Dr Seshni Moodliar v General Medical Council

An appeal under section 40 of the Medical Act 1983 is a rehearing, but the tribunal’s decision remains entitled to appropriate respect. The court may extend an apparently strict statutory appeal period where reliance on erroneous official advice would impair the very essence of the right of appeal.

Knowledge of prejudicial material does not automatically make proceedings unfair. The question is whether the risk is so grave that no reasonable direction could remove it. A tribunal may rely on hearsay if it considers the evidence fair and relevant under its procedural rules. Dishonesty is assessed by the two-stage test in Ivey. Erasure may be justified where serious dishonesty, inadequate insight and inadequate remediation make it necessary to protect the public or maintain confidence in the profession.

Dr Seshni Moodliar appealed against a Medical Practitioners Tribunal decision finding that she had acted dishonestly in medicolegal work and directing her erasure from the medical register. She advanced fourteen grounds, grouped into challenges concerning prejudicial material, recusal, factual findings and the standard of proof, hearsay evidence, reasons, dishonesty, and sanction.

The appeal was lodged four days late because the Medical Practitioners Tribunal Service had incorrectly advised her of the deadline. The central issues were whether time should be extended, whether the tribunal’s handling of earlier disciplinary findings rendered the hearing unfair or created apparent bias, whether its factual and dishonesty findings were legally flawed, and whether erasure was disproportionate.

1. Extension of time. The court extended time. Although section 40(4) of the Medical Act 1983 imposed a strict 28-day period, the provision had to be read compatibly with section 3 of the Human Rights Act 1998. Where a doctor files an appeal within the period incorrectly stated by the MPTS, and is otherwise without fault, refusal to extend time would impair the very essence of the statutory appeal right. The alternative estoppel argument was unnecessary and could not overcome a jurisdictional time limit.
2. Fairness and prejudicial material. The earlier tribunal decision should not have been opened as background once the tribunal had decided that stage 1 would concern only the new allegations. However, the appellant herself referred to the earlier findings and asserted good character. The GMC was entitled to challenge the resulting false impression. The tribunal repeatedly directed itself not to use the earlier case in determining the new facts, and its written decision complied with that direction. The risk of prejudice was therefore sufficiently removed.
3. Recusal. Applying the fair-minded and informed observer test in Porter v Magill, there was no real possibility of bias. The tribunal understood the correct test, gave the appellant ample opportunity to address the issue, and had carefully resisted using the earlier material as propensity evidence.
4. Evidence and reasons. The tribunal correctly directed itself on the balance of probabilities, assessment of evidence, demeanour, objective facts and divisible credibility. Rule 34 of the General Medical Council (Fitness to Practise) Rules Order 2004 permitted admission of hearsay evidence considered fair and relevant. The tribunal’s reasons identified the critical issues and were adequate.
5. Dishonesty. The tribunal correctly applied Ivey. A genuinely held mistake about the facts defeats dishonesty at the subjective stage. Once the tribunal found that the appellant knew the relevant facts, the objective standards of ordinary decent people determined dishonesty. The expression “unintentionally dishonest” did not alter that analysis.
6. Sanction. Erasure was justified. The tribunal was entitled to give substantial weight to serious dishonesty, risk to vulnerable patients, lack of insight, inadequate remediation and the need to maintain public confidence. It did not penalise the appellant merely for defending the proceedings or disputing impairment. The appeal was dismissed.

High Court (Administrative Court): time extended under section 40 of the Medical Act 1983; the appeal against the Medical Practitioners Tribunal’s findings and erasure direction dismissed.