Sekinat Bakare v General Medical Council
| Jurisdiction | England & Wales |
| Judge | Mr Justice Calver |
| Judgment Date | 03 December 2021 |
| Neutral Citation | [2021] EWHC 3278 (Admin) |
| Docket Number | Case No: CO/4870/2020 |
| Court | Queen's Bench Division (Administrative Court) |
[2021] EWHC 3278 (Admin)
IN THE HIGH COURT OF JUSTICE
QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT
Royal Courts of Justice
Strand, London, WC2A 2LL
THE HONOURABLE Mr Justice Calver
Case No: CO/4870/2020
Matthew McDonagh (instructed by Foster and Coleman Ltd.) for the Claimant
Alexis Hearnden (instructed by GMC Legal) for the Defendant
Hearing dates: Thursday 2nd December 2021
The appeal
On 27 November 2020, a Fitness to Practise Tribunal of the Medical Practitioners Tribunal Service (“the MPT”) concluded a Fitness to Practise hearing that lasted 18 days. The Appellant was represented by counsel before the MPT and she attended some, but not all, of the sitting days 1.
The MPT was provided with expert evidence as well as documentary evidence from 16 lay witnesses. Four witnesses gave live evidence on behalf of the Respondent (“the GMC”). The Appellant provided a witness statement dated 27 October 2020 and gave oral evidence.
In the light of its findings, the MPT directed that the Appellant's name be erased from the medical register; an immediate order for suspension was not deemed necessary. The Appellant accordingly remains on the register until the outcome
of this appealThe Appellant now appeals against the sanction imposed by the MPT pursuant to section 40 of the Medical Act 1983 (“the Act”), and invites the court to quash the sanction and substitute a “lengthy” suspension 2 which the Appellant submits is sufficient to maintain public confidence in the profession and maintain proper professional standards.
The Allegations before the MPT
The allegations against the Appellant which were referred to the MPT related to a number of separate incidents at different times. They can be summarised as follows (together with the Appellant's responses):
Clinical care allegations :
(1) Clinical care concerns in respect of Patient B (Jan 2014) and Patient C (March 2015). These charges were admitted and found proved. The Tribunal found that these allegations either did not amount to misconduct or that they did not amount to current impairment. These allegations have no relevance to the sanction of erasure that was imposed in this case.
Falsity allegations
(2) (a) Scheduling leave from a tutorial with her education supervisor at Langham Place Surgery on the basis that she was undertaking an out of hours session on 10 November 2011, which she did not in fact attend. This was admitted and found proved by the Tribunal but it found that this did not amount to misconduct.
(b) Falsely stating during a tutorial on 24 November 2011 with her trainer at Langham Place Surgery that she had attended a Vocational Training Scheme session. This was admitted (although dishonesty was denied) and was found proved. The Tribunal considered that the lie about her attendance and the embellishment about what had taken place at the session amounted to misconduct. However, the Tribunal did not consider that current impairment was made out in relation to these findings and it did not have a material bearing upon the sanction of erasure that was imposed.
(3) Making false statements about her qualifications on an application form and in interview in 2014 for the post of Specialty Doctor in sexual health at Kingston Hospital. The Appellant denied this charge. The Tribunal concluded that whilst the Appellant had stated incorrectly that she was a “Speciality Registrar” in her current job, this was not dishonest and did not amount to misconduct. None of the other charges under this Heading were proved. The findings under this heading did not have a material bearing upon the sanction of erasure that was imposed.
(4) Falsely stating on two application forms and one declaration form in respect of posts at Central and North West London NHS Foundation Trust (“CNWL”) (on 11 November 2014, 19 December 2014, 23 April 2015) that she was not currently the subject of fitness to practise investigations (in respect of the matters in sub-paragraphs (1) and (2) above). This false statement was made on an application form, a further declaration during the course of the pre-employment screening process and an application for an extension to the post. The Appellant admitted making the false statement (that she was not subject to an ongoing fitness to practice investigation when applying for the post of specialty doctor at CNWL) but denied dishonesty, saying she had made a mistake. The Tribunal determined that the Appellant had made these statements knowing that they were untrue and that this was dishonest. This dishonesty amounted to misconduct and to current impairment, engaging concerns about public confidence in the medical profession and upholding proper professional standards. These findings were material to the sanction of erasure that was imposed.
(5) The Appellant ceased working as a trainee at Langham Place Surgery under her Educational Supervisor, Dr. Greening, in about December 2011. When she left this placement the Appellant failed to return one of Dr Greening's prescription pads which she had in her possession. Some three years later, in October 2014 a prescription from that prescription pad was written out by her in an attempt to obtain a substantial quantity of vitamins from a Boots chemist. The prescription was given by the Appellant to a friend of hers visiting from Nigeria, but she wrote it in the name of her mother but with her sister's address. She also forged the initials of Dr. Greening. The Appellant was charged with (i) failing to return another doctor's prescription pad; (ii) which was used to write out a prescription in the name of a family friend and (iii) which was signed by her in another doctor's name. This was only admitted by her on day 4 of the tribunal hearing itself (and that she thereby acted dishonestly). The MPT found that this amounted to misconduct and to current impairment, engaging concerns about patient safety, public confidence in the profession and the promotion and maintenance of proper standards within the profession. These findings were material to the sanction of erasure that was imposed.
The Appellant only (belatedly) admitted dishonesty in respect of the prescription charge (paragraph 5(5) above); dishonesty was otherwise denied by her (save in respect of paragraph 5(2)(a) above, where there was no allegation of dishonesty).
In relation to the two relevant courses of dishonest conduct for present purposes, namely paragraphs 5(4) and (5) above, the following matters are relevant factual background in considering the sanction imposed by the MPT.
The falsified prescription – finding of impairment
So far as paragraph 5(5) above is concerned (the falsified prescription), the matter was referred to the police after the level of vitamin D prescribed was queried by the pharmacist with the GP surgery. The MPT specifically referred to the fact that when challenged by the police, the Appellant denied any involvement, claimed she had lost the pad (she said it had been stolen) and agreed to take part in an ID parade to prove her innocence (knowing full well that she would not be identified because she had not presented the prescription at the pharmacy and she knew the identity of the individual who had done so, namely her Nigerian friend):
“ Her pretence at assistance to the police was so thorough that the officer in charge of the case subsequently commended her for the cooperation she had provided. These events amounted to a deliberate and prolonged course of dishonesty, which Dr Bakare subsequently succeeded in covering up by lying to the police. But for those lies she would almost certainly have been convicted of fraud. There can be no doubt that these actions were serious misconduct. Any fellow practitioner would describe her actions as deplorable” (impairment determination, para.29) (emphasis added).
Having been successfully misled by the Appellant, the Police wrote to the GMC on 23 February 2015, stating that their investigation into the Appellant's possible fraudulent use of the prescription pad was closed. At the start of the MPT hearing — six years after the prescription was presented at the pharmacy — this charge was denied by the Appellant (i.e. that she dishonestly wrote out and signed a prescription in another doctor's name). The GMC case was therefore opened on that basis and it submitted that by lying to the police the Appellant had “kept digging” in a pattern of escalating dishonesty.
The GMC's expert handwriting witness was due to give oral evidence on day four of the tribunal hearing (13 October 2020) in which she would confirm that the likelihood was that the handwriting on the prescription pad belonged to the Appellant. Faced with the prospect of that evidence, on the morning of day four this charge was admitted by the Appellant. She then confirmed this admission in a witness statement served on day 8 of the hearing, dated 27 October 2020 (at paragraph 165). The MPT observed as follows so far as the Appellant's insight into her dishonesty was concerned:
“The Tribunal again has considered what insight into these actions has been demonstrated by Dr Bakare. It is to her credit that she made admissions and admitted her dishonesty. However, those admissions only came at the latest possible stage when the doctor was confronted at the hearing with not only having to explain the handwriting evidence, but also the details on the prescription related to close family members. In her statements and in her evidence, Dr Bakare repeatedly stated how sorry she was for doing what...
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