Crabbie v General Medical Council
| Jurisdiction | UK Non-devolved |
| Judge | Lord Scott of Foscote |
| Judgment Date | 23 September 2002 |
| Neutral Citation | [2002] UKPC 45 |
| Date | 23 September 2002 |
| Court | Privy Council |
| Docket Number | Appeal No. 7 of 2002 |
[2002] UKPC 45
Privy Council
Present at the hearing:-
Lord Steyn
Lord Scott of Foscote
Sir Philip Otton
On 11th July 2002, after hearing very helpful submissions from Mr Jenkins for the appellant and from Miss Vaughan Jones for the General Medical Council, their Lordships announced that they would humbly advise Her Majesty that the appeal ought to be dismissed for reasons to be given later. These are the reasons.
The appeal is against a direction given by the Professional Conduct Committee of the General Medical Council on 9th January 2002 that the name of the appellant, Elizabeth Morag Crabbie, be erased from the register.
The story is a tragic one. On 25th April 1999, Mrs Crabbie, while driving on the A94 towards Perth, failed to negotiate a left hand bend and veered onto the wrong carriageway. Her vehicle struck an oncoming car. The driver, aged 59 was killed. The passengers, his wife and 12 year old son, were seriously injured. Mrs Crabbie herself was seriously injured. A blood test taken at Perth Royal Infirmary disclosed that she had in excess of 240 mg of alcohol in 100 mm of blood. The legal limit is 80 mg. She was over three times above the legal limit.
She was in due course charged with causing death by dangerous driving and with driving after consuming so much alcohol that the proportion of it in her blood exceeded the prescribed limit. On 11th April 2000 she pleaded guilty to both charges in the High Court of Justiciary in Edinburgh and was convicted accordingly. On 25th April 2000 she was sentenced to five years' imprisonment and was disqualified from driving for ten years.
The convictions were reported to the General Medical Council who instituted disciplinary proceedings. The case was heard by the Professional Conduct Committee (the PCC) on 9th January 2002. Medical evidence before the PCC indicated that at the time of the accident the appellant had been exhibiting features of an alcoholic dependency and counsel for the appellant asked for the case to be referred to the Health Committee to be dealt with by that committee rather than by the PCC.
The PCC accepted that the appellant's fitness to practise might be seriously impaired by reason of alcohol dependency but, in view of the serious nature of the criminal convictions, refused the request for the case to be referred to the Health Committee. They took oral and written character evidence, testifying to the appellant's worth as a citizen, and, particularly, as a respected and valuable general practitioner in a rural area of Scotland. But they concluded that:
"… the nature and gravity of the offence in this case is such that the sanctions of conditions and suspension would not adequately protect the public interest."
and that in the public interest:
"… erasure is the only appropriate sentence."
They added that in their view:
"… erasure is proportional to the nature and gravity of the offence."
The appellant has appealed to the Privy Council. Her counsel, Mr Jenkins, who was also her counsel before the PCC, has put before their Lordships two grounds of appeal. First, it is submitted that the PCC erred in not referring the case to the Health Committee to be dealt with by them. Second, it is submitted that the decision to erase the appellant's name from the register was wrong in principle and manifestly excessive. The case should, it is said, have been dealt with by imposing conditions ensuring that, after her release from prison, the appellant did not resume medical practice until she was fit to do so.
A review of the PCC's handling of the case must start with a reference to the relevant statutory provisions which regulate the conduct of disciplinary proceedings instituted by the General Medical Council. The governing Act is the Medical Act 1983, as amended. Section 36(1) of the Act applies to two situations; first, where a doctor is found by the PCC to have been convicted in the British Islands of a criminal offence; second, where a doctor is judged by the PCC to have been guilty of serious professional misconduct. In either of these situations the PCC is empowered "if they think fit" to direct that the doctor's name be erased from the register, or that the doctor's registration be suspended for a period not exceeding twelve months, or that the doctor's registration be conditional on his compliance for a period not exceeding three years with such requirements as the PCC "think fit to impose for the protection of members of the public or in his interests".
Where the PCC has directed a suspension it has power to extend the suspension for a further period (not exceeding twelve months) or to direct that on the expiry of the suspension registration be conditional on compliance by the doctor with specified requirements.
Schedule 4 to the Act confers a rule-making power on the General Medical Council. The rules do not come into force until approved by the Privy Council (see para 1(5) of the Schedule). The relevant rules, duly made by the General Medical Council and approved by the Privy Council, are the General Medical Council Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules 1988, which came into effect on 15th January 1989.
Whether the case is based on a criminal conviction or is based on the conduct of the doctor, it is first placed before a "medical screener" (see rules 5 and 6). In the case of a conviction, the medical screener may, if it appears to him that the doctor's fitness to practise may be seriously impaired by a physical or mental condition, take steps to have the case dealt with under the Health Committee (Procedure) Rules (see rule 7). Otherwise the medical screener must refer the case to the Preliminary Proceedings Committee. The appellant's case must have been so referred.
The Preliminary Proceedings Committee, after considering the case, may refer the case to the PCC for inquiry, or refer the case to the Health Committee for inquiry, or decide to refer the case to neither committee (see rule 11(1)). In this way trivial convictions that do not warrant any inquiry proceedings, whether by the PCC or by the Health Committee, are weeded out. As to a reference to the Health Committee, rule 11(4) says that:
"When referring a case to the Health Committee the Committee [ie the Preliminary Proceedings Committee] shall indicate the nature of the alleged condition by reason of which it appears to them that the fitness to...
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R (Rogers) v General Medical Council
...to the Health Committee if they had first rejected erasure as a sanction, following the decision of the Privy Council in Crabbie v General Medical Council [2002] 1 WLR 3104 at paragraph 19. 22 As to Mr Jenkins' second point, Miss Sullivan submits that conditions are "intended to control the......
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...as a health case. The application was opposed by GMC's counsel and refused by the Panel … Applying rule 10(4) and Crabbie v GMC [2002] 1 WLR 3104 (PC), the Panel considered that it could not exclude the possibility that at the end of the case it might (as, in fact, it did) direct that Dr V......