Goodchild-Simpson v General Medical Council

On a statutory appeal from a professional regulatory tribunal, the High Court must decide whether the decision was wrong or unjust because of a serious procedural or other irregularity. The appeal is a rehearing only in the limited sense specified by PD 52D; appropriate respect must be given to primary findings and specialist evaluative judgments.

Interference with a tribunal’s assessment of fitness to practise or sanction is justified where there is an error of principle, material error of fact or law, serious procedural irregularity, or an evaluation outside the range of decisions reasonably open to the tribunal. Adjournment and absence decisions require fairness to the practitioner, the regulator and the public. The appeal was dismissed.

The appellant, a doctor subject to longstanding findings of impaired fitness to practise due to adverse mental health and deficient professional performance, appealed under section 40 of the Medical Act 1983 against an MPT determination imposing 12 months’ suspension.

He challenged the tribunal’s refusal to adjourn, its decision to proceed in his absence, its treatment of his personal development plan and medical evidence, and the sanction. He also sought relief connected with GP refresher training, which lay outside the statutory appeal jurisdiction. The central issues were whether the MPT’s decisions were wrong or unjust because of serious procedural or other irregularity.

1. Disposition. The appeal was dismissed. The MPT had been entitled to find that the appellant’s fitness to practise remained impaired by adverse mental health and deficient professional performance, and that 12 months’ suspension was necessary and proportionate.
2. Appellate approach. Under section 40 of the Medical Act 1983 and CPR 52.21(3), the question was whether the decision was wrong or unjust because of a serious procedural or other irregularity. Although the appeal was by way of rehearing under PD 52D, it was not a full rehearing. Appropriate respect was owed to the specialist tribunal’s primary findings and evaluative judgments, particularly on impairment, professional standards and sanction. Intervention was justified for an error of principle, material factual or legal error, serious procedural irregularity, or an evaluation outside the bounds of reasonable decisions.
3. Jurisdiction. The court’s powers under section 40(7) were confined to dismissing the appeal, quashing or varying the MPT’s direction, or remitting the matter. The court could not make orders concerning GP training or refresher schemes.
4. Adjournment and absence. The Case Manager and MPT properly exercised their broad case-management discretion. The applications concerned matters largely irrelevant to the issues before the MPT, had been made late, and would have delayed a review required in the public interest. The MPT properly balanced fairness to the appellant against fairness to the GMC, the public interest and patient safety. It was also entitled to proceed in the appellant’s absence after being satisfied that notice had been served and that his voluntary absence was not sufficient reason to delay the proceedings.
5. Substantive findings and sanction. The medical evidence provided a proper basis for finding current impairment, including evidence of deteriorating mental health, diminished insight and cessation of antipsychotic medication. The appellant had not remediated the identified performance deficiencies or produced an adequate personal development plan. Conditions were not shown to be workable or likely to be complied with, so suspension was a proportionate response.

• Medical Practitioners Tribunal: The MPT determined that the appellant’s fitness to practise was impaired by adverse mental health and deficient professional performance and imposed 12 months’ suspension.
• High Court (Administrative Court): The statutory appeal under section 40 of the Medical Act 1983 was dismissed.