Olatigbe v General Medical Council

Dishonesty by a medical professional is ordinarily likely to justify erasure because public protection includes maintaining confidence in the profession. Erasure is not automatic, however: the tribunal must assess whether the particular circumstances justify a lesser sanction, although such cases are rare.

An appellate court must respect a specialist tribunal’s evaluative judgment, particularly where it rests on findings made after hearing oral evidence. Intervention is justified only where the sanction is clearly outside the legitimate range. A tribunal is not required to speculate about a psychological explanation unsupported by independent medical evidence.

The applicant, a doctor, appealed against the Medical Practitioners Tribunal’s decision of 2 May 2019 erasing his name from the medical register. He admitted four instances of dishonesty between 2013 and 2015, including an attempt to cover up earlier dishonesty.

The Tribunal accepted that he had experienced anxiety connected with work and financial pressures, but found that this did not sufficiently explain his deliberate conduct. It also found limited insight, a lack of candour and a risk of repetition. The central issue was whether the Tribunal had failed to give adequate weight to the possible psychological explanation and had imposed a disproportionate sanction.

1. Appeal dismissed. The Tribunal’s decision to erase the applicant’s name was neither legally flawed nor disproportionate.
2. Dishonesty by a professional is at the highest end of misconduct. Erasure is the usual sanction because disciplinary proceedings protect the public and preserve confidence in the integrity of the profession. The consequence is not automatic, since Parliament entrusted sanction to the Tribunal, but a lesser sanction will be justified only in a rare case. Relevant considerations may include the nature and duration of the dishonesty, whether it was out of character or isolated, and the quality of the practitioner’s insight and remorse. This approach was expressly agreed with from Igboaka v GMC [2016] EWHC 2728 (Admin).
3. The sanction decision was an evaluative judgment. Following Bawa-Garba v The General Medical Council & Ors [2018] EWCA Civ 1879, and the appellate-caution principles in Beacon Insurance Company Ltd v Maharaj Bookstore Ltd [2014] UKPC 21 and Biogen Inc v Medeva Plc [1996] UKHL 18, the court could interfere only if the decision was wrong in the sense of falling clearly outside the range of legitimate sanctions. It was not enough that the court might have imposed a different sanction.
4. The Tribunal was entitled to decide the case on the evidence presented. The proceedings were essentially adversarial, and it was not for the Tribunal to fill an evidential gap or speculate about the applicant’s anxiety. No independent psychological or psychiatric evidence had been adduced, and no application under Ladd v Marshall [1954] EWCA Civ 1 had been made to introduce such evidence on appeal.
5. The Tribunal’s findings that the applicant had attempted a cover-up, failed to give a candid explanation and demonstrated little insight were primary factual findings available on the evidence. In light of those findings and the serial nature of the dishonesty, the case fell outside the narrow exception to the usual sanction of erasure. The five-year period under sections 41(1) and 41(2) of the Medical Act 1983 ran from the date of judgment.

• Medical Practitioners Tribunal: On 2 May 2019, erased the applicant’s name from the medical register following findings of admitted dishonesty.
• High Court (Administrative Court): The appeal against sanction was dismissed in [2019] EWHC 3283 (Admin).