Court of Appeal upholds the Medical Practitioners Tribunal decision in favour of a Paediatrician not acting dishonestly

In Raychaudhuri v General Medical Council [2018] EWCA Civ 2027 the Court of Appeal allowed an appeal by a doctor who challenged findings that his conduct was dishonest and his fitness to practice was impaired. This case involved professional disciplinary proceedings against the appellant who received a complaint in relation to how he filled in a form to record the medical examination of a child patient. In December 2014, he worked as a locum registrar paediatrician in A&E when he was due to examine a 5 month old child diagnosed with Dandy Walker Syndrome. The doctor reviewed the patient's medical records and a GP letter and used the information to fill in an Emergency Department Paediatric Initial Assessment Form in advance of examining the child. The doctor was called to attend to another patient, leaving the form partially completed, which led to confusion amongst staff on whether or not the patient had been seen to already. A meeting was called between the doctor, two nurses and a consultant where the doctor explained his intention to see the patient using the partially completed form during the examination. Subsequently, in a telephone conversation with another paediatric consultant, the doctor denied completing the examination section of the form.

The complaint was referred to the Medical Practitioners Tribunal (MPT). On assessing the complaint, the MPT concluded that although the doctor had provided misleading statements, his conduct had not been dishonest and there was no impairment to his fitness to practice. The doctor was issued with a warning against his conduct but escaped any severe sanction.

The General Medical Council (GMC) appealed to the High Court against the MPT decision on the basis that it was not sufficient for public protection.

Allowing the appeal, the High Court held that the MPT should have found that the doctor behaved dishonestly when giving the telephone account to the consultant and concluded that his fitness to practice was impaired. The High Court judge substituted findings of dishonesty and current impairment remitting the case to the MPT for further consideration in light of the findings.

The doctor appealed the High Court's decision arguing that the High Court was wrong to find he had behaved dishonestly when the MPT had acquitted him of dishonesty and wrong to find that his fitness for practice was impaired.

The Court of Appeal upheld the initial decision made by the MPT and quashed the High Court's substituted findings. It was held that the MPT fully considered whether the doctor's conduct could be regarded as dishonest. The court queried the High Court judge's approach in analysing the position as he only referred to parts of the MPT's findings whereas great weight should have been given to the MPT's full judgment.

On the question of dishonesty, the court concluded that it was clear from the doctor's conduct that the doctor did not embark on a deliberate and dishonest plan to cover up his actions. Although misleading statements were made by the doctor, the court ruled this was a pardonable and trivial effort to deflect the consultant's anger. The GMC were criticised for lodging an appeal as there is a high threshold for a court to overturn a finding of the MPT that a doctor has not acted dishonestly.

Caution should be applied by the GMC when exercising its power to appeal as only the strongest of cases will be sufficient to overturn an MPT ruling which has found in favour of a doctor. It is not enough for the GMC to simply disagree with the decision.

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