This case concerns two section 40A appeals under the Medical Act 1983, brought by the GMC concerning a MPT hearing in August 2016 and the subsequent review hearing in August 2017. The GMC’s section 40A power is new, (it came into force on 31 December 2015), and this is one of the first appeals on sanction using the s30A power.

The case concerns allegations against Dr Stone arising from an emotional and sexual relationship with a vulnerable patient, Patient A, and dishonesty in respect of a failure to declare that relationship in correspondence relating to Patient A’s claim for benefit.

The GMC appealed the original MPT decision on sanction on the basis that a 12 month order of suspension with a review, was unduly lenient. The basis of their application was that:

  1. The MPT had failed to apply the Sanctions
  2. Disproportionate weight was given to medical evidence produced on behalf of Dr Stone when considering sanction.
  3. There was a failure to give appropriate weight to the issue of dishonesty.
  4. The sanction was wrong given the seriousness of the misconduct.

Following the original MPT hearing the doctor’s case was reviewed by a separate MPT in August 2017, who concluded that Dr Stone’s fitness to practise was no longer impaired.

The outcome

The original decision by the MPT on the 4 August 2016 was quashed and substituted with an order of erasure under section 40A(6) of The Medical Act 1983. No order was made in respect of the second appeal in regarding the review hearing on the 12 August 2017.

Key points from the Judgement

The Judge upheld three of the grounds of appeal that were advanced by the GMC. They were:

  1. The MPT either misconstrued or failed to consider the Sanctions guidance. Particular reference was made to paragraphs 52, 102, 103, 127, 139 and 144 of the Sanctions Guidance. The MPT should have specifically addressed those paragraphs in its determination on sanction to make it clear that the misconduct had been balanced against the mitigating features of the case. Referring to the Sanction Guidance in general is not sufficient to indicate “the MPT grappled with the seriousness of this case.”(para 53)
  2. Disproportionate weight was placed on medical evidence when considering the extent to which this mitigated the gravity of the doctor’s conduct.
    1. Personal mitigation in a disciplinary context “carries far less weight than it might in the domain of criminal law, because all three elements of the tripartite public interest are always in play.”(para 58)
    2. in evaluating the weight to be given to Dr Hook’s evidence the MPT should have proceeded on the premise that it had set out in its Stage 2 Determination: namely, that the doctor “made a series of conscious and moral choices to behave in this way with a vulnerable patient over a prolonged period”(para 58)
    3. the wider public interest is not upheld by tribunals accepting expert evidence of this nature, and applying a “plausible and psychologically coherent narrative” to the issues under scrutiny.’” (para 61)
  3. The MPT did not give appropriate weight to the issue of dishonesty in this case.

The Judge did not uphold the fourth ground which was that the MPT’s sanction was simply wrong in the light of the seriousness of the doctor’s misconduct meaning that the only appropriate sanction could be erasure.

The full Judgement is available at:

GDC v Stone 2017] EWHC 2534 (Admin)