Doctor leaders have criticised a recent MPTS tribunal decision to permanently remove a doctor working in war-torn Sudan from the GMC register.
Dr Mohamed Ali Suleiman Ali was struck off by the MPTS in June following a series of hearings over the last two years which all maintained a finding of misconduct.
This was despite the GMC arguing that Dr Ali should not face permanent erasure from the medical register.
But leaders from the British International Doctors Association (BIDA) and the British Association of Physicians of Indian Origin (BAPIO) have said the repeated hearings on this issue are ‘disappointing’ and ‘tone deaf’.
The original finding was based on Dr Ali having been dishonest when he allowed a colleague in Sudan to put his name down as her appraiser in a GMC revalidation form.
According to the GMC and the MPTS, despite not filling out the form himself, Dr Ali dishonestly told his colleague that a UK locum agency where he had previously worked was still his designated body even though he knew this was not the case.
In a letter to the tribunal for the most recent hearing, from which he was absent, Dr Ali outlined his current situation, referencing the ‘war in Sudan’ and his ‘difficulty in getting electricity and internet and water for four years’.
The initial tribunal in 2021 found that Dr Ali, while working as a consultant paediatrician in Sudan in 2019, authorised a colleague, ‘Dr A’, to complete the appraiser section of her GMC revalidation form on his behalf.
In order to be an appraiser, the GMC stipulates that the doctor must hold a registration with a licence to practise and also have a connection to a designated body.
Based on emails between Dr Ali and both the GMC and his previous designated body Direct Medics, the tribunal established that he was aware that he did not meet these criteria. He had not held a licence to practise since 2018 and had stopped working at Direct Medics in 2017.
Despite being aware of this, the tribunal found that Dr Ali informed Dr A that he had a ‘prescribed connection to Direct Medics’ in order for her to complete the form, and that this was dishonest.
Among other accusations from the GMC, this was the only proven one that led to the finding of misconduct and ultimately a suspension of 12 months.
The tribunal suggested that Dr Ali may not have been aware of the criteria for being an appraiser, especially since Dr A completed the form on his behalf.
It said: ‘The Tribunal considered it was likely that if Dr Ali had seen the Form and been required to tick all of the listed requirements it would have been evident to him that he was not a fit and proper person to complete the Form.
‘Further, it appeared likely to the Tribunal that he would not have authorised Dr A to complete the Form knowing that the information within was being sent to and checked by the GMC and it would effectively invalidate Dr A’s appraisal.’
However, the tribunal found that Dr Ali’s dishonesty about his connection with Direct Medics was a sufficient departure from the GMC’s Good MedicalPpractice (GMP) and his actions ‘had the potential to place patients at risk of harm’.
It said: ‘The Tribunal was mindful that the GMC relies on the professionalism of doctors to maintain the revalidation process and considered that Dr Ali’s actions in stating incorrect information were both unprofessional and inappropriate.’
There were four further review hearings in which the GMC argued for maintained impairment of Dr Ali’s fitness to practise, resulting in suspensions and finally erasure in the most recent instance.
The tribunal determined that he ‘continues to show no insight into the impact of his dishonesty on patients, the profession or the public’.
In his letter, which is not available in full, Dr Ali wrote: ‘…war in Sudan and I mentioned many times we are living in a situation where there is difficulty in getting electricity and internet and water for four years and that ended with aggressive war in which I lost my home and cars and fled to Egypt by road took me over a week to reach Cairo with no food and no sleep and blood pressure shooting up and my family in U.K. have difficulty to reach me.
‘So now we are in Cairo having XXX [sic] support and food and shelter awaiting to be evacuated to reunite with my family […]’
He also wrote: ‘It seems to me that all the tribunal members living in different planet as we live sorry to say that but. I was traumatised twice […] for five years for which things happened by mistake and I apologised for that many times and wrote statements re that subject and I think it will continue the same till I die […]”
While the tribunal was satisfied that these circumstances were a ‘mitigating factor’, it ultimately found that ‘erasure was the only appropriate and proportionate sanction’ due to Dr Ali’s lack of insight into his conduct.
GMC counsel Mr Mensah argued that ‘there should be a further period of suspension’, and reminded the tribunal that it ‘should impose the least restrictive sanction possible’. The GMC did not wish to comment further.
Chairman of the BIDA junior doctors forum Dr Sai Pillarisetti said: ‘It is disappointing to see the relentless nature in which the tribunal pursued Dr Ali over the past 4 years, despite his statements describing very challenging and arduous recent events of working as a doctor on the frontlines during an outbreak of a war in Sudan and having to flee to Egypt in fear of his life.
‘There should be a role beyond simply noting such mitigating circumstances, but showing compassion and going a step further by actively supporting doctors in a meaningful way during these difficult times, so that they can recuperate and then remediate without duress. Unfortunately, instead of this they chose to pursue an erasure.’
BAPIO vice-chair Dr Joydeep Grover said the tribunal decision is ‘tone deaf and fixated on pursuing Dr Ali’s “insight”, completely blind to the fact that he has lost his home in Sudan and is living as a refugee in Egypt, away from his family’.
He said: ‘It is unimaginable to think that despite having lost all semblance of normal living, instead of being kind and understanding, the GMC expects Dr Ali to attend courses and reflect on developing insight into the dishonesty allegations to the satisfaction of the tribunal members, driving him to say ‘”Please let me be in peace”.’
There has been armed conflict in Sudan since April when fighting broke out between rival factions. It has been reported that thousands of people have been killed and injured in the ensuing month.