1.      This is an appeal pursuant to Regulation 18G(1)(b) of The National Health Service (General Medical Services) Regulations 1998 (as amended), against the refusal by Hillingdon Primary Care Trust (the PCT) to appoint Dr Rahim to the sole practitioner vacancy at The Warren Health Centre, Uxbridge Road, Hayes, Middlesex, advertised under the provisions of Regulation 18(C), (D) and (E)

2.      At the hearing held at The Hillingdon Hospital on the 12 June 2002 Dr Rahim appeared with Mr Wishart of the British Medical Association and the PCT through Mr Aldridge of Counsel.

3.      The right of appeal against such decisions are limited to a point of law (Reg.18G(1)). Dr Rahim alleges that the manner in which the PCT handled the issue of references was flawed to an extent that denied him the opportunity of competing for the vacancy on equal terms.


4.      The PCT appointed Dr Rahim as locum at The Warren Health Centre some 14 months’ before declaring the vacancy. On 10th November 2001 Dr Rahim applied to fill the vacancy. His referees were Dr P Stephens, principal of a second practice operating out of The Warren, and Dr V K Chatrath for whom Dr Rahim had worked as a locum and whose name, significantly, he had given to the PCT as referee prior to his appointment as locum at The Warren.

5.      Dr Rahim was shortlisted and his interview arranged for the 5 December 2001.  On the 29 November Dr Rahim. was informed that Dr Stephens could no longer act as referee because his partner had applied to fill the vacancy. As a fact the panel found it was Dr Rahim who suggested to the PCT that Mrs H Patel of The Warren Medical Centre, Phsyiotherapist, should replace Dr Stephens as referee.

6.      The interview panel consisted of a representative of the Human Resources Department of the PCT, the Locality Development Manager and Dr Gutteridge, Consultant in Public Health Medicine and Medical Adviser, in the chair. Dr. Gutteridge fairly conceded that it would have been desirable for a practising G.P. to have been on the panel, indeed that was the intention but the nominated practitioner was unable to attend.

7.      Dr Rahim’s interview was satisfactory and the panel intended to appoint him to The Warren vacancy subject to references. Following the decision it became apparent that, contrary to usual practice, the Human Resources Department did not have written references from either referee. At this point Dr. Gutteridge took it upon himself to speak to Dr Chatrath, which he did on the morning of the 6th December. As a result of that conversation Dr Gutteridge recommended to the panel that it should not appoint Dr Rahim and indeed the vacancy was offered elsewhere.

8.      Dr Gutteridge spoke to Dr Rahim on the morning of the 8th December to inform him that his application was unsuccessful. Dr Gutteridge’s note of the conversation is instructive. He advised Dr Rahim to think carefully about whom he should ask for a reference as Dr Chatrath. “was not happy to give him one.”  The impression gained from that observation and also from hearing Dr Chatrath’s evidence was that indeed Dr Chatrath was reluctant to say anything about Dr Rahim and did so only on being pressed. It is noteworthy that the letter from the PCT to Dr Chatrath’s practice asking for a written reference had gone unanswered although it was not clear from the evidence whether this was an oversight or intentional.

9.      After considering the evidence, re-reading the appeal bundle and taking into account submissions the panel came to the following conclusions:-



(a)   it was undesirable and indeed improper to obtain an oral reference from a clearly unwilling referee. Although the burden was upon Dr Rahim to ensure his references were available to the appointment panel, in the circumstances of this case Dr Rahim might properly have expected Dr Chatrath to provide a written reference.  He had done so on earlier occasions and Dr Chatrath referred to a written reference from his practice which apparently indicated that Dr Rahim as acceptable for a locum post.  Indeed Dr Chatrath was the named referee when Dr Rahim first applied for the locum post at The Warren.

(b)   Lack of written references should have led the panel to defer making the appointment until Dr Rahim had been informed and given the opportunity to remedy the position.

(c)   Whilst not inferring that Dr Gutteridge acted otherwise than in good faith, his report to the other panel members’ of his conversation with Dr Chatrath must have meant, of necessity, he gave his own version of the conversation, without the emphasis, immediacy and colouring of the conversation itself. A virtue of written references is that they speak for themselves and can be read by each panel member who can form his or her own view on what is in front of them.  Dr Gutteridge said that he did not ask Dr Chatrath to confirm the conversation in writing.

(d)   Dr Gutteridge was by some distance the most senior of the appointment panel. The tenor of his evidence was that he told the other members’ they should not appoint Dr Rahim. Unlike the decision to appoint Dr Rahim we were not referred to any notes of further discussions between the panel in the light of Dr Gutteridge’s report of his conversation with Dr Chatrath. In particular there was no attempt to set-off the oral reference against the 14 months’ presumably satisfactory employment as locum at the practice where the vacancy was declared.

(e)   Despite evidence from the PCT Practice Development Manager that references “ form a very important part of the appointment procedure”, no attempt was made to obtain the reference from Mrs. Patel, which may (or may not) have gone some way to redressing the unfavourable impression left by Dr Chatrath. It was wrong of the PCT to say that it did not call for Mrs. Patel’s reference because it would have made no difference. The duty to act fairly toward Dr Rahim required the PCT to have before it and consider all the material relating to Dr Rahim’s application. There is nothing in Dr Rahim’s point that he was not given the job because he had given Mrs. Patel as a referee and not a General Practitioner.



10.  The panel are of the unanimous view that the evidence discloses procedural irregularities leading to unfairness in the way in which the PCT dealt with the application by Dr Rahim, allows the appeal and remits the application to the Primary Care Trust for re-consideration with the following directions:

(i)      the PCT appoint a new selection committee to act on its behalf and, providing regulations so admit, such committee be drawn from persons outside the district covered by the Hillingdon Primary Care Trust

(ii) the papers held by the PCT in respect of the present application should remain closed and unavailable to the new selection committee

11        Any party to these proceedings has the right to appeal this decision under and by virtue of Sec.11 of the Tribunals and Inquiries Act 1992.

     Dated this               day of                                                       2002.



                                                                                        Mr Paul Kelly   -   Chairman



                                                                                                                                                Dr Rahim K Rathi   -   Professional Member

                                                                                                                                                      Mr A G W Harbour    -   Lay Member