Yeong v General Medical Council

JurisdictionEngland & Wales
JudgeTHE HON MR JUSTICE SALES,The Hon Mr Justice Sales
Judgment Date28 July 2009
Neutral Citation[2009] EWHC 1923 (Admin)
Docket NumberCase No: CO/1081/2009
CourtQueen's Bench Division (Administrative Court)
Date28 July 2009

[2009] EWHC 1923 (Admin)





The Hon Mr Justice Sales

Case No: CO/1081/2009

Dr Cheng Toh Yeong
The General Medical Council

Robert Kellar (instructed by the Medical Protection Society) for the Appellant

Eleanor Grey (instructed by GMC Legal) for the Respondent

Hearing dates: 23 rd June 2009


This is an appeal against (i) a decision dated 8 January 2009 of the Fitness to Practise Panel (“the FTPP”) of the General Medical Council (“the GMC”) that the fitness to practise of the Claimant (“Dr Yeong”) is impaired by reason of misconduct, pursuant to s. 35C(2)(e) of the Medical Act 1983 (“the Act”) and (ii) a related decision of the FTPP dated 9 January 2009 to suspend Dr Yeong's registration as a medical practitioner for a period of 12 months. The role of this court on the appeals is to determine whether either of the decisions of the FTPP was “wrong”: see CPR Part 52.11(3)(a) and the discussion in General Medical Council v Meadow [2006] EWCA Civ 1390 at [125]-[128].

Factual Background


Dr Yeong was born on 4 October 1965. He grew up and studied in Singapore, qualifying as a doctor in 1989. He came to specialise in obstetrics and gynaecology.


In 1997 he married. He and his wife have three children, aged 10, 8 and 6.


In 1999 Dr Yeong came to the United Kingdom and worked at Guys and St Thomas' Hospital in London as a senior registrar in the Assisted Conception Unit. He then returned to Singapore and worked as a consultant in the department of reproductive medicine at Kedang Kerbau Hospital between January 2001 and April 2005, assisting couples who were having difficulties in conceiving.


In April 2005, Dr Yeong moved into private practice in Singapore. He worked at the Tow Tung Clinic, practising in general gynaecology, and at the Thompson Fertility Centre, practising as a fertility/ IVF specialist.


In July 2002, whilst Dr Yeong was working as a consultant at the Kedang Kerbaul Hospital, a lady (whom I will call “GN”) made an appointment to see him in respect of medical complaints. She saw him for consultations again in February and in March 2003. Shortly thereafter, Dr Yeong met GN for lunch. On Dr Yeong's account, set out in a written plea of mitigation to the Singapore Medical Council (“SMC”) which was also before the FTPP, during this lunch meeting GN propositioned Dr Yeong and suggested they should go to a hotel room together. Soon afterwards they began a sexual relationship. In the course of that relationship, GN insisted that Dr Yeong pay substantial sums of money into her bank account. Dr Yeong paid her 4000 Singaporean Dollars (approximately £2000) per month over the course of the relationship, which was continued over about two years, resulting in a total payment to her of approximately £44,000. He also provided her with gifts. GN threatened to expose their relationship to his wife if he did not satisfy her demands.


In July 2005, Dr Yeong terminated the relationship. Thereafter, according to Dr Yeong, GN harassed him and his wife by sending him text messages, making telephone calls and accosting Dr Yeong at work.


Dr Yeong concluded that his presence in Singapore provided impetus for GN to harass him and his family. He therefore decided to leave his family behind in Singapore and work overseas, in the United Kingdom. In October 2005, he travelled to the United Kingdom to renew his registration with the GMC to practise medicine here. He was offered and accepted a full time position at the CRM Fertility Clinic in London (“CRM”) in December 2005. He has worked with CRM since that time.


In January 2006 Dr Yeong was notified that GN had made a complaint about him to the SMC. Dr Yeong notified Mr Forman of CRM of the complaint against him. Having considered the position, Mr Forman concluded that the offer of employment for Dr Yeong at CRM should remain open. Accordingly, Dr Yeong commenced employment with CRM in February 2006.


There were four charges against Dr Yeong before the SMC as follows:

1) Improper conduct bringing disrepute to the medical profession by engaging in a sexual relationship with a patient (GN) during the period from 21 April 2003 to around March 2005, and failing to preserve the absolute confidence and trust of a doctor-patient relationship, in breach of the Singaporean Medical Registration Regulations and the SMC's Ethical Code and Ethical Guidelines;

2) Improper conduct bringing disrepute to the medical profession by tampering with and/or improperly causing inaccurate changes to be made to the biodata of a patient (GN) during the period from around June 2004 to around August 2005, and thereby failing to keep medical records which were accurate, in breach of the Singaporean Medical Registration Regulations and the SMC's Ethical Code and Ethical Guidelines;

3) Professional misconduct by failing during the period from February 2003 to March 2005, to record or properly document details of the patient's (GN) visits, medical condition and results on medical examinations in the case notes for the period of treatment; and

4) Professional misconduct by failing properly to maintain patient confidentiality by improperly disclosing to a third party (GN) confidential information relating to the treatment and care of two other patients of the Kedang Kerbau Hospital during the period from February 2003 to March 2005.


Dr Yeong pleaded guilty to those charges.


In relation to the question of sanction, Dr Yeong put in a lengthy written plea in mitigation. This included the following claim;

“In sentencing, this Committee must also realise that the charges against him arises mainly as a result of his relationship with [GN] and have nothing to do with the way in which Dr Yeong generally practises. Neither was the care given to [GN] in any way compromised. Just as importantly, his acts have no impact on any other patient.”


Dr Yeong also obtained an expert report from an experienced psychiatrist, Dr Khean. Dr Khean's assessment was that Dr Yeong did not have a psychological disposition to engage in sexual relationships with patients. Dr Khean's assessment was that Dr Yeong fell into the category of physicians who may have a personal crisis or loss that causes them to be vulnerable and to seek out a patient who appears to provide support, rather than the category of persons who have some psychological disorder. According to Dr Khean, the category into which Dr Yeong fell was that most amenable to intervention and least likely to repeat such an act. Dr Khean concluded:

“The complainant had acted to 'punish' Dr Yeong and to make him suffer. She had also benefited financially to the amount in excess of about $90,000 from the relationship. The complainant played an active part in pursuing the relationship and in some respects was the dominant party (making requests and demands). Dr Yeong passively gave in to many of these demands to oblige her and avoid confrontation/conflicts with her and his wife. This only allowed the demands and problems to escalate culminating in a situation whereby he could no longer meet the demands. This led to anger and frustration in the complainant, who became more demanding.

Judging from the testimonials and references, Dr Yeong is held in the highest regard by his professional colleagues and patients. His current mentor Dr Robert Forman has confirmed that since his time working in London, no complaint about Dr Yeong had been received. Dr Yeong should be allowed to work and contribute to the best of his ability to Singapore medicine. He erred and should be given a chance to redeem himself.

The likelihood of recurrence is extremely low and this is reflected in the literature.”


In the light of these materials the SMC made the following observations in deciding to impose a suspension of Dr Yeong's medical registration in Singapore for 24 months (rather than striking him off the register):

“In respect of the first charge, it is important to bear in mind that one of the most fundamental duties of a doctor, recognised for as long as the profession has been in existence, is that a doctor must never permit his professional relationship with a patient to deteriorate into an association which would be described as improper. The Courts in Singapore and also in England have always supported the finding of the medical body that sexual intercourse with a patient is a most serious breach of the proper relationship between doctor and patient amounting to infamous conduct in a professional respect.

In any sexual relationship between the doctor and the patient, the principle is whether there is any exploitation of the patient. The patient may be physically or psychologically vulnerable to the doctor's advances. There is no evidence of this in your case. In your case, the patient was not vulnerable, and in the view of the Committee, the patient was in fact the dominant person in this doctor-patient relationship. From the first encounter, it was by mutual consent. Furthermore, there was a series of financial transactions as a result of which, a total of over $90,000 was paid to the patient over a period of 2 years.

The Committee also noted that you readily pleaded guilty to prevent putting the complainant/patient through the limelight of a hearing to state her case.

Your conduct transgressed the professional boundary between the doctor and his patient. However, you have no previous offences. On the basis of the report from Dr Ung Eng Khean,...

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