective standards of ordinary decent people. The civil standard remains the balance of probabilities. Inherent improbability and good character are relevant evidential considerations, but do not prevent a finding of dishonesty where the evidence is sufficient.

Dr Syed Ahmed, a consultant in acute medicine, appealed under section 40 of the Medical Act 1983 against a Fitness to Practise Panel decision. The Panel found that he had dishonestly claimed payment for work on hospital escalation wards during contractual hours, made duplicate claims, and claimed payment for work performed during study leave. It found misconduct, impairment of fitness to practise and directed erasure from the medical register.

The appeal challenged the factual findings, including the assessment of credibility, the treatment of supportive evidence, the alleged failure to consider the inherent improbability of fraud, the finding of dishonesty and general fairness.

1. The appeal was dismissed. The Panel’s findings were not out of tune with the evidence and were properly open to it.
2. On a section 40 appeal, respect is owed to the specialist tribunal’s expertise and its advantage in seeing and hearing witnesses. Findings of primary fact, particularly credibility findings, are virtually unassailable. The court should intervene only where compelling objective grounds show that the conclusion exceeded the generous ambit of reasonable disagreement or that the evidence had been misread.
3. The Panel properly considered evidence supporting and opposing Dr Ahmed’s account. It was entitled to find that contractual DCC time could not be used to claim additional remuneration for escalation-ward work.
4. The Panel properly considered good character and the inherent improbability of fraud. Those considerations affected the assessment of the probabilities but did not prevent a finding of dishonesty.
5. Applying Ivey v Genting Casinos (UK) Ltd, the Panel was entitled to find that Dr Ahmed knew his declarations were false and that his conduct was dishonest. The scale and timing of the additional work, duplicate claims, and simultaneous claims for study leave and escalation-ward work supported that conclusion.
6. There was no evidence of bias or general unfairness. The findings of impairment and erasure therefore stood.

High Court (Administrative Court): the appeal under section 40 of the Medical Act 1983 against the Fitness to Practise Panel’s decision was dismissed.