Dr. Marta Stefan Appellant
The General Medical Council Respondent
Delivered the 5th April 2001
|Lord Nicholls of Birkenhead|
|Lord Hobhouse of Woodborough|
|Sir Philip Otton|
[Delivered by Sir Philip Otton]
1. This is an appeal by Dr. Marta Stefan from a decision of the Health Committee of the General Medical Council given on 30th October 2000, whereby the Committee adjudged that Dr. Stefan's fitness to practise was seriously impaired and from a direction 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 from 1967, limited registration from 1979 and provisional registration from 1985. Since 1993 the Appellant has appeared before the Health Committee on a number of occasions when the Committee has found that her fitness to practise was seriously impaired on health grounds. On 27th May 1999 the Committee determined that her registration should be suspended for twelve months with immediate effect and her subsequent appeal to this Board was dismissed.
3. In the decision now challenged the Committee having considered all the information presented to them, and having paid particular attention to Dr Stefan's answers to their questions and her observations regarding her fitness to practise said:
"The Committee have also taken careful note of the opinions of the medical examiners. They have noted, in particular, the view expressed by the examiners that you still have limited insight into the nature of your condition. In the light of all the evidence, the Committee have judged your fitness to practise to be seriously impaired by reason of a condition classified in the ICD-10 Classification of Disorders as F60.0 – paranoid personality disorder. In particular the Committee have felt that you exhibited the following characteristics of this disorder: suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; a tendency to experience excessive self-importance, manifest in a persistent self-referential attitude; and a preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to yourself and in the word at large.
The Committee have carefully considered whether it would be sufficient to direct that your registration should be subject to conditions, so that you may return to some form of medical practice. In this regard they have noted the views of the medical examiners that you may be fit enough to do so.
The Committee have also noted the views of the examiners that your medical condition is less manifest than previously. However, the Committee consider that your ability to make sound professional judgments is seriously affected by your medical condition and they are concerned that the above aspects of your condition may present themselves more actively if you were to be under specific emotional or other pressures such as stress at work.
The Committee have, therefore, decided that it is necessary to direct that your registration be suspended for a further period of 12 months. This period will begin on 25 November 2000 unless you lodge an appeal in the interim on a question of law."
4. In her petition the Appellant submitted that the Health Committee were wrong to find her "guilty of negative personality", was critical of the conduct of the Committee and contended that her rights under Article 6 of the European Convention of Human Rights had been infringed. She appeared before their Lordship's Board in person, in a courteous address repeated many of her submissions and handed in a written statement. In essence, she maintains that there are no health grounds preventing her from practising as a doctor.
5. By section 40(5) of the Act of 1983 an appeal lies to the Board only on a question of law.
6. In reaching its conclusion the Committee was entitled to take into account the information before it which included psychiatric reports submitted by Dr Lachlan Campbell and Dr. T. H. Turner, the oral evidence of Dr. Campbell and the responses of the Appellant during the hearing. It cannot be said that there was no evidence on which the Committee could have concluded as it did; on the contrary, the outcome was inevitable. There was no error of law, or procedure, or infringement of Dr. Stefan's Convention or statutory right to a fair hearing.
7. The remainder of the points raised by the Appellant concern the correctness of the decision itself and background events. None of these matters reveals a question of law either as to the decision to suspend registration or as to the decision that the suspension should take immediate effect.
8. Accordingly, their Lordships will humbly advise Her Majesty that this appeal ought to be dismissed with costs.