The Judicial Committee of the Privy Council Decisions

Privy Council Appeal No. 7 of 1996

Dr. Jyoti Kumar Agarwala Appellant

v.

The General Medical Council Respondent

FROM

THE PROFESSIONAL CONDUCT COMMITTEE

OF THE GENERAL MEDICAL COUNCIL

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ORAL JUDGMENT OF THE LORDS OF THE JUDICIAL

COMMITTEE OF THE PRIVY COUNCIL,

Delivered the 7th October 1996

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Present at the hearing:-

Lord Browne-Wilkinson

Lord Steyn

Lord Cooke of Thorndon

  ·[Delivered by Lord Browne-Wilkinson]

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1. The appellant, Dr. Agarwala, appeals from the determination and direction of the Professional Conduct Committee of the General Medical Council dated 5th February 1996 that he had been guilty of serious professional misconduct and that his name be erased from the Register.

2. The matter being inquired into by the Professional Conduct Committee arose from the charge against Dr. Agarwala that he had forged two letters, one dated 7th October 1994 and the other dated 29th October 1994, both letters purporting to come from the Salford Research Ethics Committee and giving approval to Dr. Agarwala undertaking particular research projects.  The appellant was present at the Committee hearing and was represented by counsel.  At the hearing he, through his counsel, admitted the facts contained in the charge and it remained for the Committee to reach a conclusion whether those facts justified a finding that he had been guilty of serious professional misconduct and if so what the penalty should be.

  In the course of the hearing the Committee had before it a list of the research projects in which the appellant had sought approval from the Ethics Committee and it emerged that he had been engaged very substantially in research projects.  In particular the attention of the Committee was drawn to the fact that Dr. Agarwala had on an earlier occasion, namely on 13th September 1995, been charged before the Professional Conduct Committee with forging a different letter, also containing a supposed consent from the Ethics Committee.  At that earlier hearing the doctor explained that that forgery then before the Committee, which in fact took place after the two forgeries which are the subject matter of the present charge, was the result of a rash, impulsive and stupid act the like of which he had never committed before.  He therefore persuaded the Committee on that earlier occasion that this was a one-off aberrance.  Following that earlier appearance before the Professional Conduct Committee the two further forgeries the subject of the present charges were discovered, thereby demonstrating that the answer given to the Professional Conduct Committee in September 1995 was a lie.

3. The Professional Conduct Committee found that Dr. Agarwala had been guilty of serious professional misconduct and determined that his name should be erased from the Register.  On this appeal, Mr. Fordham, who did not appear before the Professional Conduct Committee, has said everything that could possibly be said on the appellant's behalf.  He has first accepted that the commission of these forgeries constitutes professional misconduct.  However, he submitted that the sentence of erasure was wrong in that it prevented the doctor from carrying on his practice at all, though the offences relate purely to the research aspect of his job.  In all these cases, as Mr. Fordham said, erasure is a very serious penalty, not only in terms of professional standing, but also because it removes the ability to earn a living.  He has emphasised a substantial number of testimonials from individual patients of the doctor, saying that he was a good doctor, a compassionate doctor and in one instance at least that he had conducted the trials of drugs with care and understanding.  In addition since the hearing before the Professional Conduct Committee there has been a petition signed by some 1200 people.

4. Mr. Fordham stressed that the purpose of the Research Ethics Committee is to supervise the research proposed and to ensure that the doctor in question can participate without prejudicing the treatment of his patients.  As to the former, other the Ethics Committees had approved the research.  As to the latter the testimonial letters show that the research could not have prejudiced the patients who are so satisfied with his services.  Mr. Fordham suggests that the function of the disciplinary Committee has three elements: first to punish, secondly to ensure that the doctor cannot cause damage and thirdly to uphold the standing of the medical profession.

5. The offence in this case, forgery on three occasions, which was not improved by lies told to the Professional Conduct Committee is in the view of their Lordships serious misconduct of a grave kind.  It is difficult to say that the punishment meted out even looked at in isolation is excessive.  As to the prevention of damage to the public the Chairman in announcing the decision of the Professional Conduct Committee said:-

"Doctors engaged in research must be scrupulously honest since decisions about the future treatment of patients may be made on the assumption that the word of a doctor can be relied on.  Doctors engaged in research who betray that trust damage the reputation of medical science and may put patients directly at risk."

6. That is a view expressed by the professional body in charge of the supervision of the conduct of doctors.  It has for many years been the approach of this Board that it will not intervene in decisions as to the suitability of the penalty unless the direction of the Professional Conduct Committee is plainly wrong or unjustified.  Their Lordships find it impossible to say that, given the severity of the offence and, given the view taken by the professional body as to the serious consequences that can flow from it, the decision of the Professional Conduct Committee can be described as plainly wrong or unjustified. Therefore despite Mr. Fordham's eloquent appeal to this Committee their Lordships will humbly advise Her Majesty that the appeal ought to be dismissed.  The appellant must pay the respondent's costs.

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