R.  (on the application of Alhy) v General Medical Council [2011] EWHC 2277 (Admin)

A Panel does not need to give reasons for imposing a sanction more onerous than that imposed by a body from another country.

The appellant, Dr A, was convicted of two offences by the Magistrates Court in Chartres, France in September 2006, in relation to the deaths of two of Dr A’s patients in 2000.

Dr A was originally sentenced to 12 months imprisonment (suspended); a 4000 Euro fine; and damages to the victims’ families.  On appeal to the Court of Appeal in Versailles in May 2008, his appeal was rejected but the sentence was varied, reducing the fine by half and banning Dr A from practising as a surgeon (but notably not as a general physician) for three years.  Dr A appealed to the Supreme Court and again this appeal was rejected.

The French regulatory body for doctors, the Ordre de National de Medicins (ODM) informed the GMC of Dr A’s ban on 27 October 2009, some seven months later.  The GMC instigated its own fitness to practise procedures, the conclusion of which was that on 21 January 2011 Dr A was found guilty of misconduct and the Panel ordered erasure from the Register.

Dr A appealed.  It was submitted on his behalf that the Panel should give reasons and state in clear and simple terms why it had departed from the sanction previously imposed by the ODM, preferring a different and significantly more onerous sanction.

The appeal was dismissed.  If the GMC should have to explain reasons for departing from the sanction or penalty of a foreign authority, that would require investigation of the penalty decision-making process for the relevant fellow European body, a task that would require the Panel to go outside their remit and beyond their competency.  Rather, the original Panel had rightly assessed matters in accordance with the GMC’s statutory purpose and good medical practice.  On reading the original Panel’s decision it was clear why the sanction of erasure had been arrived at.  The decision took into consideration not only the convictions in France and Dr A’s lack of insight in maintaining his innocence after the exhaustion of all criminal processes and appeal, but also the failure of Dr A to report his convictions to the GMC. The GMC rejected Dr A’s submission that he was entitled to rely on the ODM to notify the GMC finding instead that he had a personal obligation to advise the GMC himself.

The decision reconfirmed the GMC’s autonomy in retaining its decision making processes by reference to its own statutory basis.  Whilst recognising that the purpose of the European Union is to facilitate collaboration between Member States, there is no hierarchy between the professional bodies of those states.