Dr Sherine Amin Hendawy Ibrahim v General Medical Council
| Jurisdiction | England & Wales |
| Judge | Mr Justice Julian Knowles |
| Judgment Date | 07 February 2024 |
| Neutral Citation | [2024] EWHC 131 (Admin) |
| Year | 2024 |
| Court | King's Bench Division (Administrative Court) |
| Docket Number | Case No: CO/3899/2022 |
[2024] EWHC 131 (Admin)
Mr Justice Julian Knowles
Case No: CO/3899/2022
IN THE HIGH COURT OF JUSTICE
KING'S BENCH DIVISION
ADMINISTRATIVE COURT
Royal Courts of Justice
Strand, London, WC2A 2LL
Stephen Vullo KC (instructed by Twelve Tabulae) for the Appellant
Alexis Hearnden (instructed by GMC Legal) for the Respondent
Hearing dates: 20 April 2023
Approved Judgment
This judgment was handed down remotely at 10.30am on 7 February 2024 by circulation to the parties or their representatives by e-mail and by release to the National Archives.
Introduction
This is an appeal by Dr Sherine Ibrahim, the Appellant, under s 40 of the Medical Act 1983 against decisions of the Medical Practitioners Tribunal (MPT) dated 12, 14 and 20 September 2022. In its decisions the MPT found that the Appellant had acted dishonestly in submitting inaccurate timesheets when working as a Locum Surgical Registrar for the Maidstone and Tunbridge Wells NHS Trust (the Trust), also that he had lied to the Trust during an investigation, and therefore had committed serious misconduct. It found his fitness to practice was impaired by his misconduct, and ordered his name be erased from the Register.
The appeal is brought against all three limbs of the MPT's decisions.
The General Medical Council (GMC), which is the Respondent, resists the appeal.
The Appellant was represented by Mr Vullo KC and the GMC by Ms Hearnden, neither of whom appeared below.
Mr Vullo relied on his full and comprehensive Perfected Grounds of Appeal (Grounds), and Ms Hearnden produced a Skeleton Argument for the appeal. I am grateful to both of them. As well as my notes, I have consulted recordings of the hearing in preparing this judgment.
In the Bundle is a single comprehensive Determination by the MPT on the facts; on misconduct; on impairment; and on sanction. There are also separate decisions on each of these matters dated 12 September 2022, 14 September 2022 and 20 September 2022 respectively. Save for some anonymisation they are identical to the comprehensive Determination. In this judgment I will refer to the single comprehensive Determination, and paragraph references are to that document unless otherwise stated.
Factual background
Dr Ibrahim qualified as a doctor in 1990 with a Licentiate in Medicine and Surgery of the Society of Apothecaries (LMSSA), London. At the time of the MPT hearing he was 71 years old. I accept, as Mr Vullo submitted, that before this matter arose he had had an unblemished and distinguished record of service in the NHS going back over many years. There were numerous testimonials before the MPT (Bundle, pp647–665) about his qualities as a doctor and a colleague which it took into account, in particular at the impairment stage and the sanction stage.
Dr Ibrahim started working for the Trust in around 2013 and apart from one short break, remained there until August 2019 when he was dismissed for gross misconduct, including some of the matters which formed part of the GMC's case against him before the MPT.
The Trust had two hospital sites, at Tunbridge Wells (where Dr Ibrahim predominantly worked) and at Maidstone. The allegations that led to the MPT hearing can be summarised as follows.
Dr Ibrahim worked as part of the Trust's internal staff bank on a zero hours contract. This meant he was not guaranteed hours and would be allocated shifts, whenever needed, in order to fill gaps in the Trust's rota (see [19]).
In order to get paid for the work he undertook, he was required to complete timesheets, setting out his ‘start’ and ‘finish’ times, his ‘breaks taken’ and ‘total hours worked’. Breaks were not paid, whether they were taken by him or not. In the evidence they were sometimes referred to as ‘lunch breaks’. He was paid by the hour, at a rate of £65 per hour.
It was said that between 2 March 2018 and 8 March 2019, whilst working for the Trust, Dr Ibrahim dishonestly submitted timesheets claiming for work undertaken when he knew he had not worked until the shift finish times claimed on the timesheets. In very simple terms, car park exit times obtained by the Trust during its investigation often showed Dr Ibrahim exiting the car park at a time before the shift ‘finish time’ as declared on his timesheets. Sometimes he left more than 120 minutes before his declared shift finish time. Counsel prepared a helpful schedule of particularly early departures by Dr Ibrahim. For example, on 2 April 2018 he left two hours and 33 minutes early; on 19 April 2018: one hour 37 minutes; and 14 June 2018, one hour and 44 minutes. As I will discuss later, Dr Ibrahim's explanation for these particularly early departures was that he had been asked to go over to the Maidstone site to assist.
Each time sheet covered a week, from Monday – Sunday. Each contained a declaration of truth, which Dr Ibrahim was required to sign, which included the following statement:
“I confirm that the hours submitted are a true record of the hours worked and overtime I am entitled to claim. I understand that if I knowingly give false information this may result in disciplinary action and I may be liable for prosecutions and civil recovery proceedings…”
The timesheets then had to be countersigned by a manager, after which Dr Ibrahim would be paid.
In 2019, as a result of an unrelated incident, Dr Ibrahim was suspended by the Trust and an investigation commenced.
In the course of the investigation, the timesheets Dr Ibrahim had submitted between March 2018 and March 2019 were reviewed and compared to entry and exit data obtained from the car park at the Tunbridge Wells site. This revealed around 149 dates when he had exited the car park earlier than the ‘finish’ time stated on his timesheet for the relevant date. It also revealed some dates when he exited the car park later than the stated ‘finish’ time.
By way of example, on the timesheet for the week including Wednesday 28 March 2018 (Bundle, p406), on that day Dr Ibrahim put down an 8:00am start, a 17:30pm finish, a 30 min break, and he claimed payment for a total of nine hours. The car park data showed that on that day he exited at 16.28pm, 62 minutes before his declared shift ‘finish’ time.
The claims on days of early departures were suspected to be fraudulent by the Trust, and Dr Ibrahim was therefore made subject to internal Trust disciplinary proceedings. There were other allegations which I am not concerned with (and which have been redacted in the documents). He was summarily dismissed for gross misconduct in August 2019, and an internal appeal was rejected.
One of the GMC's allegations was that on 10 May 2019, during an interview with the Trust as part of its internal investigation, Dr Ibrahim was dishonest in relation to a statement he made about why he had adopted the practice of leaving early. There was also an issue about the length of time it took him to complete Part 5 Cremation forms, however that has now fallen away, as I shall explain.
Counsel for the GMC opened the case to the MPT as follows:
“Mr Ibrahim was, however, referred to the GMC on 2 January of 2020 by Dr Sarah Mumford. She was the Deputy Medical Director for that Trust. Dr Mumford informed the GMC that during the period of March 2018 to March 2019, it had been alleged that the doctor, Mr Ibrahim, had consistently and systematically falsified claims on timesheets for work that he had not done. It was said in the referral that, although the times stated on the timesheets – and those are timesheets completed by the doctor – matched the times that his shifts had been booked for, car park barrier data showed that in fact he had regularly left work in advance of the times stated on the timesheets.”
The allegations
The allegations before the MPT, and Dr Ibrahim's response at the outset of the hearing, were as follows:
“That being registered under the Medical Act 1983 (as amended):
1. Between 2 March 2018 and 8 March 2019, whilst working for Maidstone and Tunbridge Wells NHS Trust (‘the Trust’), you:
a. submitted timesheets (‘the Timesheets’) claiming for work undertaken until the purported end times of your shifts as set out in Schedule 1;
Admitted and found proved
b. exited the Trust's car park at the times as set out in Schedule 1.
Admitted and found proved
2. You knew you did not work until the shift end times claimed on the Timesheets.
Admitted and found proved
3. Your actions as described at paragraph 1.
a. was dishonest by reason of paragraphs:
a. 1. b.;
To be determined
b. 2.
To be determined
4. In an interview with the Trust on 10 May 2019 in respect of the:
a. inconsistencies on the Timesheets set out in Schedule 1, you stated that:
i. you had adopted a practice whereby you did not take a lunch break and instead deducted time from the end of your working day (‘the Practice’);
Admitted and found proved
ii. the Practice came about following a discussion with Dr A.
Admitted and found proved
b. completion of Part 5 Cremation forms, you stated that it takes approximately ten minutes (‘the Time Estimate’) to fully complete one form.
Admitted and found proved
5. You knew that:
a. you had not been told to adopt the Practice;
Admitted and found proved
b. the Time Estimate given was untrue.
To be determined
6. Your actions as described at paragraph(s):
a. 4. a. i. and 4. a. ii. were dishonest by reason of paragraph 5. a.;
To be determined
c. 4. b. was dishonest by reason of paragraph 5. b.
To be determined
And that by reason of the matters set out above your fitness to practise is impaired because of your misconduct.
To be determined”
The first few lines of Schedule 1 illustrate how it was set out (Bundle, p57):
| Date | End time claimed via... |
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