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GMC criticised for withholding documents in GP's fitness-to-practise case

The GMC has been criticised in the High Court for failing to share mitigating documentation with its own tribunal in a fitness-to-practise case involving a GP trainee.

Dr Abayomi Sansui had appealed the Medical Practitioners Tribunal Service's (MPTS) decision to have him struck off the medical register last year, arguing that documents he submitted to the GMC in his defence were never passed on to the tribunal.

Although the High Court decided to uphold the decision to strike off Dr Sansui, it told the GMC that in failing to submit the documents to the tribunal 'the system did not operate as it should have done'.

Dr Sansui was accused of failing to assess and keep adequate records of two patients between 2012 and 2014 while working as a surgical registrar at Friarage Hospital in North Yorkshire.

Following internal disciplinary hearings, the hospital referred the case to the GMC in 2015, which concluded that he ‘presented an ongoing risk to patients and the public’, striking him off the medical register two years later.

Dr Sansui, who was re-training to be a GP at the time, did not attend the MPTS tribunal as he ‘had limited time off as leave of absence’ and did not send a lawyer because of ‘financial constraints’, the appeal decision said.

Instead, he contacted a caseworker at the GMC, sending her ‘a substantial number of documents over a considerable period’.

These documents included a testimonial letter from his GP trainer, appraisal documents, ‘expressions of appreciation from former patients’ and ‘the results of clinical evaluation exercises undertaken by supervising doctors while working at Friarage Hospital’. 

However, in his appeal decision Mr Justice Kerr said: ‘The tribunal did not see these documents. Many of them were shown to me during the hearing of this appeal.’ 

He added: ‘The GMC and its legal advisers, for their part, should always take whatever steps are reasonable to put relevant documents in its possession before the tribunal; and counsel should check that documents in the GMC’s possession that are readily available and relevant to mitigation are provided to the tribunal; especially if it is known that an absent doctor has so requested, and more particularly still if the absent doctor is unrepresented.’

Mr Justice Kerr said: ‘I conclude, without wishing to criticise individuals in this case, that the system did not operate as it should have done.

‘Dr Sanusi’s mitigation documents sent to the caseworker should have been placed before the tribunal.’

But he added that the documents ‘were not reasonably capable of affecting the outcome that occurred’ and Dr Sansui ‘demonstrated a remarkable lack of acceptance of responsibility’.

A GMC spokesperson said: ‘We are reflecting on the decision and Mr Justice Kerr’s comments, as we do in all cases.

‘We have already taken steps to make sure that we appropriately manage any documents provided to us by a doctor if they are absent and unrepresented at their hearing.

‘This includes providing additional support to all relevant staff to make sure they are aware of our obligation to disclose any relevant material to a tribunal.’

Earlier this week, the BMA's Annual Representative Meeting voted in favour of a motion declaring ‘that it has no confidence in the GMC as a professional regulatory body’, following the controversial court case involving Dr Hadiza Bawa-Garba.

Readers' comments (9)

  • Vinci Ho

    It is always difficult to comment without all the facts in and out of the case . Purely based on what the judge said about GMC not submitting these documents, it had confirmed one of its serious failings ,we long emphasised , in disrespecting the spirit of Common Law : presumed innocence until proven guilty beyond reasonable doubts.

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  • I have never used to worry too much about the GMC as I never thought I would be at risk. I was wrong. It is an incredibly frightening, bruising and expensive process. I was completely exonerated-but my reputation tarnished. Please be as careful as you can be. Please imagine everything you ever write as being on the front page of The Daily Mail. This includes,notes,letters,private texts, e-mails,social media comments, notes on scraps of paper, private reports etc.

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  • its affect has been muted now though. it is a little like telling a child off all the time. eventually the child doesn't care anymore. i no longer see it as a negative in a doctor and i don't put points against it. in fact what i am interested in is how a doctor has reflected on it and how this has made them a better clinician. I think that this does completely shake the confidence of the doctor, however as clinicians we now need to be supportive of one another. It is interesting that the LMC has voted that the BMA now has lost confidence in the GMC. this is something for the GMC to reflect on. I am not sure what this means to us as clinicians. We as clinicians cannot rely on courts to exonerate us. we must be forgiving to our own colleagues and we must not ostracise them.

    - anonymous salaried!

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  • The case seems to have some disturbing parallels with the case of Dr Bawa-Garba. A registrar was involved and a lot of the MPTS allegations revolve around tests either not being done or not interpreted quickly enough. Of course we now know that registrars are in an incredibly vulnerable position being both overwhelmed by the pressure of under-resourced NHS hospitals and generally unsupported by their seniors who will hang them out to dry wherever they can get away with it. The remaining report reads as a character assassination and disturbingly the Dr in question lacked appropriate representation, mitigating data was omitted by the tribunal and at the end of the day the system sought to assign blame on an individual basis interpreting defence as a form of guilt, "Dr Sansui ‘demonstrated a remarkable lack of acceptance of responsibility’." Is this really what we call justice these days?

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  • Dr Sansui is not white - so even the judge would not want to rock the boat for GMC. In police cases where evidence has been suppressed even rapists and murders go scot free if evidence id mishandled. Not so for a BME - End apartheid !

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  • Sounds similar to rape cases where the evidence is withheld to increase conviction and forget about justice or doing the right thing.
    This case just makes the profession trust the GMC even less. The vote of no confidence should lead to big changes.

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  • Keep dragging the dead horse...

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  • Just Your Average Joe

    https://www.mpts-uk.org/static/documents/content/Dr_Abayomi_Lukman_SANUSI_18_October_2017.pdf

    Look at the MPTS notes and it is not like Dr BG really - as there a doctor did their best in trying and exceptionally challenging circumstances completely unsupported by the system.

    Here there are issues with refusing to see patients when requested, failure to support junior colleagues and some probity questions.

    Yes fair hearing questionable when evidence withheld and no representation, but as judge said outcome not likely to have changed.

    Fair decision probable on basis on evidence - so not a case of discrimination and scapegoating like Dr BG.

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  • Read the tribunal information. The doctors knowledge and judgement in treating acutely ill patient was poor- he needed information and training not punishment- that’s why he is still a training . But to use this to strike him off the list is shocking. It’s like someone caught for speeding and sent to life in prison. One of the main problems with the GMC is proportionality with punishment. They had already decided they had reached their minimal threshold to strip his licence of him and had no hesitation to suppress whatever information that would counter this. Think twice about staying in the UK because the system is definitely there to get you.

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