Pool v General Medical Council [2014] EWHC 3791 (Admin)

A consultant psychiatrist, Dr P, succeeded in his appeal against a suspension order of three months which was imposed after allegations relating to his role as an expert witness in a hearing before the Health Professions Council were found proved. The High Court found that the fitness to practise panel of the GMC had been entitled to find that Dr P was not an expert in the relevant field and that it had given adequate reasons for its finding. However, a three month suspension was disproportionate, and a condition preventing him from acting as an expert witness for a period of three months was a proportionate sanction.

Background

In August 2011, Dr P accepted instructions to act as an expert witness in a case against a paramedic known as A who had been diagnosed with personality disorder and post-traumatic stress disorder caused, in part, by abuse suffered as a child.

Dr P prepared an expert report and, at the hearing in March 2012, A objected to Dr P's evidence on the basis that he did not have sufficient experience in the field of personality disorders to qualify as an expert. Dr P's evidence was not heard. A referred Dr P to the GMC.

At a hearing before a fitness to practise panel, Dr P faced allegations relating to his status as an expert and the content of his report. Dr P argued that he had gained enough practical work experience to be considered an expert, despite not being on the relevant GMC Specialist Register or a member of the relevant Royal College, and not having published in any relevant peer-reviewed journals.

The GMC and Dr P both called expert evidence but the panel preferred the evidence of the GMC's expert. It found the allegations against Dr P proved and that they amounted to misconduct and his fitness to practise was impaired. It imposed a suspension order of three months after noting that it judged that Dr P lacked insight and that the imposition of conditions would not be proportionate to the misconduct.

The appeal

Dr P submitted that the panel had been wrong in the findings it had made on the allegations, that it had failed to provide adequate reasons, and that the sanction imposed was unnecessary and disproportionate.

The court found against Dr P except in relation to the sanction, where it found the decision of the panel flawed for two reasons. Firstly, although the panel had stated that it was not possible to formulate conditions that would enable Dr P's lack of insight to be remediated, it had gone on to state that the misconduct could be remediated by the development of insight, which could be facilitated by a suspension of three months.

Secondly, the panel stated that its only area of concern in relation to Dr P's fitness to practise was in relation to his holding himself out as an expert in certain fields. There was no criticism of his clinical work. The sanction of suspension would not only prevent him from acting as an expert witness in cases where he was not competent but would also prevent him from working as a clinician and from acting as an expert witness in those areas where he was qualified to call himself expert.

The court found that “Proportionality requires that there is a reasonable relationship between the penalty imposed and the misconduct giving rise to the impairment… the imposition of a sanction which not only addressed the need to ensure that doctors did not act in fields outside their professional competence, but also prevented them from acting in areas within their professional competence and from carrying on their clinical practice was disproportionate”.

Accordingly, the three month suspension was replaced by a condition preventing Dr P from acting as an expert witness in fitness to practise cases for three months.