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Appeals court tells GMC to show 'restraint' as it quashes bid to sanction doctor

The Court of Appeal has quashed another High Court ruling in favour of the GMC seeking stricter sanctions for a doctor following a fitness-to-practise tribunal.

Handing down the judgment, the judge further suggested the GMC should exercise more 'restraint' when seeking to strengthen sanctions via the courts.

Although the Government has said it will remove the GMC's right to bring Medical Practitioner Tribunal Service (MPTS) decisions to the High Court to be overturned, the GMC has said it intends to continue doing so until legislation is changed.

Today's case, which follows the Court of Appeal's high-profile ruling to reinstate struck-off junior doctor Hadiza Bawa-Garba last month, focused on paediatric locum Dr Hemmay Raychaudhuri.

Dr Raychaudhuri was found to have completed a medical examination form for a five-month-old baby without having performed an exam, while working in the A&E at Royal Berkshire Hospital in 2014.

The MPTS initially found that his actions ‘were not such that public confidence in the profession would be undermined’ if his fitness to practise was not found to be impaired and therefore decided to only impose a warning.

But the GMC said the MPTS ‘should have found that the appellant’s fitness to practise was impaired’ and successfully overruled the decision in the High Court, with the judge referring the case back to the MPTS to consider ‘the appropriate sanction’.

According to the Medical Act, if a doctor’s fitness to practice is found to be impaired, doctors can face suspension or erasure from the medical register.

But appeal judges quashed the High Court ruling today, expressing ‘regret that it was brought’.

Lord Justice Bean said in the judgment that the MPTS ‘were well placed to make an evaluative judgment of the nuances of how the various individuals had interacted and that judgment should have been accorded great weight, not only by the court but by the GMC in deciding whether to bring an appeal at all’.

He added: ‘The discretion given by section 40A(3) to appeal against any decision which the GMC consider not sufficient for the protection of the public is a wide one, but in my view it is a discretion to be exercised with restraint where it involves a challenge to a finding of fact in the practitioner’s favour.’

Former health secretary Jeremy Hunt announced in June that the GMC would be stripped of its right to appeal fitness-to-practice decisions, following the Government’s ‘rapid review’ into medical gross negligence manslaughter.

But the GMC later confirmed to Pulse that it is not intending to halt appeals against its own fitness-to-practise tribunal until the law is changed.

And Pulse revealed in March that 23 GMC appeals brought to date had all sought stricter sanctions, or to block a doctor from being registered to practise in the UK, while no appeal was for more lenient treatment.

Medical Defence Union head of advisory services Dr Caroline Fryar said: ‘Doctors are profoundly affected by fitness-to-practise proceedings and, understandably, considerably relieved to learn the tribunal has made a finding in their favour.

‘Most doctors don’t understand they are still in peril of having this finding appealed and many think this is unfair. This case addressed an important point of principle… and we are pleased the appeal was successful.’

A GMC spokesperson said: ‘We accept the judgment of the Court of Appeal and welcome the clarification that the High Court did have jurisdiction to hear our appeal. 

‘We will reflect on the decision and the judges’ full comments, as we do in all cases.’

Readers' comments (36)

  • Took Early Retirement

    GMC: lower than vermin.

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  • What we actually need is an investigation into the names of the people who are doing this. It's not just the CEO. There is a fundamental problem of accountability here and it should not be down to the appeal courts to ask for restraint - this is a resource intensive, expensive, stressful and time consuming way for doctors to seek justice and proportionate handling of their cases. A group of people are profiting handsomely form this chaos. They need a bright light shone on them.

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  • On and on it goes. Poor judgement, wrecked lives and as Bulldog says above no accountability.

    Who will rid us of this turbulent priest?

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  • AlanAlmond

    Bulldog | GP17 Sep 2018 5:42pm
    Completely agree. Who are the people bringing these cases, what are their names? Here we have a highest court in the land telling them to restrain themselves. Don’t you think it’s in the public interest to know who these people are ?

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  • Cobblers

    100% agree Took Early Retirement. Vermin.

    Worse than that it's the doctors that are paying for these excrescences.

    But not me as of a couple of weeks ago. Hehehe
    And I am not paying £10 to come off the register. Stuff them.

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  • bad decision again - presumably Charlie pissed out his skull again

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  • The GMC say they 'will reflect' but will they change their practice as a result? I doubt it very much. Doesn't sound like much 'reflection' to me.

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  • time to stop paying GMC fees

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  • but I don't want to be sacked, I'll never get a useless job from old cronies again

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  • If only we had a union to organise a mass refusal to pay the fee.

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  • Vinci Ho

    ‘We will reflect on the decision and the judges’ full comments, as we do in all cases.’
    Are we really to believe that GMC is serious about this ?
    What is the ‘new advice’ for us to understand the word ‘reflect’ as far as appraisal is concerned?
    Ironic , isn’t it ?
    Fundamentally, there is a marked difference in the interpretation of ‘fitness to practise ‘ between MPTS and GMC on numerous occasions. You wonder why? Remember, this is a pattern that keeps repeating itself. The two regulatory bodies are , in essence, fighting to discredit each other . So what is the endgame here ?
    As being alluded in previous comments , this cannot prevent conspiracy theorists from speculating that certain group was ‘gaining’ out of this chaos . After all , demeanour of GMC is never short of belligerence , bigotry and brutality .
    In addition to the failure in providing explanations for the hefty casualties through suicide during previous FTP proceedings , there is sufficient ground to call for an independent inquiry .

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  • An indecent enquiry is the best way forward,the relationship between the medical profession and the gmc is broken,something needs to be done to stop this becoming terminal,if it isn’t already.

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  • Maverick

    Just leave...

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  • Are the CMC law unto themselves?

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  • It sounds like a nexus
    You scratch my back and I shall scratch yours
    The people benigifitting are solicitors, barristers and Wc and the GMC
    It’s simple maths isn’t it.
    An independent enquiry will reveal a lot more than what appears on the surface!

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  • "It sounds like a nexus "
    if it looks like s**t and smells like s**t,it is s**t!!!
    amongst the people benefitting-dont forget the GMC experts/appraisers from our own profession-lower than vermin.

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  • So much for the GMC telling us to reflect when they have not led by example. The profession has lost faith in the organisation. It is biased and corrupt.

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  • Council of Despair

    I'm trying to look at things from the GMC's perspective - they have a duty to protect patients but are they going about this in the right way?

    - Keeping the public happy should not be the GMC's objective, for example, I'm sure some members of the public want Doctors who upset them to be put in front of a firing squad but that would not be legal or morally correct. In the same token - what is Public Confidence? The GMC says it wants to maintain public confidence but they haven't defined it and how do you measure it? The vote on Brexit and some of the comments from the public in the media such as the Daily Mail make it clear that some members of the public are at best ignorant and at worse racist - so if those members of the public decide that they don't like foreign doctors - should the GMC for 'public confidence' be harsher on foreign doctors? This is effectively the GMC's argument that they want to maintain 'Public Confidence' and it is a weak argument as they - the GMC have not said what public confidence means.

    - The expectation by professionals and it appears even by the government is that the GMC should be impartial, balanced and fair and be prepared to make thoughtful decisions that can be backed up with sound logic and arguments i.e. one would expect the GMC to make decisions that make you think - 'that was a reasoned, logical, well thought up, even evidenced argument that the GMC has made'. It appears that the GMC is not doing this at present and even worse than that they don't have insight into the fact that their decision making doesn't make sense and alienates professionals and even the state. The GMC may not care about this as they feel their main prerogative is to protect patients BUT they also have a duty of care to doctors and equally to look at educating and supporting doctors. If they can't see that their actions are actually alienating doctors and they haven't actually demonstrated that they have gained public confidence then this is worrying. Overall this reflects a complete failure of leadership in the GMC.

    The GMC is basically saying - 'we are going to do what we think is right, but we are not prepared to explain our decision making or provide any sound evidence, and we really don't care what doctors, the state care and we are not going to even evaluate if we have gained public confidence'. It's an odd state of affairs and I don't see how the GMC can continue on this track? do you?

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  • GMC is not alone. I was warned by NHSE to mind my own business as I agreed to allow a suspended GP to retrain at my Practice. The GP colleague had been suspended following a complaint by NHSE it seems and I persisted. So I was punished with a decline in my weighted list by 200 patient although list size fell by only 7.
    Glad all the same, the GP colleague is back at work having regained his license although he preferred to move out of Medway and Kent to preserve his sanity.
    These people behave like stalkers- they need to be restrained in some way - I'll invite ideas how:)

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  • Council of Despair

    This is an interesting statement

    And Pulse revealed in March that 23 GMC appeals brought to date had all sought stricter sanctions, or to block a doctor from being registered to practise in the UK, while no appeal was for more lenient treatment.

    As I'm sure that I read a statement from either Stephenson or Massey that claimed that the GMC had also appealed decisions they felt were too harsh? I'm sure this is worth looking into as if it is the case that the GMC is seeking tougher sanctions all the time it indicates their (the GMC's) thinking re sanctions. I'm not saying they are right or wrong but it suggests that the GMC views the sanctions on doctors as too soft. This will be useful for young doctors to know if they are contemplating a career in the UK.

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  • Cobblers. I applied to come off the register last year and despite paying into the GMC for 39 years, they had the cheek to ask me for £10 as well - greedy swine.

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  • and still people agree to be ROs and appraisers for this organisationm - Uncle Toms all of them

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  • @Bulldog:
    GMC, Good Medical Practice, Domain 4: 64
    "If someone you have contact with in your professional role asks for your registered name and/or GMC reference number, you must give this information to them."
    Would you like to ask them?

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  • Cobblers

    Philtrum!! Really nice to hear from you. No longer DN-UK (their loss) and GP-UK is quiet recently.

    39 years this year too. No longer. GMC can whistle.

    Keep well.

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  • Yet again I’m wondering who exactly does Charlie Massey answer to?
    Secondly, this is what happens when the regulator is not a majority of actual professionals working in the profession.
    Why are we paying the fees?

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  • Re: Council of Despair : the GMC does not need to Appeal an MPTS decision if it thinks the sanction too light, as the GMC can 'lighten' a sanction without need to seek permission or appeal to any other body. They just seem to have difficulty with imposing a harsher sanction without an appeal (since it puts them on shaky legal ground).
    I must be missing something here though: if the doctor completed a form dishonestly, he is NOT fit to practice, unless it was due to some accident and not deliberately dishonest?
    We are not told this.
    At previous cases, GMC has been happy to let dishonest doctors continue to practice, even when persisting on fraud for several years and blaming this on a later action by another person, an excuse which requires you believe in time travel!

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  • The most extraordinary paradox is that the GMC is contesting the rulings of its own tribunal service. This says two things: (1) it does not trust the MPTS and (2) as it only appears to contest MPTS rulings which it deems too lenient, it is biased. Given that it is also prepared to invoke the courts it would appear that doctors are at risk of triple jeopardy. This has to stop.

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  • "general medical doctor's persecutor council" GMDPC. may be more appropriate name for them.
    is this a significant event to be reported to gmc for those who made decision?

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  • Dame Janet Smith threatened (after the Shipman Enquiry) to close the GMC down for its failure to protect the public (no mention of outliers). The GMC apparatchiks panicked at the concept of loosing their lucrative and comfortable existence and rapidly took control of proposed doctors assessment proposals (DOH and the Medical Colleges were supposed to be partners in the process). The GMC then used the ‘delegated / secondary’ legislation (under the Medical Act) in legal terminology, in a manner which ‘is neither consistent nor scientific’ and for the GMC’s own ends. As has been stated in Blackstones Commentaries on the Laws of England (1765) - its tyranny when ‘the right of making and enforcing the laws is vested in the same man, or the same body of men’. This is historically and notoriously so with delegated legislation. It frequently leads to injustice and oppression and brings all concerned, including the law, into disrepute.

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  • May I suggest a change of the GMC's corporate mission statement to--
    "Hounding doctors, Protecting ourselves" .
    Let's face it their attempts to overrule the MPTS has nothing to do with protecting patients. In addition the legal fees wasted trying to have MPTS rulings overturned by the High court are being paid through our membership subscriptions. I paid my last one in January and thanks to retirement shall not be renewing it.Like Philtum, I will not pay to have my name taken off the register either.
    I feel there needs to be a nationwide witholding of subsciptions until the GMC proves itself to be a truly independent regulator "Supporting doctors,Protecting patients".

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  • Don't forget the High Court Judges who tend to sit alone (or the divisional court judges who sit as a pair). The common characteristic is that they are 'weak' or 'young' and 'kowtow' to institutions like the GMC. Their names are public record. At the appeal Court level (Bawa Garba) or Supreme Court level (Michalak), the justices feel strong enough not to kowtow and to do the right thing.

    Please spare doctors the severe trauma when GMC appeals against the MPTS by allocating 'strong and experienced' judges.

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  • As has been mentioned before, when doctors make considered decisions in highly fraught circumstances, which in hindsight were incorrect, they are quite likely to end up with a charge of ‘gross negligent manslaughter’. Judges seem immune to such adversity.

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  • Onwude, judges simply get clinical events wrong.
    Take Dr BG.
    She was convicted ' for ignoring needless decline in Jack Adcock, BEFORE transfer to a general ward'
    But Jack was unresponsive on admission and bouncing about when transferred from CAU to ward 28. He had actually IMPROVED.
    But the expert witness said Dr BG had ' ignored obvious decline', completely the opposite of the fact of improvement and transfer. Personally, I think this is misrepresentation of clinical fact and Dr BG's conviction is wrong legally and medically.

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  • CENSORSHIP?

    ‘We will reflect on the decision and the judges’ full comments, as we do in all cases.’
    AND THEN CARRY ON REGARDLESS !!

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  • Appeals court tells GMC to show 'restraint'- SOUNDS LIKE HOLDING BACK A RABID DOG!!

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  • Just leave the country anyone who can. your lives will be much better

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