Srirangalingham v General Medical Council

JurisdictionUK Non-devolved
CourtPrivy Council
JudgeLord Mackay of Clashfern
Judgment Date12 Nov 2001
Neutral Citation[2001] UKPC 48
Docket NumberAppeal No. 46 of 2001

[2001] UKPC 48

Privy Council

Present at the hearing:-

Lord Millett

Lord Mackay of Clashfern

Sir Swinton Thomas

Appeal No. 46 of 2001
Dr. Sivagurunathan Srirangalingham
Appellant
and
The General Medical Council
Respondent
[Delivered by ] Lord Mackay of Clashfern
1

The appellant was brought before the Professional Conduct Committee (PCC) of the respondent Council and on his own admission on 12th April 1999 the following charges were found proved:-

"That, being registered under the Medical Act,

  1. (1) On 16 June 1994

    1. a. you were consulted by Mrs Atkinson, a patient for whom you were responsible under the NHS at the material times,

    2. b. You did not carry out an adequate examination of Mrs Atkinson,

    3. c. You thereby did not place yourself in a position in which to assess adequately her condition and treatment needs;

  2. (2) a. On 22 August 1994, during two home visits to Mrs. Atkinson,

    b. You did not carry out an adequate examination of Mrs. Atkinson,

    c. You thereby did not place yourself in a position to assess adequately her condition and treatment needs;

  3. (3) At the relevant times you did not keep adequate medical records of Mrs. Atkinson's treatment;

  4. (4) On 27 January 1996

    1. a. You were requested by telephone by Mr T Hutchinson to visit Mr Ronald Hutchinson, a patient registered on the NHS list of your partner, Dr (Mrs) S Srirangalingam,

    2. b. i. You did not obtain full details of Mr R Hutchinson's condition from Mr T Hutchinson,

      ii. You did not visit Mr R Hutchinson,

    3. c. You thereby did not place yourself in a position in which to assess adequately Mr R Hutchinson's condition and treatment needs;

  5. (5) On 27 January 1996

    1. a. You were unable to move your car from your drive because of snow,

    2. b. You did not have alternative arrangements in place for your patients to receive home visits, if required,

    3. c. Your practice arrangements on 27 January 1996 were thereby inadequate;

  6. (6) On 28 January 1996

    1. a. You visited Mr R Hutchinson at his home,

    2. b. During the course of this visit, Mr Hutchinson wounded himself with a knife,

    3. c. After calling an ambulance, you departed before the ambulance arrived,

    4. d. You thereby disregarded your professional responsibilities to Mr Hutchinson at a time when he required the care and attention of a registered medical practitioner;

  7. (7) On 5 October 1996

    1. a. You visited Mrs C S Magee, a patient for whom you were responsible under the NHS at the material time,

    2. b. You did not carry out an adequate examination of Mrs Magee,

    3. c. You thereby did not place yourself in a position in which to assess adequately her condition and treatment needs;

And that in relation to the facts you have been guilty of serious professional misconduct."

2

Following the aforesaid findings the PCC determined and directed that for a period of twelve months the registration of the appellant be conditional on his compliance with the following requirements:-

"1. You shall continue to seek and follow the advice of Dr James Harrison to improve the standards of your clinical care and communication skills;

2. Before the next hearing of your case by this Committee, you shall supply the Council with objective evidence of your professional development under Dr Harrison's advice;

3. You shall seek and follow the advice of the independent medical adviser in general practice to your local health authority about the size of your patient list with a view to reducing your own workload which has contributed to the findings today."

3

The PCC resumed consideration of the appellant's case at a hearing on 5th May 2000. There had been no alleged breach of the above conditions in the interim. The PCC determined and directed that for a further period of twelve months the appellant's registration should be subject to the following requirements:-

"1. You shall consult and follow the advice of Dr Harrison and Dr Ruffett to continue to improve the standards of your clinical knowledge and skills, and communication skills. Under their guidance you should undertake such further professional development as is necessary to achieve the clinicalstandards of a general practitioner completing vocational training.

2. As part of this process you shall keep a portfolio of your personal development plan, and through that demonstrate how you are ensuring that your continuing education is directed towards your clinical performance as a general practitioner. This portfolio should be produced at a resumed hearing of your case.

3. You shall continue to undertake regular audits of your practice - of your own devising - and produce the results for consideration at the resumed hearing of your case. These reports of your audits should indicate where you have changed your practice as a result.

4. You shall submit the video evidence of your patient consultations to appropriate assessors appointed by the Postgraduate Institute for Medicine and Dentistry at the University of Newcastle, so that your skills can be objectively addressed. You should make any improvements considered necessary. You should submit evidence to the Committee that your interpersonal skills in these consultations are of an adequate standard.

5. You shall maintain your efforts through the assistance offered by the Health Authority about reducing the size of your patient list and seeking further assistance in your practice to help reduce your workload."

4

The PCC resumed consideration of the appellant's case at a hearing on 30th May 2001. The PCC were invited to determine whether there had been a breach of the second section of the conditions 1 And 4 which their Lordships have quoted. It was accepted on behalf of the respondent Council that in respect of the other conditions there had been total compliance by the appellant.

5

At the conclusion of the hearing on 31st May the PCC made the following decision. Addressing the appellant the Chairman said:-

"… when the Committee considered your case in April 1999 and judged you guilty of serious professional misconduct, they found you had provided a poor standard of care to yourpatients. On a number of occasions you had failed to take proper history,...

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