The Judicial Committee of the Privy Council Decisions

JUDGMENT OF THE LORDS OF THE JUDICIAL

COMMITTEE OF THE PRIVY COUNCIL,

Delivered the 13th December 1999

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Present at the hearing:-

Lord Nicholls of Birkenhead

[Delivered by Lord Nicholls of Birkenhead]

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1. This is an appeal by Dr. Bodh Kanchan pursuant to section 40 of the Medical Act 1983 following a determination and direction of the Professional Conduct Committee of the General Medical Council made on 10th July 1998. Dr. Kanchan was found guilty of serious professional misconduct, and the Committee directed that his name should be erased from the medical register after twenty-eight days unless he exercised his right of appeal. The Committee also ordered that Dr. Kanchan's registration should be suspended forthwith.

 

2. The hearing before the Professional Conduct Committee took place over five days, from 6th to 10th July 1998. Experienced counsel, instructed by the solicitor to the Medical Defence Union, represented Dr. Kanchan. The charges concerned the quality of the care given by Dr. Kanchan to two National Health Service patients registered on his list. He was responsible for their general medical care. The facts admitted or proved were as follows. On 3rd June 1995 he was consulted in his surgery by Anthony "X", a fourteen year old boy. Dr. Kanchan found him to be jaundiced with a tender and enlarged liver. He diagnosed viral hepatitis. On the following day, 4th June, Dr. Kanchan was telephoned by Anthony's mother, Mrs. X, and told that Anthony was no better. On the next day, 5th June, Mrs. X telephoned again, at 8.30 a.m. She told Dr. Kanchan that Anthony had deteriorated further, and asked him to visit Anthony at home. Dr. Kanchan did not visit Anthony, but he advised Mrs. X to take Anthony to the accident and emergency department at West Middlesex University Hospital. Dr. Kanchan did not make adequate arrangements for Anthony's referral to hospital. On 7th June Mrs. X had a further telephone conversation with Dr. Kanchan. She reported further deterioration in Anthony's condition. Dr. Kanchan did not visit him at his home even though he had information which should have indicated to him that a visit was necessary. He failed to initiate adequate arrangements to ensure Anthony received the treatment he required.

 

3. The second patient was an elderly man, Mr. "Z". On 5th December 1995 Mr. Z was admitted to Teddington Memorial Hospital under arrangements made by Dr. Kanchan. He did not give written instructions to the nursing staff about the medication to be administered to Mr. Z on that day, nor had he prepared a care plan for Mr. Z. On 12th December, at around 8.15 p.m., Dr. Kanchan visited Mr. Z in hospital. He decided to transfer him immediately to West Middlesex University Hospital, but he did not undertake an adequate examination of Mr. Z before deciding to make the transfer. Dr. Kanchan did not prepare a letter of referral or addendum to the medical notes to explain the purpose of the referral, nor did he make adequate arrangements to tell West Middlesex University Hospital of the referral. Throughout Mr. Z's stay in Teddington Memorial Hospital Dr. Kanchan did not conduct a detailed examination of him in order to assess his condition and treatment needs. Dr. Kanchan did not respond adequately to the test results with which he was supplied, nor did he maintain adequate medical records.

 

4. When announcing the determination of the Committee, the chairman stated that the facts proved demonstrated that Dr. Kanchan had fallen well below the professional standards patients are entitled to expect, particularly in his disregard for vulnerable patients, both young and old.

 

5. In support of his appeal Dr. Kanchan lodged a substantial volume of material. At the hearing of the appeal he presented his own case. Dr. Kanchan advanced full and reasoned submissions on why the Committee's determination was flawed. He sought to show, regarding each of the disputed findings, that the conclusions of the Committee were wrong, and that there was no question of misconduct. The findings were out of line with the evidence. Witnesses changed their stories more than once and contradicted themselves. Their evidence was unreliable. There were inconsistencies between the evidence of different witnesses, and contradictions between oral and documentary evidence. The charges could not be regarded as proved beyond reasonable doubt. Dr. Kanchan sought to introduce further evidence, some of peripheral relevance, some irrelevant and inadmissible. He criticised the conduct of other persons professionally involved in the two cases. He produced many testimonials to his character and competence. His professional standards had never previously been queried. The sentence was harsh.

 

6. Their Lordships have carefully considered all this material, in the light of Dr. Kanchan's submissions. They have not been persuaded that any case has been made out for the admission of such of the further evidence as was relevant and admissible. They consider that the Committee could properly make the findings it did on the evidence before it. The Committee took an extremely serious view of the conduct thus disclosed. Their Lordships consider it was open to the Committee to do so.

 

7. Their Lordships will humbly advise Her Majesty that this appeal should be dismissed and that the direction for erasure of Dr. Kanchan's name from the medical register should now take effect. Dr. Kanchan must pay the respondent's costs of his appeal to their Lordships' Board.