Elefterescu v The Royal College of Veterinary Surgeons

On an appeal from a professional disciplinary tribunal, an appellate court must exercise great caution before disturbing findings of contested fact because the tribunal saw and assessed the witnesses. It must give appropriate respect to the tribunal’s judgment on professional misconduct and sanction, while retaining responsibility to decide whether the penalty is appropriate, necessary in the public interest, or excessive and disproportionate. Removal from a professional register may be proportionate where serious clinical failures, dishonest records, harm to animal welfare, lack of insight and continuing risk are established. A practitioner’s recent arrival in the jurisdiction may be relevant context, but does not displace the tribunal’s assessment where the practitioner held himself out as experienced and proficient.

Dr Horia Elefterescu appealed as of right under section 17 of the Veterinary Surgeons Act 1966 from three decisions of the respondent’s Disciplinary Committee. The Committee rejected a bias objection, found seven charges substantially proved, held that the conduct was disgraceful in a professional respect, and directed removal from the Register of Veterinary Surgeons. The charges included serious clinical incompetence, inadequate examinations, misleading clinical records and dishonesty. The appeal challenged the factual findings, the fairness of the proceedings, the findings of dishonesty and competence, and the proportionality of the sanction. The central issues concerned the scope of appellate intervention and whether removal was appropriate and proportionate.

Disposition

Lord Kitchin delivered the judgment of the Board. The appeal was dismissed. The direction removing Dr Elefterescu’s name from the Register was appropriate and proportionate.

1. Appellate approach. The Board must exercise great caution before interfering with findings of contested fact because the disciplinary tribunal observed the witnesses, weighed their evidence and assessed credibility. It must also accord appropriate respect to the tribunal’s assessment of serious professional misconduct and the measures required to maintain professional standards and protect the public. That respect does not amount to excessive deference. The Board may decide whether a sanction is appropriate, necessary in the public interest, or excessive and disproportionate, and may substitute a penalty or remit the case: Ghosh v General Medical Council [2001] UKPC 29; [2001] 1 WLR 1915.
2. Findings on the evidence. The Committee had ample evidence to uphold the findings concerning the unnecessary and incompetent TPLO procedure, the failure to assess the animal properly, the failure to act on post-operative radiographs, and misleading and dishonest clinical records. The involvement of other veterinary surgeons was peripheral because the treatment decision was Dr Elefterescu’s own clinical judgment. The Board also upheld the dishonesty findings concerning records for the cats Storm Page, Sampson Page and Chino Biggs. The Committee had directed itself on dishonesty by reference to Ivey v Genting Casinos (UK) Ltd [2017] UKSC 67; [2018] AC 391.
3. Fairness. The late-disclosed attendance note concerning Ms Eldon did not render the proceedings unfair. Dr Elefterescu received the material, was invited to seek an adjournment and chose not to call the witness. The unused expert reports were also disclosed and available for him to rely upon.
4. Sanction. The misconduct involved very serious clinical failures, animal suffering, widespread breaches of professional standards, dishonesty, lack of insight and unjustified confidence creating an ongoing risk to animal welfare. In those circumstances, removal from the Register could not be impeached.

• Privy Council: Appeal dismissed. The Board upheld the Disciplinary Committee’s direction removing the appellant’s name from the Register: [2020] UKPC 6.
• Disciplinary Committee of the Royal College of Veterinary Surgeons: Found the charges substantially proved, held the conduct disgraceful in a professional respect, and directed removal from the Register.