Teewary v The General Medical Council

On an appeal from a Medical Practitioners Tribunal, the High Court must allow the appeal only if the tribunal’s decision was wrong or unjust because of a serious procedural or other irregularity. A tribunal considering non-compliance with a lawful direction to undergo a health assessment is not entitled to reconsider the direction’s lawfulness or determine the merits of the underlying complaint. Those matters may be relevant to sanction only in a sufficiently exceptional case. A doctor’s willingness to undergo a different or preferred assessment does not provide a good reason for failing to comply with the regulator’s direction. Regulatory proceedings may proceed in the doctor’s absence where the doctor has been given a fair opportunity to participate but seeks to frustrate or delay the process.

Dr Clay Kumar Teewary appealed under the Medical Act 1983 against a Medical Practitioners Tribunal decision suspending his registration for 12 months following his failure to undergo two GMC-directed health assessments. The assessments had been directed after concerns arose from his communications with a woman and from subsequent communications with the GMC.

The Tribunal found non-compliance, rejected his asserted reasons, and imposed an immediate suspension. It had proceeded in his absence during a material stage of the proceedings. The appeal alleged that the direction was no longer rationally justified, that the assessment process was unfair, and that the Tribunal had denied him a fair hearing.

1. The appeal was dismissed. Under CPR r. 52.21(3), the court could intervene only if the Tribunal’s decision was wrong or unjust because of a serious procedural or other irregularity. The court was required to respect the Tribunal’s specialist judgment and was not entitled simply to substitute its own view.
2. The Tribunal correctly treated the GMC’s direction as valid and binding. Any challenge to its lawfulness should have been made by judicial review. The Tribunal had no jurisdiction to determine that issue in non-compliance proceedings.
3. The Tribunal was concerned with whether Dr Teewary had failed to comply and whether there was a good reason for that failure. The merits of the underlying complaint and the credibility of the complainant were not matters for determination in those proceedings. The possible continuing need for assessment could theoretically bear on sanction, but could not justify non-compliance. On the facts, the retraction of the complaint, favourable reports obtained independently, and drug tests did not remove the obligation to undergo the directed assessment.
4. The asserted unfairness in the assessment process provided no good reason for non-attendance. Dr Teewary could provide relevant information and documents to the GMC-appointed assessors. The Tribunal was entitled to conclude that the complaint about disclosure was fundamentally flawed.
5. The Tribunal had acted fairly in proceeding in Dr Teewary’s absence. He had been given an opportunity to make submissions on non-compliance, had used the hearing to pursue repeated applications for delay, and then failed to participate when alternative arrangements were offered. The Tribunal was entitled to regard this as voluntary non-participation and to proceed in the public interest.
6. There was no basis to interfere with the 12-month suspension or its immediate effect. The Tribunal had rationally concluded that persistent non-compliance, lack of insight and continuing health concerns made conditions unworkable and suspension proportionate to the statutory overarching objective.

• Medical Practitioners Tribunal: found non-compliance with the GMC’s direction to undergo health assessments and suspended Dr Teewary’s registration for 12 months, with immediate effect.
• High Court (Administrative Court): dismissed the appeal against the Tribunal’s decision.