Dr D Kwan - Professional Member
Mrs MJ Frankel - Member
WOLVERHAMPTON CITY PRIMARY CARE TRUST
DOCTOR ANTHONY PRYCE JONES
(Registration Number 3095719)
DECISION WITH REASONS
1. On 23 September 2004 Dr Jones (“the Respondent”) was convicted of indecent assault and sentenced to a 9 month custodial sentence and was placed on the Sexual Offenders Register for 10 years. Dr Jones applied for permission to appeal to the Court of Appeal against his conviction and sentence. His application (or his appeal, if permission had been given, as to which the information provided is unclear) was refused by the Court of Appeal on 11 April 2005.
B. Removal from Performers’ List
2. By a letter dated 29 September 2004 Messrs Mills & Reeve, acting on behalf of Wolverhampton City Primary Care Trust (“the PCT”), gave notice that the PCT removed the Respondent from its Performers’ List with effect from the date of his conviction. That removal was mandatory under Regulation 10(1)(b) of the National Health Service (Performers Lists) Regulations 2004 (“the Regulations”) which states that a Primary Care Trust “must remove the performer from its Performers’ List where it becomes aware that he … has been convicted in the United Kingdom of a criminal offence, committed on or after the day prescribed in the relevant Part, and has been sentenced to a term of imprisonment of over six months”.
C. Application for National Disqualification
3. The PCT began an investigation by its Professional List Panel on 24 June 2004. The report of the Investigating Officer dated 16 December 2004 recommended that the PCT apply for national disqualification of the Respondent on the ground of his unsuitability under Health & Social Care Act 2001 section 25, inserting section 49F(4) into the National Health Service Act 1977.
4. By letter dated 20 December 2004 the PCT applied to the FHSAA for an order for the national disqualification of the Respondent. By agreement this application was not heard before the disposal of the appeal to the Court of Appeal.
5. The power to make a national disqualification is contained in section 49N of the Health & Social Care Act 2001. In August 2004 the Department of Health provided Guidance on National Disqualifications in Delivering Quality Primary Care: PCT Management of Primary Care Practitioners’ Lists.
6. That Guidance contains two relevant propositions: “where the facts of the case are serious it would be wrong to allow the doctor to offer his services to every [PCT] in turn in the hope that he will find one willing to accept him” (paragraph 8.1.2) and “Unless the grounds for their decision were essentially local it would be normal to give serious consideration to [ ] an application [for National Disqualification](paragraph 8.1.5).
7. By a letter dated 25 May 2005 from Messrs RadcliffesLeBrasseur (acting on behalf of the Respondent) the Respondent informed the FHSAA that he did not intend to oppose the PCT’s application. They confirmed this to the FHSAA by e-mail dated 7 June 2005. It was, therefore, for the PCT to establish that a National Disqualification should be imposed.
D. The hearing
8. The hearing of the application took place at the Care Standards Tribunal on 8 June 2005. All members of the Appeal Panel confirmed that they had no conflict of interest in hearing the appeal. The PCT was represented by Ms J Hundle of Messrs Mills & Reeve. The Respondent did not appear and was not represented.
9. The PCT relied upon the seriousness of the incident proved to the criminal standard against the respondent and in particular the sexual nature of the assault carried out against a person sent to him for a medical report in connection with a claim arising out of a traffic accident. The length of custodial sentence and the listing of the Respondent on the Register of Sexual Offenders for ten years were evidence of that seriousness.
10. It was further submitted that the person assaulted was in a patient-doctor relationship at the time of the assault, even if not a patient on the respondent’s general practice list.
11. There were further allegations referred to in the Appeal Bundle of inappropriate sexual behaviour in relation to two colleagues at British Pregnancy Advisory Service and in relation to one NHS patient of the Respondent.
12. Finally the PCT relied on the Respondent’s failure to accept the chaperoning requirements placed upon him by the PCT and, indeed, his attempt to subvert them by introducing into the records an invitation to female patients to withhold consent to the PCT having access to those records for the purpose of auditing the effectiveness of the chaperoning arrangements.
13. We have been cautious in placing weight on the misconduct allegations that have not been proved (and indeed that the Respondent’s solicitors went some way to denying in their letter dated 28 October 2004). The allegations are to some extent corroborated by statements of Ms Gaw, Ms Winnall, Ms World, Ms Edwards and Ms Wright that were before us. The Respondent did not co-operate with the PCT’s investigation in the light of his impending trial and the PCT did not persist in the investigation, once obliged to remove him from the PCT’s Performers’ List. In all these circumstances and in the light of the fact that the Respondent has not chosen to appear or be represented before us to refute the allegations or to oppose the application, we are disposed to think it highly improbable that the incident that resulted in the Respondent’s conviction was an isolated one.
14. In any event that latter incident was a clear and serious breach of the relationship of trust necessary between doctor and patient. The Respondent sought unsuccessfully to dispute the verdict so that it appears unlikely that he has any insight into his position. In this context we were told that he denied to the PCT that he was suffering any ill-health or strain such as may have led or contributed to his unacceptable conduct.
15. The length of his sentence is an indicator of the seriousness of his conduct and we consider it would be highly inappropriate for a doctor in general practice to be subject to a ten-year presence on the Register for Sexual Offenders.
16.Although the attempts of the Respondent to frustrate the chaperoning arrangements imposed by the PCT are in one sense less shocking than the proved and alleged assaults and other sexual misconduct, they provide ample evidence that the Respondent has acted in an entirely unsuitable manner to be allowed to continue in general practice.
17. Although, again, on the evidence before us the events complained of have taken place within a local compass, they were not of a particular local character and there is no reason to suppose the Respondent would be less inclined to behave in a similar manner, if he were to practise general medicine in a different locality.
18. The only decision on the proper approach to the imposition of a national disqualification is to be found in the Case 10626 before this Authority of Tower Hamlets PCT v Kothari where the Panel decided: “It was accepted by Mr. Badenoch that if removal from the medical list of Tower Hamlets Primary Care Trust was warranted, there were no logical reasons to justify Dr. Kothari being allowed to practice elsewhere on an NHS list. It seems to us that this concession was rightly made for the deficiencies identified do not relate to geographical locality or, indeed, the precise list upon which Dr. Kothari might seek to exercise practice”. That reasoning applies equally to this case.
19. Our order is that, pursuant to Section 49N (3) of the National Health Service Act 1977, Dr. Anthony Pryce Jones be disqualified from inclusion in all Performers Lists prepared by all Primary Care Trusts.
20. We direct that a copy of this decision be sent to the persons and bodies referred to in Regulation 47 of the Family Health Services Appeal Authority (Procedure) Rules 2001.
21. Any party to these proceedings has the right to appeal this decision under and by virtue of Section 11 of the Tribunals and Inquiries Act 1992.
Mark Mildred – Chair
9 June 2004