Sait v The General Medical Council

Sexual motivation means conduct pursued either for sexual gratification or in pursuit of a future sexual relationship. Inappropriate conduct must not be equated automatically with sexually motivated conduct; the decision-maker must consider whether another explanation exists. An appellate court reviewing an evaluative finding based substantially on oral evidence and credibility must exercise considerable caution. It should intervene only where the finding is wholly contrary to the weight of the evidence or a decision-making error renders it unsafe. Adequate reasons need not address every evidential point, and an appellate court should focus on substance rather than narrow textual analysis.

The appellant appealed against a Medical Practitioners Tribunal decision dated 21 May 2019 finding that conduct towards a former patient had been sexually motivated, constituting misconduct and impaired fitness to practise. A two-month suspension was imposed. The appeal followed an earlier judgment, Sait v The General Medical Council [2018] EWHC 3160 (Admin), which set aside the original sexual-motivation finding and directed a retrial of that issue. The appellant challenged the second Tribunal’s evidential reasoning, alleged reliance on unpleaded or irrelevant matters, and alleged speculative fact-finding.

1. Appeal dismissed. The Tribunal’s finding that the appellant’s conduct was sexually motivated was upheld.
2. Sexual motivation was defined as conduct undertaken either in pursuit of sexual gratification or in pursuit of a future sexual relationship. Inappropriate conduct must not automatically be treated as sexually motivated; the decision-maker must address whether another explanation exists.
3. The issue involved an evaluation of the appellant’s state of mind from surrounding circumstances. Although an appellate court may be less disadvantaged when drawing inferences from undisputed facts or documents, it must apply no lesser caution where the relevant primary facts and evaluation depend on oral evidence and credibility. Intervention was justified only if the finding was wholly contrary to the weight of the evidence or a decision-making fault rendered it unsafe.
4. The Tribunal had adequately addressed the evidence. A judgment must be read as a whole and need not record every point supporting a party’s case. The appellate court should avoid narrow textual analysis and concentrate on whether the decision is substantively sustainable.
5. The anti-ambush principle did not require every aspect of contextual evidence to be pleaded in advance. The additional matters had been put to the appellant in oral evidence, and he had a fair opportunity to respond. The Tribunal was also entitled to infer that the absence of later contact reflected the patient’s lack of interest in a future relationship.
6. The Tribunal’s credibility findings and conclusions were not unsafe. The appeal was dismissed.

• High Court (Administrative Court): In Sait v The General Medical Council [2018] EWHC 3160 (Admin), the first appeal was allowed to a limited extent and the sexual-motivation issue was remitted for retrial.
• Medical Practitioners Tribunal: On 21 May 2019, the Tribunal found sexual motivation, misconduct and impaired fitness to practise, imposing a two-month suspension.
• High Court (Administrative Court): The present appeal was dismissed.