General Medical Council v Rajesh Shah

The General Medical Council appealed under section 40A of the Medical Act 1983 against a Medical Practice Tribunal Service decision which found misconduct by Mr Shah (including sexual misconduct contrary to section 26 of the Equality Act 2010) but imposed a 12 month suspension with review rather than erasure. The High Court dismissed the appeal.

The court held that the tribunal's factual findings were not challenged and its evaluative decisions on impairment, risk of repetition, insight and remediation and on sanction fell within the bounds of reasonable decision-making. The tribunal properly applied the Sanctions Guidance, identified aggravating and mitigating factors, and gave adequate reasons for preferring suspension to erasure. Alleged errors of principle (including reliance on the Equality Act 2010 finding, assessment of remediation and use of paragraph 109 of the Sanctions Guidance) did not show the tribunal's decision was wrong or procedurally unfair.

Background and parties. The appellant was the General Medical Council (GMC). The respondent was Mr Rajesh Shah, a thoracic surgeon. Following a 13-day disciplinary hearing before the Medical Practice Tribunal Service (MPTS) the tribunal on 29 August 2024 found a mixture of proved and unproved allegations, including unwanted sexual touching of a colleague (Colleague B), breaches of the Equality Act 2010 (section 26) and admitted failures in mandatory training. The tribunal suspended Mr Shah for 12 months with a review at the end of the period.

Nature of the appeal / relief sought. The GMC appealed under section 40A of the Medical Act 1983 seeking substitution of erasure for suspension or, alternatively, remittance for reconsideration with directions.

Issues framed. The court articulated four grounds (in summary): (1) error in concluding that conduct towards Colleague A and use of language about female colleagues did not amount to serious misconduct; (2) error in analysis of risk, insight and remediation at impairment stage; (3) misapplication or misquotation of paragraph 109 of the Sanctions Guidance; and (4) inadequate consideration of insight, remediation and risk at the sanction stage.

Court's reasoning. The court emphasised that the tribunal's primary findings of fact were not challenged and that evaluative decisions on sanction and impairment attract judicial deference unless there is an error of principle or the decision is outside reasonable bounds. On each ground the court concluded the tribunal had acted within permissible bounds: (a) the tribunal reasonably assessed the seriousness of the conduct towards Colleague A within a spectrum of sexual harassment; (b) the tribunal properly assessed risk of repetition, insight and remediation and was not obliged to adopt any particular order of reasoning; (c) any misquotation of earlier wording in the Sanctions Guidance or omission of a discrete phrase did not show departure from the Guidance’s steer or result in an illegitimate outcome; and (d) the tribunal gave adequate reasons and identified relevant aggravating and mitigating factors and a review mechanism to test developing insight.

Disposition and wider comment. The appeal was dismissed. The judgment summarises applicable authorities (including Bawa-Garba, Jagjivan, Sawati and Bramhall) and reiterates the limited circumstances in which a court should overturn multifactorial evaluative decisions of disciplinary tribunals.

The appeal is dismissed. The court held that the tribunal’s factual findings were unchallenged and that its evaluative decisions on impairment, risk of repetition, insight, remediation and sanction fell within the bounds of reasonable adjudication. Alleged errors of principle, including reliance on the Equality Act 2010 finding, assessment of remediation and any misquotation of Sanctions Guidance paragraph 109, did not render the tribunal’s decision wrong or procedurally unfair, and suspension for 12 months with a review was a proportionate outcome.

Tribunal decision by the Medical Practice Tribunal Service on 29 August 2024 (MPTS hearing of 12–29 August 2024). Appeal to the High Court (Administrative Court) under section 40A of the Medical Act 1983 resulting in judgment [2025] EWHC 899 (Admin) dismissing the GMC's appeal.