Dr Thomas Plimmer v General Medical Council

An appeal from a Medical Practitioners Tribunal is by way of rehearing. The High Court may substitute its own decision, but should respect the Tribunal’s specialist expertise and its advantage in assessing witnesses. Findings of primary fact, particularly credibility findings, should be disturbed only where they exceed the generous ambit of reasonable disagreement or contain a material error.

In regulatory proceedings, the protection of public confidence and professional standards may justify severe sanctions for sexual misconduct connected with professional practice. Personal mitigation carries limited weight where misconduct involving integrity undermines the profession’s reputation. Erasure may be justified even where patient-safety risk is low.

The claimant, a general practitioner, appealed under section 40 of the Medical Act 1983 against a Medical Practitioners Tribunal’s findings of misconduct, impairment and sanction. The Tribunal had found proved several allegations involving sexual misconduct towards colleagues and other women, including non-consensual sexual contact, unsolicited sexual material, sexual activity at work and a threat to another woman. It also found impairment by reason of adverse mental health, including compulsive sexual behaviour disorder.

The claimant challenged three factual findings, the assessment of impairment, the application of the four features identified in the Fifth Shipman Report, and the decision to erase his name rather than suspend him. The central issues were whether the Tribunal’s findings were wrong or procedurally unfair, and whether erasure was inappropriate or disproportionate.

1. Appeal dismissed. The Tribunal’s findings, impairment determinations and direction for erasure were not shown to be wrong.
2. Under section 40 of the Medical Act 1983, read with CPR Part 52, the appeal is a rehearing. The court may substitute its own decision, but must give appropriate respect to the specialist Tribunal, particularly on professional standards, credibility and primary fact. It must not defer more than the circumstances warrant.
3. The Tribunal had carefully assessed the evidence of the principal witnesses against contemporaneous messages and interview records. Its findings on the three challenged allegations were open to it and did not exceed the generous ambit within which reasonable disagreement was possible. The allegation concerning the threat was not procedurally unfair because the charge necessarily required consideration of whether the words would or might be conveyed to the threatened person.
4. Impairment by misconduct was inevitable on the totality of the findings. The parties accepted that the conduct brought the profession into disrepute and breached fundamental professional tenets. The Tribunal’s additional findings that the other identified features of impairment were engaged to a lesser extent did not undermine its conclusion, which rested on the former two features.
5. The Tribunal was entitled to find that sending sexual images to a vulnerable work colleague, and other sexual conduct connected with the workplace, constituted serious misconduct. Regulation may reach private conduct where it realistically and qualitatively touches professional practice or the standing of the profession, applying the reasoning in Beckwith v Solicitors Regulation Authority [2020] EWHC 3231 (Admin).
6. Sanction required assessment of seriousness, the protective purpose of regulatory sanctions and the sanction best fulfilling that purpose. The Tribunal properly considered the Sanctions Guidance, aggravating and mitigating features, the risk of repetition, public confidence and professional standards. Erasure was appropriate and was not clearly inappropriate or disproportionate. The appeal was dismissed.

The judgment does not state a prior appellate decision in the same proceedings. It records an appeal under section 40 of the Medical Act 1983 from findings and sanction imposed by a Medical Practitioners Tribunal.