Kefala v General Medical Council

An appeal under section 40 of the Medical Act 1983 is a full rehearing, but the appellate court must calibrate its intervention to the nature of the finding under challenge. It may draw its own inferences from primary facts, while generally respecting findings dependent on witness assessment. Evaluative findings applying a legal standard should not be disturbed unless outside the range of reasonable disagreement. Dishonesty is determined by the two-stage test in Ivey v Genting Casinos (UK) Ltd: the tribunal first establishes the person’s actual knowledge or belief as to the facts, then applies the objective standards of ordinary decent people. Knowingly making false declarations about criminal convictions may justify a finding of dishonesty without proof of motive or benefit.

Dr Kalomoira Kefala appealed under section 40 of the Medical Act 1983 against a Medical Practitioners Tribunal decision finding that her fitness to practise was impaired by misconduct and suspending her for three months. The appeal was confined to the finding of dishonesty arising from her failure to disclose a Greek criminal conviction on two University of Southampton forms. She challenged the Tribunal’s findings that the conviction was criminal, that it was required to be declared, that she knew her answers were untrue, and that the answers were dishonest. The central issues were the proper appellate approach to those findings and the application of the Ivey v Genting Casinos (UK) Ltd test.

1. The appeal was dismissed. The Tribunal’s findings were not wrong on the facts or law.
2. Under section 40 of the Medical Act 1983, the appeal is by way of rehearing. Nevertheless, where findings depend on oral evidence and credibility, the appellate court should show appropriate caution. It may draw its own inferences from primary facts. For evaluative judgments involving the application of a legal standard, intervention is generally justified only where the conclusion falls outside the bounds of reasonable disagreement.
3. The Thessaloniki decision was a criminal conviction. The court record showed that a criminal court had tried the appellant, found her guilty of an offence under penal law and imposed a custodial sentence, albeit suspended. The appellant’s own answers and evidence supported that conclusion.
4. The University guidance applied to Form 1 and was received by the appellant. The MSc Allergy Programme was a programme in health, so all convictions, including spent convictions, had to be declared. The answer that no conviction required declaration was therefore untrue. Alternatively, if the course had not been a programme in health, the negligence offence was not an offence of a violent nature and would not have been a relevant criminal conviction under the guidance.
5. For Form 2, the Tribunal was entitled to prefer Dr Hollis’s evidence and conclude that the appellant knew the Thessaloniki decision was a criminal conviction and that her answer was untrue.
6. The Tribunal correctly applied Ivey v Genting Casinos (UK) Ltd. It found the appellant’s actual knowledge and belief at the first stage, then concluded at the second stage that knowingly giving false information about convictions was dishonest by ordinary standards. No separate finding of motive or benefit was required, and the Tribunal’s reasons were sufficient.
7. The court observed that it had difficulty understanding why the GMC had brought the proceedings in the particular circumstances, but that observation did not undermine the Tribunal’s sound findings.

• High Court (Administrative Court): The appeal under section 40 of the Medical Act 1983 against the Medical Practitioners Tribunal’s decision dated 9 August 2019 was dismissed. The Tribunal’s finding of dishonesty and consequential decision remained undisturbed.