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You are here: BAILII >> Databases >> The Judicial Committee of the Privy Council Decisions >> Graf v. The General Medical Council The Health Committee of the GMC [1997] UKPC 61 (10th December, 1997) URL: http://www.bailii.org/uk/cases/UKPC/1997/61.html Cite as: [1997] UKPC 61 |
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Privy
Council Appeal No. 47 of 1997
Dr.
Roland Graf Appellant
v.
The
General Medical Council Respondent
FROM
THE
HEALTH COMMITTEE OF THE
GENERAL
MEDICAL COUNCIL
---------------
JUDGMENT OF THE LORDS
OF THE JUDICIAL
COMMITTEE OF THE PRIVY
COUNCIL,
Delivered the 10th
December 1997
------------------
Present at the hearing:-
Lord Slynn of Hadley
Lord
Steyn
Lord
Hope of Craighead
·[Delivered by Lord Slynn of Hadley]
-------------------------
1. On
24th June 1996 the Health Committee of the General Medical Council constituted
under Schedule I Part III paragraph 22 of the Medical Act 1983 directed that
Dr. Roland E. Graf's registration as a medical practitioner be suspended for a
period of twelve months. The reason for
that direction was that the Committee judged Dr. Graf's fitness to practise to
be seriously impaired by reason of his mental condition. He did not appeal against that decision
within the twenty eight days provided by section 40(3) of the 1983 Act. On 25th June 1997 the Health Committee at a
resumed hearing under Part IV of the General Medical Council Health Committee
(Procedure) Rules Order of Council 1987 were deeply concerned about his mental
condition, again judged his fitness to practise to be seriously impaired and
directed that his registration be suspended for a further period of twelve
months.
By petition dated 21st July 1997 Dr. Graf
appealed against that direction.
2. Before
their Lordships Dr. Graf appeared in person.
It was explained to him that an appeal from a decision of the Health
Committee lay only on a question of law by reason of section 40(5) of the Act
of 1983. He nevertheless wished to
explain, and their Lordships listened to, a number of grievances about which he
feels deeply.
3. The
background can be stated shortly. Dr.
Graf qualified as a doctor in 1969. He
has not practised since 1974 when he gave up practice, largely it seems through
problems with his eye sight. He does
not now wish to practise as a doctor.
4. In
1981 he asked to be exempted from paying the annual registration fee because of
illness and subsequently because of financial problems. He was advised by the General Medical
Council to apply for his name to be removed from the Register. He did not wish to do that. By letter dated 7th December 1981 he was
told that the Council would need to consider whether he was fit to
practise. He was eventually interviewed
by two consultant psychiatrists on 5th March 1982 who, by reports each dated
18th March 1982, found that he was not suffering from a mental illness but that
he was suffering from a personality disturbance which was likely to affect his
ability to practise as a doctor. By
letter dated 20th April 1983 the General Medical Council agreed that his case
would not be referred to the Health Committee if he undertook to continue to
refrain from practice and to agree that the Health Screener appointed by the
Medical Council might request periodic reports from Dr. Graf's general
practitioner. The General Medical
Council considering that those undertakings had been given, he was told that no
further action would be taken in his case.
5. In
1995 the General Medical Council received information appearing to come from
the Fosse Health Trust that Dr. Graf had applied for a post as a clerical
officer with the Trust. Having
considered the application the Health Screener took the view that Dr. Graf
should be re-examined to see whether he was fit to practise. In the light of that and subsequent
correspondence his case was referred to the Health Committee under rule 9(3) of
the Rules. Further correspondence took
place leading to the meeting of the Health Committee on 24th June 1996 when his
registration was suspended. He has taken a number of points which, whether or
not they are technically open to him on this appeal, can shortly be dealt with.
6. In the
first place he objected to the Health Committee sitting in private. That they were plainly bound to do by virtue
of rule 17(1) of the Rules.
7. He
said next that there was no information raising a question as to whether his
fitness to practise was seriously impaired by reason of his physical or mental
condition. If his case had begun under
rule 6 of the Rules, the application for the post of clerical officer and the
letters from Dr. Graf were capable of constituting such information. The proceedings, however, were under rule 9
where, undertakings having been given, if thereafter as a result of a report
from a medical supervisor or from other information it appears to the President
that the doctor's "physical or mental condition has otherwise deteriorated
he may then refer the case to the [Health] Committee". Here it seems to their Lordships that in the
correspondence and in the application form there was information on which the
President could properly refer the case to the Health Committee.
8. He
then complained that neither the Registrar under rule 12(1) nor the Committee
indicated "the physical or mental condition by reason of which it is
alleged that his fitness to practise is seriously impaired". It is accepted, he said, that he was not
suffering from a mental illness, and mental disorder is not specific enough to
be, and is not in any case, a mental condition within the meaning of the
rule. Since Dr. Graf was unwilling in
1996 to undergo a medical examination and in the light of the earlier reports of
his personality disturbance or disorder it was obviously difficult for a
precise diagnosis to be made.
In Crompton
v. The General Medical Council (No. 2) [1985] 1 WLR 885 their Lordships'
Board accepted that an indication of "mental disorder" could, if a
more precise clinical diagnosis was difficult, be a sufficient notice of the
mental condition relied on. Whilst it
is desirable that as precise a notification as is possible of the mental
condition relied on should be given, their Lordships consider, as did the Board
in Crompton, that in the present case a sufficient indication of the
"mental condition" was given as to enable the appellant to deal with
it. Finally as to the hearing he
alleges that the notification of the Health Committee's decision was prepared
before the meeting of the Committee.
There is nothing to support that.
The Chairman of the tribunal told him that the determination was
"written and approved by us immediately before you came in the
room". That clearly meant that it
had been prepared after the parties had withdrawn and before he was re-admitted
to the hearing following the Committee's deliberation in camera.
9. His
overriding submission, however, is that he is not suffering from a mental
condition such as seriously to impair his fitness to practise within the
meaning of section 37 of the 1983 Act.
This is essentially a question for the Health Committee and not one of
law for their Lordships. No issue of
law or procedure, apart from those to which reference has been made, has been
raised by Dr. Graf upon which their Lordships could possibly interfere with the
decision of the Health Committee.
Without referring to the voluminous bundle of letters from Dr. Graf
which was produced to the Health Committee and to their Lordships it is
sufficient to say that there was clearly material before the Committee upon
which they could conclude as they did.
10. Their
Lordships will humbly advise Her Majesty that the appeal should be dismissed.
© CROWN COPYRIGHT as at the date of
judgment.