SHERAZI v GENERAL MEDICAL COUNCIL

An appellate court may refuse to admit evidence concerning matters known and available before a tribunal hearing where the evidence could have been provided earlier and would not probably have materially affected the outcome. The Ladd v Marshall principles remain relevant, and an exception requires circumstances which genuinely justify departure from them. A later appraisal has limited relevance where it post-dates the review hearing and does not demonstrate focused remediation of the concerns previously identified. Where a practitioner has been properly notified, voluntarily fails to engage, supplies no evidence of remediation and gives the tribunal no reason to expect future engagement, erasure may be an available and proportionate sanction.

The appellant, a medical practitioner, appealed against a medical practitioners tribunal’s decision to erase him from the medical register following a review hearing which he did not attend. The tribunal had previously found his fitness to practise impaired by deficient professional performance and imposed a nine-month suspension, requiring him to demonstrate remediation at review.

Before the review, the appellant did not provide the requested evidence and indicated that he was not interested in attending. He later sought to adduce material which had existed before the review and a further appraisal undertaken in September 2020. The central issues were whether the additional evidence should be admitted and whether it could justify setting aside the review decision and sanction.

1. Appeal and additional evidence. The appeal was dismissed. The application to adduce evidence which pre-dated the review hearing was refused.
2. Proceeding in the appellant’s absence. The tribunal had clearly notified the appellant of the remote hearing. His finding that he had been served and was voluntarily absent was unassailable. The decision to proceed in his absence was not open to criticism.
3. Tribunal’s substantive findings. The tribunal was entitled to find that the appellant had supplied no information or evidence, had demonstrated no insight or remediation since the earlier hearing, and had persistently failed to engage meaningfully with the regulator. In that context, a further period of suspension was not expected to achieve any useful purpose, and erasure was properly open to the tribunal.
4. Admission of further evidence. Applying Ladd v Marshall principles, the first two limbs were not satisfied. The material had been available and could readily have been supplied when requested. The evidence, principally concerning continuing professional development, was also far from sufficient to have an important influence on the result, particularly given the persistent non-engagement and the breadth of the impairment concerns.
5. The later appraisal was undertaken after the review hearing. It contained no evidence of active appraisal involvement before that hearing and no focused steps addressing the specific concerns previously identified. Even if admitted, it could not establish that the tribunal’s decision was wrong. The circumstances did not justify an exception to the Ladd v Marshall principles, with Jasinerachi v GMS providing a relevant illustration.
6. The court recorded that, even if the refused evidence had been admitted, the appeal would still have been dismissed.

• Medical Practitioners Tribunal: In 2019, the tribunal found the appellant’s fitness to practise impaired and imposed a nine-month suspension with review. On 28 July 2020, at the review hearing, it proceeded in his absence and ordered erasure.
• High Court (Administrative Court): The appeal against the review decision was dismissed. The application to adduce additional evidence was refused.