BAILII is celebrating 24 years of free online access to the law! Would you consider making a contribution?
No donation is too small. If every visitor before 31 December gives just £5, it will have a significant impact on BAILII's ability to continue providing free access to the law.
Thank you very much for your support!
[Home] [Databases] [World Law] [Multidatabase Search] [Help] [Feedback] | ||
England and Wales High Court (Administrative Court) Decisions |
||
You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Russell, R (on the application of) v General Medical Council [2008] EWHC 2546 (Admin) (24 July 2008) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2008/2546.html Cite as: [2008] EWHC 2546 (Admin) |
[New search] [Printable RTF version] [Help]
QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
Strand London WC2A 2LL |
||
B e f o r e :
____________________
THE QUEEN ON THE APPLICATION OF MOYA CATRIONA RUSSELL | Claimant | |
v | ||
GENERAL MEDICAL COUNCIL | Defendant |
____________________
WordWave International Limited
A Merrill Communications Company
190 Fleet Street London EC4A 2AG
Tel No: 020 7404 1400 Fax No: 020 7831 8838
(Official Shorthand Writers to the Court)
Ivan Hare (instructed by General Medical Council) appeared on behalf of the Defendant
____________________
Crown Copyright ©
"The Panel has given consideration to the seriousness, and your culpability in your admitted breach, of the condition imposed on your registration, to abstain absolutely from the consumption of alcohol. It notes that you had breached a GMC undertaking, by which you had agreed to abide in 2003, to abstain absolutely from the consumption of alcohol, which led to your initial referral to the GMC's Health Committee. Ms Powell said that, in 2004, you realised that you should be completely abstinent and that this might not be easy. You did comply with the conditions imposed in 2005 but you did not fully comply with the conditions imposed in August 2006; specifically, you have admitted to the consumption of alcohol.
The Panel has also noted that you were not truthful with your medical supervisor, Dr Gilvarry, appointed on behalf of the GMC, when you told him in July 2007 that you had abstained from the consumption of alcohol. Ms Powell, on your behalf, told the Panel that you deeply regret not being frank with Dr Gilvarry.
The Panel considers that any breach of a condition imposed by your regulatory body, namely the GMC, should be considered as serious. In considering where your breach lies in the scale of seriousness, it has noted that you have admitted that you have consumed alcohol on three occasions since August 2006. You told the Panel in August 2007 that you had been abstinent for approximately six weeks and Dr McAllister Williams said that you reported no alcohol intake since the start of this hearing in August. However, the Panel is concerned that you do not appear to fully understand the seriousness of the requirement to comply with conditions imposed by the GMC. In making this statement, the Panel does recognise that you have complied with all other conditions.
The Panel has also had regard to the public interest issues raised by your breach of the current conditions. It heard the advice from the legal assessor in August 2007 that the Panel can consider whether a breach of a condition is so serious as to be culpable in order to constitute a failure to comply with the requirements of the GMC.
The Panel has considered whether it would be sufficient for the protection of patients, members of the public, the public interest and in your own interests to place conditions on your registration for a further period. In doing so it has had regard to the issue of proportionality of the GMC's Indicative Sanctions Guidance (April 2005).
The Panel has taken into account the initial breach of your undertakings, and the subsequent breach of your conditions. On both occasions the breach related to abstinence from alcohol.
The Panel is very concerned that you have consumed alcohol on several occasions, despite giving an undertaking that you would not, and despite the clear terms of the conditions previously imposed. The Panel considers that it would compromise the integrity of the regulation of the medical profession if it were once again to impose conditions on your registration, knowing that you have, on previous occasions, not complied with conditions. For these reasons, the Panel has concluded that, based on the information presented on 21st August 2007 and at the reconvened hearing today, it would be insufficient to conclude this case by extending the conditions on your registration.
The Panel considers that it must send a clear signal to you and the profession that conditions imposed by a Fitness to Practise Panel must be complied with. This is fundamental to the maintenance of public confidence in the profession and confidence in the regulatory process. The Panel has the power to direct suspension for up to 12 months. It considers that it would be disproportionate to direct suspension at the top end of the scale. It has concluded that it is sufficient to send a signal to you and the public that conditions must be complied with by imposing suspension for two months. The Panel considers this to be sufficient time for you to reflect on the absolute necessity to comply with conditions.
The Panel wishes to make it clear that, had you not breached the condition imposed by the previous Panel to abstain from alcohol, it would have been minded to impose a sanction of conditional registration."
I now turn to the two grounds of appeal.
The procedural challenge
"Mr Williams has in passing, if I may put it like that, referred to suspension, very much in passing. I would submit that suspension in these circumstances would be wholly disproportionate, and indeed would not be in the public interest. Dr Russell has for the past twelve months since the last review hearing provided a good clinical service, and has not been criticised for that. Her ability to provide that service has not been jeopardized by the breaches of Condition 4, in the professional opinion of those who have provided you with reports. [Condition 4 was the condition in relation to abstinence from alcohol consumption].
It would, in my submission, be a disaster for this doctor if this Committee were to take such a harsh view of circumstances that they were to impose suspension. She has struggled long and hard against a debilitating condition, to her considerable credit, and has achieved a position of considerable stability. It is a condition that is susceptible to recurrence, particularly when under stress, and it is greatly to be hoped that she will be allowed to continue in the progress that she has made in continuing her professional development that she has achieved thus far."
(1) the Panel gave no indication that a short suspension might be under consideration by them;
(2) Ms Powell was not invited to deal with the potential effects of a suspension on Dr Russell; and
(3) She was not invited to address the Panel as to the proportionality of even a short suspension when looked at in the context of Dr Russell's personal and employment circumstances.
"4. It is impossible to predict how the appellant would respond to the stress of suspension if this happens. However, it is clear to me from my contact with the Appellant that she is highly committed to her career in medicine. As a result, it is fairly clear that she would find any threat to her [career] extremely distressing and stressful. There is a very strong likelihood that such stress would lead to a destabilisation of her condition and potential relapse into a significant episode of mood disturbance. My specific concern therefore is that suspension could lead to a relapse of the Appellant's illness thus exacerbating any potential threat to her very future in medical employment. Had I been asked earlier to express an opinion on these issues, I confirm that I would have done so in these terms."
"I had wondered if the GMC had considered this knock-on effect when they imposed the suspension in the first place. I had intend to write to them expressing my concern for a form of punishment that had significant negative effects on the employing organisation once the case had been finalised."
"13. The report of the psychiatrist was not agreed by the Respondent and so it would have been necessary to have him called and cross-examined if I were to accede to Mr Powell's submission. The fact that the appellant had not been advised that it would be helpful to obtain such a report cannot justify an attempt now to fill the gap. Fault of his advisers, if such there was, does not provide a good reason for introducing new evidence."
"34. I refused the application to admit the fresh evidence because:-
a. The admission of fresh contested evidence is very much the exception in s.40 appeals and would require compelling justification...
c. The evidence could plainly have been obtained and placed before the GMC for comment and response long before now and might well have triggered a discretionary review of the conditions and an examination of the accuracy of the assertions therein..."
"(d) the practitioner may present his case and may adduce evidence and call witnesses in support of it;
(e) the FTP Panel shall receive further evidence and hear any further submissions from the parties as to whether the fitness to practise of the practitioner is impaired or whether the practitioner has failed to comply with any requirement imposed upon him as a condition of registration...
(g) the FTP Panel may receive further evidence and hear any further submissions from the parties as to its decision whether to make a direction under section 35D(5), (6), (8), (10) or (12) of the Act..."
The substantive challenge
"It is well established, for very good reasons, that the Board will not interfere with the exercise of the discretion of the Professional Conduct Committee in matters relating to penalty. The assessment of the seriousness of the misconduct upon proof of a conviction is essentially a matter for the committee, in the light of their experience of the range of cases which come before them. They are best qualified to judge what measures are required to maintain the standards and reputation of the profession and to assess the seriousness of the misconduct. As a general rule therefore the Board will be very slow to interfere with decisions of the committee on matters relating to penalty."
"16. In these circumstances it seems to me to be clear that we should follow the guidance given in the cases decided before the change in the appeal system effected on 1 April 2003. First, the Privy Council is of course a source of high authority; but secondly, we are in any event considering an effectively identical statutory regime. As it seems to me there are in particular two strands in the relevant learning before 1 April 2003. One differentiates the function of the Panel or committee in imposing sanctions from that of a court imposing retributive punishment. The other emphasises the special expertise of the Panel or committee to make the required judgment.
17. The first of these strands may be gleaned from the Privy Council decision in Gupta v the GMC [2002] 1 WLR 169, 1702 at paragraph 21 in the judgment of their Lordships delivered by Lord Rodger of Earlsferry:
'It has frequently been observed that, where professional discipline is at stake, the relevant committee is not concerned exclusively, or even primarily, with the punishment of the practitioner concerned. Their Lordships refer, for instance, to the judgment of Sir Thomas Bingham MR in Bolton v Law Society [1994] I WLR 512, 517-519 where his Lordship set out the general approach that has to be adopted. In particular he pointed out that, since the professional body is not primarily concerned with matters of punishment, considerations which would normally weigh in mitigation of punishment have less effect on the exercise of this kind of jurisdiction. And he observed that it can never be an objection to an order for suspension that the practitioner may be unable to re establish his practice when the period has passed. That consequence may be deeply unfortunate for the individual concerned but it does not make the order for suspension wrong if it is otherwise right. Sir Thomas Bingham MR concluded, at p 519: "The reputation of the profession is more important than the fortunes of any individual member. Membership of a profession brings many benefits, but that is a part of the price."
Mutatis mutandis the same approach falls to be applied in considering the sanction of erasure imposed by the committee in this case.'"