Dr Magdi Selim v General Medical Council

JurisdictionEngland & Wales
CourtQueen's Bench Division (Administrative Court)
JudgeMr Justice Kerr
Judgment Date29 Apr 2016
Neutral Citation[2016] EWHC 1865 (Admin)
Docket NumberCO/6662/2015

[2016] EWHC 1865 (Admin)

IN THE HIGH COURT OF JUSTICE

QUEEN'S BENCH DIVISION

THE ADMINISTRATIVE COURT

The Courthouse

1 Oxford Row

Leeds

West Yorkshire

LS1 3BG

Before:

Mr Justice Kerr

CO/6662/2015

Between:
Dr Magdi Selim
Appellant
and
General Medical Council
Respondent

The Claimant appeared in Person

Mr Paul Ozin QC (instructed by General Medical Council) appeared on behalf of the Defendant

Mr Justice Kerr
1

Dr Selim, the appellant, is a qualified general practitioner. He qualified in Egypt in 1988 as a doctor and became a member of the Fellow of the Royal College of Surgeons in Dublin in 1995. He holds other medical qualifications including a diploma in pharmacy from Newcastle University Medical School and he qualified in this country as a general practitioner in 2000. In 2005 he began a GP practice in Brierley and about five or six years later took in two other partners to that practice who were also doctors, Dr I and Dr J.

2

In 2010, around the time when he was setting up his partnership with the other two doctors, a disciplinary matter arose concerning an official form that he had completed relating to a patient's travel to New Zealand, and amendments to that patient's records. In fitness to practise proceedings in 2010, that was found to have been done in a misleading and dishonest way, and the panel on that occasion found that his fitness to practise was impaired but decided, after considering steps taken by him to remedy the misconduct, to take no further action on his registration.

3

In 2013, further disciplinary matters arose from certain conduct in August 2010. In that matter, Dr Selim admitted that he had in August 2010 submitted documentary portfolio, as evidence in support of an interim "membership by assessment of performance" application to the Royal College of General Practitioners; and that the content of that documentary portfolio was inaccurate and misleading. In that matter, the panel subsequently found in 2013 that the alterations to the portfolio had been "targeted, focused and systematic" and that they had been made for "professional gain".

4

That matter was adjudicated upon in March 2013. As a result, Dr Selim was suspended from practice for six months commencing on 4 April 2013. I am not, in this appeal, directly concerned with those two prior disciplinary matters but I mention them as part of the chronological history and because they become relevant later to the question of sanction.

5

In May 2013, written complaints were made against Dr Selim by his two partners in the GP practice at Brierley. It is clear from the documents that I have been shown that there has been a serious falling out between, on the one side, Drs I and J and, on the other, Dr Selim.

6

On 3 September 2013, a fitness to practise panel hearing took place and was in the nature of a review hearing. That review hearing went in Dr Selim's favour. The panel noted that there had not then been any repetition of his dishonest behaviour, and he had kept his knowledge up to date. It concluded that his fitness to practise was not impaired by reason of his misconduct; but that his then current suspension would last until 3 October 2013, when the six month period was due to expire.

7

Following the expiry of that suspension period an assessment exercise took place at a Holiday Inn hotel from 4 to 6 November 2013. That was for the purpose of assessing Dr Selim's levels of performance. It was conducted in a manner, the details of which I need not go into, which involved an assessment process by reference to comparisons with other doctors.

8

The result was that although Dr Selim achieved a relatively good score for operative and technical skills (60.75%) by reference to "simulated surgery", the overall finding was that his performance was "unacceptable" in five areas giving "cause for concern". In one other area — operative and technical skills — his performance was found to be "acceptable". The decision to that effect was recorded in a document signed on 28 January 2014 by the doctor whom I assume was the lead assessor, Dr Parsons.

9

The outcome of that exercise led to the imposition of an interim suspension on Dr Selim, with the consequence that he was not able to return to his medical practice. Over the following year or so, there was a process of correspondence and investigations, the detail of which I will not recite. It included allegations and counter-allegations as between Dr Selim and Drs I and J, leading ultimately to the formulation of charges against Dr Selim in a document not dated but, I am told, produced in around the start of 2015.

10

The investigation phase was thus concluded, and charges laid against Dr Selim. They were lengthy and quite detailed. The first group of charges centred on allegations of pressurising a dispenser of pharmacological products at the practice into signing a written testimonial for Dr Selim, prepared by him, which she allegedly signed reluctantly and under pressure. There were multiple allegations of wrongful access to medical records including those of Drs I and J, and the children of one of them, during a period of suspension. There were allegations of words spoken to the practice manager, known as "colleague H", to the effect that Dr Selim would "bring Dr I down" or "get Dr I and Dr J out" and other intemperate accusations against them of lying and the like.

11

There was an allegation of misleading colleague H about Dr Selim's reason for gaining access to the medical records I have already mentioned, by saying, allegedly falsely, that it was at the request of the General Medical Council (GMC). There was an allegation that Dr Selim had wrongfully given colleague H a written warning arising from her involvement in the GMC's investigation into Dr Selim's conduct. There was an allegation of writing, for selfish reasons, a callous and inappropriate letter to the bereaved parents of a deceased daughter, in which blame was laid at the door of Dr J; and there were other allegations concerning unauthorised use of the deceased girl's medical records.

12

Those were the allegations subsequently found proven. There were others that were subsequently found not proven, which I therefore need not go into in detail. There was in addition an allegation of deficient professional performance arising from the assessment in November 2013.

13

Eventually the matter came before a panel of the Medical Practice Tribunal Service (MPTS) and the matter was heard over some 16 days in the period from September to December 2015. Dr Selim was represented by counsel throughout although not always the same counsel. In the usual way, the GMC was legally represented and there was a legal assessor available to give advice to the members of the panel.

14

It has been suggested by Dr Selim today that the procedure before the panel and its composition were such as not to amount to a fair hearing. As Mr Ozin QC has for the GMC has pointed out, the procedure is well recognised as compliant with ordinary standards of fairness and I am confident that there is nothing in the complaint that the process was in a general sense flawed whether by reason of the composition of the panel or otherwise.

15

The panel heard evidence from a number of witnesses: including Dr Parsons, the lead assessing doctor; Dr Clowes, another performance assessor; the dispenser, known as colleague A; Dr I; Dr J; colleague H and others, and not least from Dr Selim himself. After hearing, in the usual way, submissions from each of the parties in relation to the charges, the panel gave its written determination on the facts on 17 November 2015.

16

After recording areas of factual common ground and its assessment of the witnesses, the panel proceeded to record its findings and reasons for them. I should say that the panel's assessment of Dr Selim was that he was a disingenuous witness whom they found evasive and who (it was said in paragraph 25 of the first determination) had developed his "own interpretation of events and documents over time and many aspects of [his] evidence were neither credible nor reliable."

17

The panel, it is sufficient to say, preferred the evidence of other witnesses to that of Dr Selim on all matters where there was a factual conflict. Thus it accepted, for example, the evidence of colleague A that she had not written the testimonial and that she had signed it under pressure from Dr Selim, who denied writing it and pressurising colleague A to sign it. In relation to disclosure of the medical records of Drs I and J, the panel rejected Dr Selim's assertion that he made those disclosures out of a genuine public health concern, arising from an allegation by him that one of his two colleagues had attempted to cover up diagnosis of a particular dangerousness illness.

18

The panel found that Dr Selim did not have any genuine public health concern and had made the disclosures for the improper purpose of discrediting his colleagues rather than protecting...

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    ...obvious reasons. C. The law and applicable principles 23 Kerr J most usefully set out the applicable principles recently in Dr Magdi Selim v General Medical Council [2016] EWHC 1865 (Admin) as follows: "26 Those then are in brief the facts. Dr Selim appeals against the erasure decision......

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