Bashir Ahmedsowida v General Medical Council

On a practitioner’s statutory appeal, the High Court must conduct an appellate rehearing and decide whether the Tribunal’s decision is wrong or unjust because of serious procedural irregularity. Appropriate respect is due to the specialist Tribunal, but the court must exercise its own secondary judgment on impairment and sanction.

Where suspension serves both to mark serious misconduct and to allow remediation, a previous period of immediate or interim suspension need not be credited if credit would shorten the period necessary to restore fitness, reduce risk and protect the public. The absence of an immediate suspension order pending appeal is not inconsistent with a substantive suspension needed for longer-term remediation.

A doctor appealed under section 40 of the Medical Act 1983 against an MPTS Tribunal’s decision finding current impairment by misconduct and imposing 12 months’ suspension. The decision followed an earlier appeal in which Kerr J had set aside findings of impairment and erasure and remitted the case for reconsideration by a differently constituted Tribunal.

The appellant challenged the Tribunal’s assessment of insight, remediation and risk of repetition, and argued that it should have credited an earlier period of approximately eight months’ immediate suspension. He also argued that the refusal to impose an immediate suspension order was inconsistent with the finding that suspension was necessary for remediation.

1. Appeal dismissed. The Tribunal’s findings on impairment and the 12-month suspension were upheld.
2. The appeal under section 40 of the Medical Act 1983 is appellate rather than supervisory and proceeds by way of rehearing without rehearing the evidence. The court must decide whether the decision was wrong or unjust because of serious procedural or other irregularity. It must exercise its own secondary judgment while according appropriate deference to the Tribunal’s specialist assessment.
3. The Tribunal was entitled to find that repeated and serious dishonesty, together with attitudinal concerns, required significant and demonstrable remediation. It fairly assessed the evidence and was entitled to conclude that insight and remediation remained incomplete and that some risk of repetition remained. Impairment was also justified by the need to maintain public confidence in the profession.
4. Following Adil, prior suspension may be relevant where the sanction’s purpose is punishment, deterrence or marking gravity. It may have little or no relevance where suspension is required to restore fitness, mitigate risk or protect the public. Where both purposes apply, credit need not be given if it would undermine the time required for remediation and public protection.
5. There was no inconsistency between imposing a substantive suspension to permit remediation and declining an immediate order under section 38. A substantive sanction addresses longer-term remediation; an immediate order addresses the shorter period pending appeal and any immediate risk.

1. High Court (Administrative Court) — The present appeal under section 40 of the Medical Act 1983 was dismissed.
2. High Court — On 21 December 2021, Kerr J allowed the earlier appeal, set aside the 2021 Tribunal’s impairment finding and erasure sanction, and remitted the case for reconsideration.
3. MPTS Tribunal — On 23 November 2023, the Tribunal found current impairment by misconduct and imposed 12 months’ suspension.