The Judicial Committee of the Privy Council Decisions

Bhadra v. Medical Act 1983 (General Medical Council) [1999] UKPC 6 (10th February, 1999)

Privy Council Appeal No. 58 of 1998

Dr. Tushar Kanti Bhadra Appellant

v.

The General Medical Council Respondent

FROM

THE PROFESSIONAL CONDUCT COMMITTEE

---------------

JUDGMENT OF THE LORDS OF THE JUDICIAL

COMMITTEE OF THE PRIVY COUNCIL,

Delivered the 10th February 1999

------------------

Present at the hearing:-

Lord Steyn

[Delivered by Lord Steyn]

------------------

1. This is an appeal by the appellant under Section 40 of the Medical Act 1983 from a determination and directions of the Professional Conduct Committee (the PCC) of the General Medical Council made under Section 36 of the Act of 1983.

 

2. The appellant is nearly 60 years of age. He qualified in 1962. He has worked in the United Kingdom since 1972. In the last twelve years he has worked only as a locum. He has been employed in many posts including some work in Accident and Emergency departments of hospitals. In January 1997 he obtained employment as a Locum Staff Grade doctor in a busy Accident and Emergency Department at Northampton General Hospital. The matters giving rise to these proceedings occurred in January 1997 two days after he took employment at the hospital. He was engaged under a contract that could be terminated at any time. His employment was terminated in January 1997.

 

3. After a two day hearing the PCC found proved against the appellant three central facts, namely that -

 

(1) he had on 8th January 1997 refused to examine a 75- year-old patient admitted with central chest pain thereby placing the patient at risk (paragraph 3);

 

(2) he had on the same day examined a 47-year-old asthmatic patient who was suffering from severe breathlessness and left the patient in the resuscitation room without making adequate arrangements for his care thereby placing the patient at risk (paragraph 4);

 

(3) the appellant knew that he did not have sufficient clinical knowledge and skill to perform the duties reasonably expected of a Staff Grade Doctor in an Accident and Emergency Department (paragraph 6).

 

4. The PCC determined that the appellant was guilty of serious professional misconduct and directed that the appellant’s name be suspended from the Register for 12 months. In addition the PCC directed that it was necessary for the protection of members of the public that the appellant’s registration be suspended with immediate effect.

 

5. In a careful argument counsel for the appellant submitted that the specific findings of fact under paragraphs 3 and 4 were "not justified". When those arguments were tested it became clear that there was ample evidence to support the findings. The real complaint was that the PCC rejected the appellant’s explanations. It is unnecessary to review the evidence against and for the appellant. As it was fully entitled to do, the PCC rejected the appellant’s explanations and accepted contrary accounts by hospital staff. This part of the appellant’s argument must be rejected.

 

6. Counsel for the appellant submitted that, even if the specific allegations in paragraphs 3 and 4 stand, the general finding in paragraph 6 that the appellant knew that he did not have sufficient clinical knowledge and skill to perform the relevant duties was unwarranted. In coming to this conclusion the PCC specifically rejected the option of finding that the appellant should have known that he did not have the necessary knowledge. In the result the PCC made a strong finding. Their Lordships have carefully examined the competing arguments on this point. The principal argument on behalf of the appellant was that his real experience lay in the surgical field, and that the two specific cases raised problems beyond his experience. It was said that he was simply being ultra cautious. Their Lordships are satisfied that the PCC was entitled to conclude that this is not a tenable position for a Staff Grade Doctor in a busy Accident and Emergency Department. The two incidents involving severe chest pains in the case of an elderly patient and severe breathlessness in the case of an asthmatic patient, are common occurrences in Accident and Emergency Departments. The PCC was entitled to conclude that the appellant must have known in advance that he would be unable to cope with such problems. The arguments against the finding under paragraph 6 must be rejected.

 

7. The challenge to the finding that the appellant was guilty of serious professional misconduct must now be examined. The framework in which this issue must be considered is the specific findings contained in paragraphs 3 and 4 (elderly patient with chest pains and the asthmatic patient) and the general finding in paragraph 6 that the appellant knew when he commenced work in the Accident and Emergency Department that he did not have sufficient clinical knowledge to act as a Staff Grade Doctor in an Accident and Emergency Department. In these circumstances the further finding by the PCC of serious professional misconduct was justified. The contrary argument is rejected.

 

8. Lastly, Counsel for the appellant submitted that the penalty of suspension, which was directed to apply with immediate effect was disproportionate. The adverse impact on the appellant is great, and Counsel submitted that the PCC wrongly rejected the lesser alternative of imposing conditions in respect of the type of work the appellant would be allowed to do in future. Given the findings of fact in this case, and the duty to protect the public, their Lordships are satisfied that the directions made by the PCC were lawful and in the particular circumstances well within its discretion. There is no reviewable error.

 

9. Their Lordships humbly advise Her Majesty that the appeal ought to be dismissed.