QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
B e f o r e :
|GENERAL MEDICAL COUNCIL||(DEFENDANT)|
Computer-Aided Transcript of the Stenograph Notes of
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MR A DE LA ROSA (instructed by Lloyd & Associates, London) appeared on behalf of the CLAIMANT
MR G CLARKE (instructed by Inhouse Legal Team, GMC) appeared on behalf of the DEFENDANT
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"Every appeal to which this paragraph applies must be supported by written evidence and if the court so orders oral evidence and will be by way of re-hearing."
That would seem to take precedence over the provisions of rule 52.11, which provides:
"Every appeal will be limited to a review of the decision of the lower court unless -
(a) a practice direction makes different provision for a particular category of appeal; or
(b) the court considers that in the circumstances of an individual appeal it would be in the interests of justice to hold a re-hearing."
"'The principles upon which this Board acts in reviewing sentences passed by the Professional Conduct Committee are well settled. It has been said time and again that a disciplinary committee are the best possible people for weighing the seriousness of professional misconduct, and that the Board will be very slow to interfere with the exercise of the discretion of such a committee ... The committee are familiar with the whole gradation of seriousness of the cases of various types which come before them, and are peculiarly well qualified to say at what point on that gradation erasure becomes the appropriate sentence. This Board does not have that advantage nor can it have the same capacity for judging what measures are from time to time required for the purpose of maintaining professional standards.'"
Those observations relate to sentence but can be applied mutatis mutandis to findings of serious professional misconduct. Lord Millett went on:
"For these reasons the Board will accord an appropriate measure of respect to the judgment of the committee whether the practitioner's failings amount to serious professional misconduct and on the measures necessary to maintain professional standards and provide adequate protection to the public. But the Board will not defer to the committee's judgment more than is warranted by the circumstances..."
And it would obviously be a dereliction of my duty if I were simply to say, "The Committee are the experts, they formed the view that the conduct fell sufficiently far below that to be expected of a general practitioner and therefore amounted to serious professional misconduct". On the other hand, I must and do attach considerable weight to that finding on the basis that they indeed are the experts and they know what is required by the profession.
"Son phoned and asked for a home visit. His mother is ill in bed for 2 days. Not eating, losing weight, getting chest pain. Dr N arranged a home visit by deputy."
Then in relation to the Sunday call he records:
"Son phoned and asked for a home visit on his mother as she is ill for 2 days, not eating. Dr N explained that he should have brought in the visit slip. He became annoyed and threatened. Doctor N gave him Medicall's [that is the deputy service] Tel No to contact directly for a visit."
"'Good Medical Practice' (both October 1995 and May 2001, which were current at the time of the respective events) also states that 'Patients are entitled to good standards of practice and care from their doctors', that doctors 'must listen to patients and respect their views' and it makes clear that doctors must provide and arrange investigations or treatment where necessary. Your response to the requests for treatment made on behalf of Mrs [H] on 29 January 1998 and 1 February 1998 fell below the standards which would normally be expected of a general practitioner in that you failed to put yourself in a position to assess accurately the needs of the patient, did not take full account of the information provided to you and failed to communicate your intended actions clearly to the representative of the patient. These serious failures, which could have compromised the treatment of your patient were compounded by your inconsiderate approach to Mrs [H]'s relatives, whom you recognised to be anxious and distressed, when they attempted to provide details of their condition."
"Your treatment of Mr [R] in 2001 has also highlighted serious shortcomings in your practice. You failed, despite several contacts from the Social Services, to place yourself in a position to assess adequately Mr [R]'s condition. Nevertheless, you referred Mr [R] to Dr Rands for an opinion and treatment, giving the impression that you had carried out an examination without having done so. Good Medical Practice states that 'you must not sign documents which you believe to be false or misleading'. Your actions in this regard were unacceptable as you were not in a position to know whether this was an appropriate referral and had not been able to assess the seriousness of his condition."
"The Committee have taken account of the submissions of Counsel and the advice of the Legal Assessor in determining whether your conduct in these cases amounted to serious professional misconduct. The Committee recognise some of the difficulties inherent in inner-city practice. Nevertheless, your practice has fallen seriously short of the standards expected from a General Practitioner. The Committee are also concerned at your lack of insight into the deficiencies in your practice and your failure to accept responsibility for these shortcomings. The Committee have therefore found you guilty of serious professional misconduct."