The Judicial Committee of the Privy Council Decisions

Saxena v. The General Medical Council (Medical Act 1983) [2000] UKPC 3 (7th February, 2000)

Dr. Ram Pratap Saxena Appellant

v.

The General Medical Council Respondent

FROM

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JUDGMENT OF THE LORDS OF THE JUDICIAL

COMMITTEE OF THE PRIVY COUNCIL,

Delivered the 7th February 2000

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Present at the hearing:-

Lord Nicholls of Birkenhead

Lord Clyde

Sir Andrew Leggatt

[Delivered by Sir Andrew Leggatt]

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1. Dr. Ram Pratap Saxena appeals to Her Majesty in Council from a determination and direction of the Professional Conduct Committee ("the PCC") of the respondents, the General Medical Council ("the GMC") made on 21st July 1999 by virtue of which under section 36(1)(i) of the Medical Act 1983 his name was directed to be erased from the Medical Register after 28 days unless he exercised his right of appeal. The PCC further ordered that Dr. Saxena's registration be suspended with immediate effect.

 

2. The PCC found two charges proved:

 

(A) that at Manchester Crown Court on 5th January 1998 following pleas of guilty Dr. Saxena was convicted on two counts of attempting to pervert the course of justice, for which he was sentenced to a total of 9 months' imprisonment, and

 

(B) that Dr. Saxena was guilty of serious professional misconduct in relation to (1) his treatment of a patient Shenneth Henry, and (2) many dishonest statements in his curriculum vitae and in job applications relating to his professional practice.

 

3. The two parts of charge B had nothing in common with each other except that both were alleged to constitute serious professional misconduct.

 

4. The conviction the subject of charge A arose out of an attempt by Dr. Saxena to procure a witness to give false evidence on his behalf at his trial for road traffic offences, and out of a further similar attempt on appeal. The prosecution case at his trial for perverting the course of justice was that on 3rd June 1995 Dr. Saxena's car had collided with another car. Both drivers got out of their cars, but Dr. Saxena then drove off without having identified himself. Interviewed by the police, he said that his car had not been involved in an accident, and that at the material time he had not been driving it. He was charged with offences of failing to stop after an accident, failing to report an accident and driving without due care and attention. Before the trial on 28th February 1996 he was alleged to have asked Miss Shirley Roachford, a registered mental nurse at Strangeways Prison where he also held an appointment, to give him a false alibi by asserting that he was treating an inmate at the time of the accident. He offered her money if she complied. She refused and informed the prison authorities. Dr. Saxena was convicted. He appealed to the Crown Court. Before the hearing of the appeal on 10th May 1996 he again approached Miss Roachford, instructing her on several occasions to say that at the time of the accident he was dealing with a violent inmate. He again offered her money. These instructions were covertly recorded. When arrested he denied all impropriety.

 

5. Dr. Saxena was charged with two offences of attempting to pervert the cause of justice, to each of which he pleaded guilty at Manchester Crown Court. The Court heard that on 21st December 1982 at Cardiff Crown Court Dr. Saxena had been convicted on six counts of obtaining property by deception and sentenced to 12 months’ imprisonment on each count concurrent, three months to be served and the remainder suspended. In respect of these offences the PCC had suspended his registration for 12 months. In course of an appeal to the Board he argued then, as he has before their Lordships on the present occasion, that his convictions, which he admitted, were wrong and unjust. The appeal was dismissed. After remarking that the offences with which he was concerned were serious offences against public justice, the judge at Manchester Crown Court said that Dr. Saxena "must have known when he committed each of those offences that they were offences of dishonesty and that they would be considered by the Court against the background of what happened in 1983 [sic]". Sentences totalling 9 months’ imprisonment were imposed. In his sentencing remarks the judge made plain that although on the day on which the road traffic offences were committed the book kept at the prison showed arrival and departure times that spanned the time of the offences, he accepted the evidence that a person such as Dr. Saxena could, without reference to the book, leave the prison in his car and come back again an hour later, and it would not have to be entered in the book. Nonetheless in aid of his argument that he could not have committed the road traffic offences because he was in the prison, Dr. Saxena tendered to their Lordships the excerpt from the gate occurrence book which showed his arrival and departure times on the day in question.

 

6. When announcing the findings of the PCC the Chairman said to Dr. Saxena:-

"As far as the conviction is concerned, your behaviour in attempting to bribe a witness to give false evidence at the trial for a relatively minor motoring offence and again before the hearing of the appeal following your conviction was reprehensible. Such conduct demonstrates an utter lack of honesty and integrity on your part. The Committee are particularly concerned that the offences arose in connection with your work as a doctor practising as you were within the prison service at that time and the witness also being an employee of the prison."

 

7. When making the direction now appealed against and the order for suspension the Chairman emphasised that the Committee would have made both the direction and the order had they only been considering either charge A or charge B.

 

8. Before their Lordships Dr. Saxena, who conducted his own appeal, put in a Skeleton Argument which was permitted to stand as his Case. It is a diffuse document running to 10 pages. These submissions were elaborated in a Reply to the respondents’ Case, running to 17 pages, and were also developed orally. The Reply stressed what Dr. Saxena described as "racialist" features of the charges. For ease of exposition it is convenient to attempt to summarise Dr. Saxena's argument. He claims that he was working in the prison at the time of the accident and so could not have been party to it, and that the gate occurrence book supports him. He says that he was sacked as medical officer of the prison because he believed that an inmate had been murdered, and had not committed suicide, as the authorities asserted. The police concocted the charges of perverting the course of justice on the instructions of the prison governor. Despite the fact that he caressed Miss Roachford, with whom he said he was on intimate terms, he did not detect any listening device concealed upon her. What he was recorded as saying was all rubbish. Dr. Saxena told their Lordships that he wrongly pleaded guilty to the offences of perverting the course of justice through automatism, and also through pressure from his counsel and solicitor, who asked him not to give evidence because he had been poisoned by insulin accompanied by lack of food. He said that the judge at Manchester Crown Court also suffered from automatism, and was affected during his sentencing remarks by an epileptic fit which delayed the proceedings for 15 minutes. The judge would not allow Dr. Saxena to change his solicitor or counsel, and refused an adjournment. He had a preconceived idea that there was no alternative to a custodial sentence. The conviction should have been disregarded because it was under appeal. He also submitted that a custodial sentence had not been merited having regard to his help for the community in Aberafon and Hackney, his research, the books he has written, and the international conferences he has attended.

 

9. Before the Board Dr. Saxena put in a report from a consultant neurologist Dr. Jeffrey Gawler of 2nd December 1999, which recorded an indication from the referring General Practitioner that there had been a change in Dr. Saxena's personality with a tendency to paranoia. Dr. Gawler concluded that "at the present time, the nature of Dr. Saxena's episodes of disturbed consciousness is uncertain". The General Practitioner in his own report of 15th July 1999 confirmed that Dr. Saxena's medical history included "Mental illness characterized by groundless and persecutory delusions ...".

 

10. Dr. Saxena pleaded guilty to both counts of attempting to pervert the course of justice; his conviction, now over two years old, was admitted and proved; and his application for leave to appeal against sentence was refused by the single judge, and not renewed. Reference has been made to grounds of appeal dated 16th April 1999, in which complaint is apparently made about Dr. Saxena's solicitor and counsel, but they have not been produced. The PCC was entitled to refuse a further adjournment and to proceed with the hearing. It was conducted fairly and in accordance with correct legal principles. Dr. Saxena has no basis for impugning his conviction. Charge A was thus established. In the light of his previous conviction and suspension, the direction and order for suspension made by the PCC were in all respects proper, were necessary for the protection of the public, and in their Lordships’ judgment are unassailable. In relation to charge A that conclusion was reached without reference to charge B. So it is fatal to this appeal.

 

11. Since, however, the appeal was also brought in respect of charge B, their Lordships will briefly refer to that aspect. Charge B alleged serious professional misconduct by Dr. Saxena in two main respects: first, his misconduct in relation to the examination of Shenneth Henry, and in relation to her medical records, and in asking her for donations, and secondly, his misconduct in submitting job applications concerning his medical practice which contained statements that were false and misleading. As to the first, Dr. Saxena admitted that as her doctor he was consulted by Ms. Henry on three occasions in November and one in December 1992. Ms. Henry and her mother gave evidence before the PCC. Ms. Henry said that she was not examined during any of the consultations. Her medical records were before the PCC, as was Dr. Saxena's letter asking for donations. In relation to this part of charge B the findings of the PCC were expressed by the Chairman thus:-

"As regards your treatment of Ms. Henry, the Committee make no criticism of your failure to examine her when she first visited you on 3 November 1992. However, on her subsequent visits to you when she informed you that her symptoms were persisting and that she was deteriorating you should have examined her to assess her condition and to decide on the appropriate treatment which she so clearly needed. The standard of care you provided fell well below that which Ms. Henry was entitled to expect and which a competent doctor should provide."

 

12. Although Dr. Saxena did not give evidence before the PCC, nor did he call any, he nevertheless submitted that the allegations about Ms. Henry were word against word. He claimed that he did not give evidence before the PCC because he could not read (due to a stitch in his eye following a cataract operation), and because he was subject to fainting fits. Dr. Saxena said that he did examine Ms. Henry, albeit over her clothes in order to avoid a false allegation of misbehaviour, such as she had made before. She was put up to her account by others. The PCC should not have concluded that the records were misleading: they were 100% accurate. Even if Ms. Henry had sent money in response to his letter asking for donations, he would have returned it. He also submitted orally that there was no neglect of any of his duties. In default of any evidence from Dr. Saxena himself or otherwise to suggest that the PCC's findings of fact were wrong, they are findings which the PCC were not only entitled, but were peculiarly well qualified, to make, and there is no basis for their Lordships to disturb them.

 

13. The other part of the charge concerning serious professional misconduct related to false statements in documents. Dr. Saxena admitted that his date of birth was given as 10th December 1948 in CV’s submitted to the Locum Group in October 1993 and July 1996; in an application form dated 4th November 1995 for a part-time post as medical officer at HM Prison, Risley; in an application dated 30th November 1995 to join the General Practitioner list of Manchester FHSA; and in an application dated 16th June 1997 to join the General Practitioner list of Wigan and Bolton Health Authority. He also admitted that in his Risley application he had stated that he had not been convicted of a criminal offence. The PCC found proved all the admitted facts. The date of birth given in these documents was to be contrasted with the application made in 1968 to the respondents for full registration in which Dr. Saxena gave his date of birth as 10th December 1940, and with other indications that he must have been born before 1948.

 

14. In his concluding remarks the Chairman said to Dr. Saxena:-

"On several occasions you obtained, or attempted to obtain, employment by providing false and misleading information about your age and, on one occasion, your criminal history. Patients and employers or potential employers are entitled to expect that information provided by doctors about such charges is accurate and reliable. The Committee are appalled by the catalogue of your dishonesty and at the cavalier attitude you took to such important matters."

 

15. Before their Lordships Dr. Saxena contended that his then wife Kalpana Kaushal had been having a relationship with a police informer called William Mitton (or Milton), in consequence of which the police would not register any complaint against her. He said that she was very corrupt. She forged his birth certificate and typed fake testimonials which she gave to the police. She altered his application for employment and his CV. He reported the matter to the police on eight occasions, but without avail. When his official date of birth was 1940, he used 1940: when it was 1948, he used 1948. He expanded orally upon this assertion by explaining that because his passport said "1948", he adopted it, and that it was not done dishonestly. He did not, however, refer to any attempt to have the date in his passport changed. Before the PCC there was no evidence to support his assertion that he did not act dishonestly. On the contrary, the evidence before them was consistent only with the "catalogue of … dishonesty" in a professional context which they found and deplored.

 

16. Despite Dr. Saxena's voluble asseverations both in writing and orally that he was not guilty of either part of charge B, their Lordships are not persuaded that there was any other conclusion available to the PCC in relation to charge B than that to which they came: that the conduct of Dr. Saxena referred to in it amounted to serious professional misconduct. Once again they considered the charges independently of each other. Under charge B having regard to its gravity they directed the erasure of Dr. Saxena's name from the Register, and for the protection of the public they ordered that his registration be suspended forthwith.

 

17. For these reasons the findings of the PCC together with their direction and order in relation to both charges were unimpeachable; and accordingly their Lordships will humbly advise Her Majesty that the appeal should be dismissed with costs.