R (Gupta) v General Medical Council
| Jurisdiction | UK Non-devolved |
| Judge | Lord Rodger of Earlsferry |
| Judgment Date | 21 December 2001 |
| Neutral Citation | [2001] UKPC 61 |
| Court | Privy Council |
| Docket Number | Appeal No. 44 of 2001 |
| Date | 21 December 2001 |
Present at the hearing:-
Lord Steyn
Lord Hobhouse of Woodborough
Lord Rodger of Earlsferry
Privy Council
[Delivered by Lord Rodger of Earlsferry]
On 1 June 2001 the Professional Conduct Committee of the respondent Council ("the Committee") found the appellant, Dr Prabha Gupta, guilty of serious professional misconduct, directed that her name be erased from the register, found that it would be in the appellant's own best interests that her registration should be suspended with immediate effect and accordingly ordered that her registration be suspended forthwith. On 13 June the appellant lodged and served her petition of appeal to their Lordships' Board under section 40 of the Medical Act 1983. On 22 June the appellant issued proceedings in the High Court under section 38(6) of the 1983 Act seeking the termination of the immediate suspension of her registration. On 25 July 2001 the Administrative Court quashed that part of the Committee's decision in which it ordered that the appellant's registration should be terminated forthwith: The Queen (Gupta) v General Medical Council The Times 16 October 2001. The effect of the order of the Administrative Court was to permit the appellant to continue to practise pending the determination of her appeal to the Board.
Where a case has been referred to the Committee for inquiry, rule 17 of The General Medical Council Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules Order in Council 1988 (as amended) requires the solicitor appointed by the respondent Council to send the medical practitioner concerned a notice of inquiry specifying "in the form of a charge or charges, the matters into which the inquiry is to be held". The charge against the appellant before the Committee was in these terms:
"1. a On 9 March 1996, Dr R P Gupta was found guilty of serious professional misconduct, and a direction made that his name be erased from the Register. A direction was also made that his registration should be suspended with immediate effect;
b following the lodging, and subsequent withdrawal of an appeal, Dr Gupta's erasure took effect on 25 July 1996, and Dr Gupta has not been registered with the GMC since this date;
2. Dr R P Gupta
a. was in 1996 and is your husband;
b. in March 1996 was your partner;
3. you were aware of the matters set out at heads 1 and 2 above;
4. a. between about May 1996 and about December 1998 Dr R P Gupta took part in consultations which you held with various patients who attended your surgery premises at 8 St Kilda Road, Ealing, London W13 9DE, and 59 Rutland Road, Southall, for medical services;
b. you permitted Dr R P Gupta to take part in such consultations;
5. a. between about May 1996 and about December 1998 Dr R P Gupta held consultations with various patients who attended your surgery premises at 8 St Kilda Road, Ealing, London W13 9DE, and 59 Rutland Road, Southall, for medical services;
b. you knew that Dr R P Gupta was holding consultations with patients;
6. a. in or around mid-1997 you were made aware that Dr R P Gupta had recently given an MMR injection to a child;
b. in or about July 1998 you were aware that Dr R P Gupta
i. had been consulted by Mrs 'A' at the Southall surgery premises;
ii. had written a referral letter for Mrs 'A' to Ealing Hospital;
7. a. you permitted Dr R P Gupta to hold consultations with patients at your surgery premises;
b. you failed to prevent Dr R P Gupta holding consultations with patients at your surgery premises."
As can be seen from heads 1 and 2, the Dr R P Gupta referred to in the charge is the appellant's husband whose name was erased from the register for serious professional misconduct in 1996. The allegations in heads 4, 5, 6 and 7 relate to instances where he was said to have acted as a medical practitioner in the appellant's practice.
Before the Committee the appellant admitted the allegations in heads 1, 2 and 3. Addressing the appellant, the chairman explained the Committee's decision on the allegations in the charge in these terms:
"Dr Gupta, having carefully considered all the evidence, the Committee have made the following findings of fact in your case. Heads 1, 2 and 3 of the charge have been admitted and found proved. Heads 4(a) and 4(b) have not been found proved. Heads 5(a) and 5(b) have been found proved. Heads 6(a), 6(b)(i) and 6(b)(ii) have been found proved. Heads 7(a) and (b) have been found proved."
The only other passage in the transcript which gives any indication of the Committee's thinking about the evidence on the facts is to be found in its determination on the sanction to be imposed. When addressing the appellant, the Chairman said, "Your evidence to this Committee was inconsistent and by reason of our determination untruthful in many respects".
The appellant appeals against the decision of the Committee finding heads 5, 6 and 7 proved. She does so, first, on the basis that the Committee failed to give reasons for its finding that, as a matter of fact, these heads had been proved. She argues, secondly, that in any event, in the exercise of its appellate function, this Board should take account of various criticisms of the evidence led in support of these heads and, on that basis, should allow her appeal against the Committee's decision on these matters of fact. On the other hand, the appellant accepts that, if those findings were properly made, the Committee was entitled to conclude that she had been guilty of serious professional misconduct. She appeals, however, against the Committee's direction that her name should be erased from the register, on the ground that the sanction was excessive in all the circumstances.
In arguing that the Committee's decision was bad for want of reasons, Ms Booth readily acknowledged that she was asking the Board to break new ground - or, as she put it, to take the next incremental step in a developing field. In that connexion she drew attention to the decision of the Board in Stefan v General Medical Council [1999] 1 WLR 1293 holding that there was a common law duty on the Health Committee of the respondent Council to give at least a short statement of the reasons for its decisions. As counsel herself pointed out, Lord Clyde had specifically acknowledged (at pp 1296H -1297A) that there were differences between appeals from the Health Committee and appeals from the Professional Conduct Committee, not least because appeals from the Health Committee were confined to points of law. In Stefan their Lordships had therefore refrained from expressing any view as to the existence of any equivalent duty on the Professional Conduct Committee to give reasons.
The position as to the duty of the Professional Conduct Committee to give reasons, as presently understood, is to be found in Selvanathan v General Medical Council [2001] Lloyd's Rep Med 1. In that case the amended allegation against the practitioner was to the effect that he had knowingly given a false and misleading response to an inquiry by his local health authority in relation to a complaint by a patient. The evidence against the practitioner was all agreed and the Committee's decision depended on the inferences drawn from that evidence and from the oral evidence given by the practitioner. After considering the evidence, the Committee decided that particular heads of the charge had been proved. The Committee gave no reasons for its decision. The practitioner appealed to this Board on the basis that the Committee should have given its reasons for finding against the practitioner on the charge that he had known that his response to the health authority had been false and misleading. Giving the decision of the Board, Lord Hope of Craighead first of all drew attention to the nature and composition of the Committee, comprising medical practitioners and lay members, acting with the legal advice of their assessor. The rules required the Committee, as a committee, to reach a view on the matters for its determination and there was no provision for expressions of dissent. "In these circumstances," said Lord Hope at p 7,
"it is not to be expected of the Committee that they should give detailed reasons for their findings of fact. A general explanation of the basis for their determination on the questions of serious professional misconduct and of penalty will be sufficient in most cases.
In the present case the complaint is that reasons should have been given to explain the basis upon which the Committee found against the appellant on the questions of fact raised by head 2(b). It was plain, however, from the outset that their decision on this point was going to depend upon inferences which it was open to them to make from agreed facts and on the Committee's assessment of the appellant's credibility. The issue was a relatively simple one, and all the appellant needed to know in order to decide what to do next was the decision which the Committee had reached upon it. There are no grounds for thinking that the appellant has suffered any prejudice due to the absence of reasons directed specifically to this finding. In these circumstances their Lordships do not consider that it was necessary for reasons for this part of the Committee's decision to be given."
In that passage their Lordships affirmed the existence of a duty to give a general explanation for the Committee's decisions on questions of serious professional misconduct and of penalty. By contrast, they rejected the existence of any such duty to give reasons for the Committee's decision on the matters of fact in that case.
Counsel did not suggest that the decision in Selvanathan had been incorrect in this respect or that it would have...
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