Dr Seamina Khan v General Medical Council

The GMC and the Medical Practitioners Tribunal are not confined to patient complaints or allegations concerning clinical performance. Their regulatory functions extend to dishonesty and other conduct relevant to public protection, public confidence, and professional standards.

A decision by the CPS or another body not to prosecute does not deprive the GMC or Tribunal of jurisdiction to investigate and determine related professional misconduct. Published GMC threshold guidance remains guidance and does not itself define or restrict the Tribunal’s statutory jurisdiction.

On a statutory appeal under section 40 of the Medical Act 1983, the High Court conducts a rehearing and may substitute its own decision. Persistent dishonesty, absent remorse, insight or remediation, may justify erasure where necessary to protect the public and maintain confidence in the profession.

Dr Seamina Khan appealed under section 40 of the Medical Act 1983 against a Medical Practitioners Tribunal determination directing that her name be erased from the Medical Register.

The Tribunal had proceeded in her absence under rule 31 of the General Medical Council (Fitness to Practise) Rules 2004. It found multiple instances of dishonest applications, fabricated references and documents, dishonest communications, and GP work undertaken while she was not included on the relevant medical performers list. It found misconduct, impairment of fitness to practise and erasure to be appropriate.

Dr Khan challenged only the GMC’s and Tribunal’s legal powers. She argued that the matters had been previously closed or investigated, that the CPS decision not to prosecute barred further investigation, that the allegations were outside the GMC’s remit, and that she had been permitted to work without inclusion on the English List.

1. Appeal dismissed. The Tribunal’s findings of fact, misconduct, impairment and sanction were lawful, justified and unassailable. Erasure was neither excessive nor disproportionate. Dr Khan was ordered to pay the GMC’s reasonable costs, summarily assessed at £7,500. Permission to appeal was refused, subject to the Court of Appeal’s jurisdiction under section 55 of the Access to Justice Act 1999 and CPR 52.7.
2. The statutory appeal under section 40 of the Medical Act 1983 is an appeal by way of rehearing. The High Court may substitute its own decision and need not defer to the Tribunal beyond what the circumstances require.
3. The GMC’s overarching objective under section 1 of the Medical Act 1983 includes protecting public health, safety and well-being, promoting public confidence in the medical profession, and maintaining proper professional standards and conduct. The GMC and Tribunal are therefore not limited to patient complaints or clinical performance and conduct.
4. A CPS decision not to prosecute, including a decision made on public-interest grounds, does not bar the GMC from investigating or the Tribunal from determining related professional allegations. The Welsh Board’s notification expressly preserved the GMC’s ability to investigate. Even an alleged departure from GMC guidance could affect the Tribunal’s jurisdiction only through an abuse of process application, and none was made.
5. The court rejected the contention that GMC communications concerning revalidation authorised Dr Khan to work as a GP without inclusion on the English medical performers list. Revalidation arrangements were distinct from the legal requirement to be included on the relevant list.
6. The absence of direct patient harm or challenge to clinical competence did not remove the jurisdiction to address dishonesty. Persistent dishonesty, particularly where there was no remorse, insight or remediation, was capable of making erasure necessary in the public interest.

• Medical Practitioners Tribunal: Proceeded in Dr Khan’s absence under rule 31 of the General Medical Council (Fitness to Practise) Rules 2004 and directed erasure from the Medical Register.
• High Court (Administrative Court): Dismissed the statutory appeal under section 40 of the Medical Act 1983. Costs were ordered against Dr Khan and permission to appeal was refused.