The Judicial Committee of the Privy Council Decisions

COMMITTEE OF THE PRIVY COUNCIL,

Delivered the 22nd November 1999

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Present at the hearing:-

Lord Slynn of Hadley

[Delivered by Lord Slynn of Hadley]

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1. Dr. Stefan appeals from a decision of the Health Committee of the General Medical Council on 27th May 1999 that her registration as a doctor should be suspended for a period of twelve months pursuant to section 37(1)(a) of the Medical Act 1983 and that such suspension should have immediate effect pursuant to section 38(1) of that Act.

 

2. Dr. Stefan was given temporary registration as a medical practitioner in the United Kingdom from 1967, limited registration from 1979 and provisional registration from 1985. From 1993, however, she appeared before the Health Committee for them to consider whether her fitness to practise was "seriously impaired by reason of [her] physical or mental condition". On 21st June 1993 and on 20th June 1994 her registration was made subject to conditions for periods respectively of eight months on the basis that her fitness to practise was seriously impaired. Subsequently on 23rd February 1995 when she refused to agree to conditions her registration was suspended for eight months and on 21st February 1996 and 24th February 1997 respectively further suspensions of twelve months were ordered. Appeals to the Board against the decisions of 21st June 1993, 23rd February 1995 and 24th February 1997 were dismissed.

 

3. On 23rd February 1998 the Committee ordered indefinite suspension but on 8th March 1999 her appeal was allowed by the Board since reasons for indefinite suspension on the ground of unfitness to practise were not given.

 

4. In the decision now challenged the Committee said that having considered the written and oral evidence "the Committee have judged your fitness to practise to be seriously impaired by reason of paranoid personality disorder". They continued:-

"In reaching this finding the Committee have had regard to paragraph 24(2) of their procedure rules. The Committee do not consider that your cardiac condition is relevant to your fitness to practise.

 

The Committee have carefully considered whether it would be sufficient to direct that your registration should be subject to conditions, so that you could return to medical practice. However, they take the view that your medical condition could seriously affect your ability to make sound professional judgments.

 

They are concerned in particular by the evidence that your condition is a continuing and episodic one.

 

Accordingly, whilst noting Dr. Adams’ opinion on your fitness to practise, the Committee have felt bound to direct that your registration be suspended for a period of 12 months.

 

The Committee have further determined that it is necessary for the protection of members of the public, and would be in your own best interests, to order that your registration be suspended forthwith."

 

5. Rule 24(2) of the Procedure Rules provides:-

"In reaching their judgment the Committee shall be entitled to regard as current serious impairment either the practitioner's current physical or mental condition, or a continuing and episodic condition, or a condition which, although currently in remission, may be expected to cause recurrence of serious impairment."

 

6. Dr. Stefan in her case set out many criticisms of the Health Committee, of things which she contended had been said about her and the way the proceedings had been conducted. In addition she set out her contentions as to the merits of the decision. At the hearing before the Board she challenged the accuracy and honesty of the transcript of the hearing before the Committee and denied that she was in any way suffering from paranoia.

 

7. In the written evidence given by Dr. Adams, a psychiatrist who examined her, it was said that she was now able to control the expression of her opinions about her colleagues and minority groups but that "any emotional disturbance that might occur would be liable to precipitate paranoid comments". In his written opinion he wrote that "Dr. Stefan is able to practise on a limited basis in her chosen speciality under Consultant supervision and with medical supervision from the GMC". In his oral evidence he said that he thought "perhaps she could [practise] under supervision" but that the condition was a continuum and that problems could occur under stress. Members of the Committee and the clinical assessor of the Committee, a psychiatrist, asked many questions. On the basis of the answers to those questions and the written report, it cannot be said that there was no evidence on which the Committee could conclude as it did.

 

8. The remainder of Dr. Stefan’s submissions go to the correctness of the decision and as to the way events of the past had been taken out of context. They raise matters for the Committee but they do not show any question of law either as to the decision to suspend registration or as to the decision that the suspension should take immediate effect.

9. Accordingly since by section 40(5) of the Act of 1983 an appeal lies to the Board only on a question of law, their Lordships will humbly advise Her Majesty that this appeal ought to be dismissed.