Reddy v General Medical Council

An appeal under section 40 of the Medical Act 1983 is a rehearing without rehearing the evidence. The appellate court may correct material errors of fact or law and draw justified inferences, but should remain extremely cautious before disturbing primary factual findings, particularly findings based on witness credibility. In regulatory proceedings, the court should show appropriate diffidence on professional expertise, impairment and sanction, although less deference may be appropriate on issues such as dishonesty. A tribunal’s reasons are adequate where they make clear why the unsuccessful party lost; the tribunal need not address every evidential point expressly. Robust case management and judicial irritation do not, without more, establish apparent bias or procedural unfairness.

Professor Akhilesh Reddy appealed under section 40(1)(a) of the Medical Act 1983 against a Medical Practitioners Tribunal’s findings that he had dishonestly failed to disclose that he was receiving full-time salaries from the University of Cambridge and University College London. The Tribunal found misconduct, impairment of fitness to practise and imposed a nine-month suspension.

The appeal challenged the Tribunal’s treatment of financial evidence, its consideration of related disciplinary proceedings, its failure to address evidence concerning a contact at Cambridge, and alleged apparent bias and procedural unfairness. The central issue was whether the Tribunal’s findings were wrong or unjust because of a serious procedural or other irregularity.

1. Appeal dismissed. The appeal was formally against the suspension, but in substance challenged the Tribunal’s factual findings. If those findings stood, impairment and sanction were accepted as appropriate.
2. Under section 40 of the Medical Act 1983, the appeal is a rehearing without hearing the evidence again. The court may correct material errors of fact and law and draw inferences justified by the evidence. It must, however, be extremely cautious before interfering with primary findings, especially where the Tribunal saw and heard the witnesses. Less deference may be appropriate when assessing dishonesty, but the credibility advantage of the Tribunal remains important.
3. The Tribunal had not materially misused the expense payments referred to in its determination. Its central reasoning was that, having expected some overlap, Professor Reddy would have checked earlier statements and queried the apparent overpayments. Any misunderstanding about the scale of clinical payments was minor and could not have affected the outcome.
4. The Tribunal was entitled to treat Professor Reddy’s inability to recall the account given in the UCL disciplinary proceedings as damaging to his credibility. It relied on his answer in the present proceedings, not on speculation about what had occurred in the earlier proceedings.
5. A tribunal need not refer expressly to every matter raised in evidence or submissions. Its reasons were detailed and made clear why Professor Reddy’s account was rejected. The evidence that he supplied the name of a Cambridge contact was neutral and did not require express treatment.
6. The Tribunal applied the civil standard of proof and had been advised that cogent evidence was required in a dishonesty case. There was no basis for inferring that it applied a different standard.
7. Case management decisions, including time limits for taking instructions, do not establish apparent bias merely because they are adverse or expressed with irritation. Applying the apparent-bias test, no fair-minded and informed observer would conclude that there was a real possibility of bias. The Tribunal’s conduct did not cause procedural unfairness.

• High Court (Administrative Court): Appeal under section 40(1)(a) of the Medical Act 1983 dismissed. The Medical Practitioners Tribunal’s findings, impairment determination and nine-month suspension were upheld.
• Medical Practitioners Tribunal: Determined that Professor Reddy had acted dishonestly, that his fitness to practise was impaired, and directed a nine-month suspension.