R v General Medical Council, ex parte Gee
| Jurisdiction | England & Wales |
| Judge | Lord Keith of Kinkel,Lord Brandon of Oakbrook,Lord Templeman,Lord Mackay of Clashfern,Lord Goff of Chieveley |
| Judgment Date | 30 April 1987 |
| Judgment citation (vLex) | [1987] UKHL J0430-2 |
| Date | 30 April 1987 |
| Court | House of Lords |
[1987] UKHL J0430-2
Lord Keith of Kinkel
Lord Brandon of Oakbrook
Lord Templeman
Lord Mackay of Clashfern
Lord Goff of Chieveley
House of Lords
My Lords,
I have had the opportunity of considering in draft the speech to be delivered by my noble and learned friend Lord Mackay of Clashfern. I agree with it, and for the reasons he gives would dismiss the appeal.
My Lords,
I have had the advantage of reading in draft the speech prepared by my noble and learned friend, Lord Mackay of Clashfern. I agree with it, and for the reasons which he gives I would dismiss this appeal.
My Lords,
For the reasons to be given by my noble and learned friend, Lord Mackay of Clashfern, I would dismiss the appeal.
My Lords,
The appellant, to whom I shall refer as "Dr. Gee," is a medical practitioner registered with the General Medical Council, "the G.M.C.", and has been so for many years. On 12 April 1984 Dr. Gee was given notice by the registrar of the G.M.C. that the G.M.C had received from certain persons named complaints, and from the solicitor to the G.M.C. information, which appeared to raise a question whether he had committed serious professional misconduct within the meaning of section 36(1) of the Medical Act 1983. The letter of notification continued:
"In the complaints and information it is alleged that over a period including May 1982 to August 1983 at your practice premises in Harley Street and in Rochester, you abused your professional position as a medical practitioner by supplying to individual patients, in return for fees, quantities of drugs including dexamphetamine sulphate and thyroid extract, repeatedly, over extensive periods; (a) without first adequately examining the patients, or seeking adequate information as to their medical history; (b) without first consulting the patients' general practitioners about the proposed treatment, or notifying to those general practitioners after treatment had first commenced the details of any drugs supplied and the dosages prescribed; (c) without making adequate enquiries on each occasion about the effect of this treatment on the patients' health; (d) without offering appropriate advice when a patient reported to you the harmful effects upon her of the drugs which you had supplied."
Copies of supporting statutory declarations and of a statement were sent with this notification. The notification concluded with the intimation that it was intended that the registrar should be directed to refer the complaints and information to the Preliminary Proceedings Committee ("P.P.C.") in which event it would be the duty of that committee to consider the complaints and information and any explanation furnished by Dr. Gee and to determine whether the case should be referred to the Professional Conduct Committee ("P.C.C.") for inquiry into a charge against him. The date of the next meeting of the P.P.C. was stated and Dr. Gee was invited to submit any explanation of the matters raised in the notification which he had to offer for consideration at that meeting.
Explanations on behalf of Dr. Gee were submitted to the P.P.C. but by letter dated 22 May 1984 Dr. Gee was informed that the P.P.C. had determined that a charge should be formulated against him on the basis of the complaints and information and that an inquiry into the charge should be held by the P.C.C. By letter dated 13 June 1984 Dr. Gee was notified by the solicitors to the G.M.C. on behalf of the G.M.C. that in consequence "of a complaint made against you to the council an inquiry is to be held into the following charge against you." There then followed a statement in the same terms as that which I have already quoted from the letter of 12 April 1984 save that the period in question is reduced to that between about June 1982 and about July 1983 and there is added after the allegation which I have quoted, as amended, the words "and that in relation to the facts alleged you have been guilty of serious professional misconduct." The notice went on to specify the date and time fixed for the inquiry and to give further information relating to it. As a result of an application for judicial review of a refusal by the president of the G.M.C to grant an adjournment and a contested hearing before McNeill J. the inquiry was adjourned.
As a result of later correspondence, Dr. Gee was given particulars of the patients in respect of whom evidence was to be led in support of the charge. These included the four patients mentioned in the original statutory declarations and statement sent with the letter of 12 April 1984 who have been referred to as the group A patients but included also four other patients not mentioned in these documents conveniently referred to as the group B patients. A voluminous correspondence between Dr. Gee's solicitors and the solicitors for the G.M.C. followed. On 1 November 1984 Dr. Gee applied to the president of the G.M.C. for an order that the charge be amended so as to charge Dr. Gee with eight separate charges of professional misconduct, that is to say, one charge in respect of each patient, on the ground that the charge as drawn was duplicitous. The president refused and an application was made for judicial review of that decision. Dr. Gee subsequently sought an undertaking from the solicitors to the G.M.C. that the P.C.C. would not proceed to consider charges against Dr. Gee relating to the group B patients and that further particulars would be supplied by the G.M.C. to Dr. Gee of the charge made against him. The solicitors to the G.M.C. refused to give the undertaking sought or to supply the particulars requested and an application was made for judicial review in respect of these matters. Leave to apply was granted in respect of both applications, the first by Webster J. on 14 December 1984 and the second by Woolf J. on 2 July 1985. These two applications were heard together by Mann J. who, on 1 November 1985, held in favour of Dr. Gee on all three issues. The G.M.C. appealed and on 19 May 1986 the Court of Appeal (Dillon and Nicholls L.JJ, Lloyd L.J. dissenting) allowed the appeal save in respect of the supply of further particulars. Dr. Gee was granted leave to appeal against that decision to your Lordships' House. No issue is now raised with respect to the giving of particulars and accordingly the two issues raised in this appeal are firstly, whether the rule against duplicity applies in proceedings before the P.C.C. and, if so, whether the charge against Dr. Gee which I have narrated is duplicitous, and secondly, whether the G.M.C. can proceed to lay before the P.C.C. evidence relating to the group B patients.
Dr. Gee submits that the charge against him is duplicitous in that it alleges distinct instances of professional misconduct in respect of each patient now named and that to proceed with a charge in this form is not in accordance with the express terms of the relevant statutory rules or at least with the principles of fairness implied in them. The G.M.C. submit that the charge is not bad for duplicity since it alleges a course of conduct capable of constituting serious professional misconduct and that it should be allowed to proceed.
Dr. Gee further submits that since no facts relating to the group B patients were put before the P.P.C. and therefore were not referred to the P.C.C. by the P.P.C. it is not within the statutory jurisdiction of the P.C.C. to consider such matters. The G.M.C. submit that the question raised by the matters considered by the P.P.C. and referred by it to the P.C.C. was such that the group B patients provide further evidence in relation to what has been referred and that it is open to the P.C.C. to consider that evidence.
Before dealing with these rival submissions in more detail it is necessary to consider the statutory background. The governing statute is now the Medical Act 1983 which consolidated the Medical Acts 1956 to 1978 with amendments recommended by the Law Commission and the Scottish Law Commission. Section 1(1) of that statute provides that:
"There shall continue to be a body corporate known as the General Medical Council (in this Act referred to as "the General Council") having the functions assigned to them by this Act."
Section 1(3) provides:
"There shall continue to be four committees of the General Council known as the Education Committee, the Preliminary Proceedings Committee, the Professional Conduct Committee and the Health Committee (in this Act referred to as 'the Statutory Committees') constituted in accordance with Part III of Schedule 1 to this Act and having the functions assigned to them by this Act."
Section 36 so far as material provides:
"(1) Where a fully registered person - ( a) is found by the Professional Conduct Committee to have been convicted in the British Islands of a criminal offence, whether while so registered or not; or ( b) is judged by the Professional Conduct Committee to have been guilty of serious professional misconduct, whether while so registered or not; the committee may, if they think fit, direct - (i) that his name shall be erased from the register …"
Against such a direction there is an appeal to Her Majesty in Council under section 40(1)( a) and (4) of the Act. Sections 42 and 43 provide, so far as material:
"42.(1) The Preliminary Proceedings Committee shall have the functions assigned to them by this section. (2) It shall be the duty of the Committee to decide whether any case referred to them for consideration in which a practitioner is alleged to be liable to have his name erased under section 36 above … ought to be referred for inquiry by the Professional Conduct Committee … (3) If the committee decide that a case ought to be referred for inquiry by...
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