Court Replaces No Action Decision with Conditions in Medical Misconduct Case

Citation: [2023] EWHC 3228 (Admin)
Judgment on


In the recent judgment of the General Medical Council v Nour Mohamed Magdy Aly Rezk, the High Court tackled issues pertaining to the appropriate sanctions for medical practitioners, specifically addressing matters related to sexual misconduct, fitness to practise impairments, and the considerations surrounding sanctions such as suspension and conditions. The court critically analyzed the decision made by the Medical Practitioners Tribunal Service (MPTS) and provided a thorough interpretation of applicable legal principles.

Key Facts

The case involved Dr. Rezk, an Egyptian-trained doctor working in the UK, who had been found guilty by the MPTS of inappropriate and sexually motivated conduct towards nursing staff, characterized as sexual harassment. Despite these findings, the MPTS concluded that no action should be taken against Dr. Rezk, citing ‘exceptional circumstances’ related to his personal and professional stress during the COVID-19 pandemic.

The General Medical Council (GMC) appealed this decision, arguing that the MPTS failed to give sufficient weight to public confidence in the medical profession and proper professional standards, erred in classifying the circumstances as exceptional, and thus incorrectly took no action against Dr. Rezk.

The court applied several legal principles to assess the MPTS’s decision. Notably, the ‘overarching objective’ defined in the Medical Act 1983 guided the determination of whether sanctions should be imposed. This objective aims to protect the public by maintaining confidence and standards within the medical profession. Furthermore, the court considered the ‘Bolton principle’, which stresses the profession’s reputation over the interests of an individual practitioner.

The court scrutinized the MPTS’s treatment of aggravating factors, finding that there was a failure to adequately consider the seriousness of Dr. Rezk’s misconduct. There was also a significant emphasis on the examination of whether the identified mitigating circumstances in Dr. Rezk’s case were indeed exceptional enough to justify taking no action.

In assessing sanctions, the court applied the Sanctions Guidance issued by the GMC, which provides a structure for determining the proportionality and appropriateness of various sanctions. It is advised to consider sanctions starting with the least restrictive, taking into account the necessity to protect the public and the proportionality of the sanction to the misconduct.


The High Court determined that the MPTS’s decision to take no action was wrong. By not imposing any sanctions, the MPTS’s ruling was deemed inconsistent with the mandate to maintain public confidence and uphold professional standards in light of the serious findings against Dr. Rezk.

The court replaced the MPTS’s decision by imposing conditions on Dr. Rezk’s registration for a period of 12 months, tailored to ensure he continues to address his attitudes towards female colleagues and to prevent recurrence of similar misconduct. The court also ordered a review before the end of the period to consider any further remediation. This decision was seen as striking an appropriate balance between the interests of Dr. Rezk and the public interest.


The General Medical Council v Nour Mohamed Magdy Aly Rezk case demonstrates the judiciary’s role in policing the disciplinary processes for medical practitioners. Ensuring that sanctions align with statutory objectives and the maintenance of public trust in the profession is of paramount importance. The High Court elucidated that, in instances of professional misconduct, sanctions must reflect the gravity of the behavior and the need for maintenance of public confidence and professional standards. The decision to impose conditions, rather than taking no action or suspending the practitioner, underscores the balance between individual consequences and the overarching goal of public protection.

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