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The Professional Standard Authority for Health and Social Care v General Medical Council & Anor.

[2023] EWHC 967 (Admin)
A doctor was disciplined for wrongly writing lots of prescriptions. The punishment wasn't harsh enough, so a court sent the case back to be decided again because the original decision wasn't explained clearly enough.

Key Facts

  • Professor Sundara Lingam, a medical practitioner, was found guilty of misconduct for inappropriately prescribing almost 300 private prescriptions between 2013 and 2014.
  • The prescriptions lacked sufficient patient information and some were for patients who did not exist.
  • Professor Lingam admitted the misconduct but claimed he believed he was participating in a humanitarian effort.
  • The Medical Practitioners Tribunal (MPT) imposed a 24-month conditions of practice order.
  • The Professional Standards Authority (PSA) appealed the leniency of the sanction.

Legal Principles

The PSA can appeal a decision if it's insufficient for public protection (finding or penalty).

Section 29 of the National Health Service Reform and Health Care Professions Act 2002

Sufficiency of a decision considers public health, safety, well-being, public confidence in the profession, and proper professional standards.

Section 29(4A) of the 2002 Act

Appeal court should show restraint and deference to the MPT's expertise, unless there's an error of principle or the evaluation is unreasonable.

Council for the Regulation of Healthcare Professionals v GMC and Ruscillo [2005] 1WLR 717; GMC v Jagjivan [2017] 1 WLR 4438; Bawa-Garba v GMC [2019] 1 WLR 1929

Inadequate reasons for a decision constitute a serious irregularity.

CRHP v GDC and Marshall [2006] EWHC 1870 (Admin); GMC and PSA v Bramhall [2021] EWHC (2109) (Admin); PSA v GOC and Rose [2021] EWHC 2888 (Admin)

The GMC's overarching objective is public protection, including patient safety, public confidence, and professional standards.

Section 1 of the Medical Act 1983

MPT Panels have an inquisitorial duty to ensure the case is properly presented and evidence is thorough.

Council for the Regulation of Healthcare Professionals v GMC and Ruscillo [2005] 1WLR 717

Departure from the Sanctions Guidance requires clear, substantial, and specific reasons.

GMC and PSA v Bramhall [2021] EWHC 2109 (Admin)

Outcomes

The MPT's decision was quashed and remitted for reconsideration.

Inadequate and unclear reasoning regarding the sanction constituted a serious procedural error. The court could not determine if the sanction was 'wrong' due to insufficient explanation of the Panel's consideration of seriousness, mitigation, aggravation, and the application of the Sanctions Guidance.

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