HEARING ON 18TH NOVEMBER 2002
( GMC Number 0960449 )
Application by the Applicant for a national disqualification to be imposed on the Respondent under the provisions of Section 49N (4) (b) of The National Health Service Act 1977, introduced by The Health and Social Care Act 2001.
This application was heard by us today at the Bradford Hospitals NHS Trust, The Bradford Royal Infirmary, Bradford. Prior to the hearing, all three members of the Panel had signed a declaration to the effect that they did not have any “interest” in the application, which would preclude them from hearing it in an independent and impartial manner.
The Applicant was represented by Mr G. M. Horne, The Head of Primary Care Services for The West Yorkshire Central Services Agency. He was assisted by Mr N. Coulter, The Administration and Contracts Manager for the Agency.
The Respondent did not attend before the Panel nor was he represented; nor had he submitted any written or documentary evidence.
In that respect, the Panel had written evidence before it from The Family Health Services Appeal Authority ( FHSAA) that (i) all appropriate documentation, together with details of the date, place and time of the hearing, had been sent to the Respondent by post to his home address on 18th October 2002 and had not been returned by the postal authorities and (ii) further copies had been posted through his letterbox at his home address by process servers on 25th October 2002. In these circumstances, Mr Horne invited us to deal with the application in the Respondent’s absence.
Having considered this issue, the Panel was satisfied that the Respondent had been properly served with, and had received, notice of this application and the documentation in support thereof pursuant to Rules 29(3) and 23(1) of The Family Health Services Appeal Authority (Procedure) Rules 2001 (The Rules). Furthermore, even if service had only been effected on 25th October 2002 (and not the earlier date of 18th October 2002), the Respondent had had more than 21 days in which to send or deliver a “written reply” to the FHSAA pursuant to Rule 23(3) of the Rules. The Panel noted, however, that he had omitted to do so. Indeed, he had not responded in any way.
In these circumstances and as we had no evidence before us that the Respondent had a reasonable excuse (or any at all) for not attending, we decided to hear and determine the application in the Respondent’s absence pursuant to Rule 40(1) (a) of the Rules.
The Panel had seen copies of the written application made by the Applicant and the documents in support thereof. They are (i) a letter dated 15th August 2002 from The West Yorkshire Central Services Agency to the FHSAA, (ii) a letter dated 12th April 2002 from The General Medical Council to The West Yorkshire Central Services Agency, (iii) a letter dated 30th May 2002 from The West Yorkshire Central Services Agency to the FHSAA and (iv) a letter dated 29th May 2002 from The West Yorkshire Central Services Agency to the Respondent.
The background to the application is clear from these documents and Mr Horne has confirmed the situation to us today. It is as follows. On 29th May 2002, the Applicant refused the Respondent’s application to be included in the supplementary list of doctors approved by them for the purposes of assisting in the provision of general medical services.
The ground on which they refused his application was that set out in 6(1) (a) of The National Health Service (General Medical Services Supplementary List) Regulations 2001 (the Regulations), which reads as follows:-
“that the Health Authority having considered the declaration required by regulation 4(4) and (5) and any other information in their possession in relation to this application, consider he is unsuitable to be included in the list;”
The declaration in question (according to the written application) is that required by Regulation 4(4) (j). That reads:-
“4(4) The doctor shall send with the application a declaration as to whether he –
(j) is, or has been where the outcome was adverse, the subject of any
investigation into his professional conduct in respect of any current
or previous employment.”
In this respect, Mr Coulter told us today that the Respondent’s application and accompanying declarations were dated and signed by him on 20th March 2002. We did not see the application and declarations themselves because the Applicant had not included them in the documents on which it intended to rely for the purposes of this application. However, Mr Coulter read a declaration to us, on which he maintained the Applicant relied for the purpose of the present application. In answer to the question “Are you currently the subject of any investigation by any licensing, regulatory or other body into your professional conduct or performance anywhere in the world?”, the Respondent had replied “No”. In passing, we note that this is not the declaration referred to in the Applicant’s written application (the letter of 29th May 2002 to the Respondent) but is clearly a reference to the declaration required by Regulation 4(4) (g) and not (j). In either event, however, the Respondent was declaring that he was not currently the subject of an investigation into his professional conduct.
The Applicant maintains that this declaration was a false declaration in view of the contents of the letter dated 12th April 2002 from The General Medical Council. We will not set out in full the contents of that letter. However, it is clear from it that, on 11th February 2002, the Council’s Preliminary Proceedings Committee considered a number of serious allegations against the Respondent. That Committee then decided that, if these allegations were proved, they would amount to serious professional misconduct. The Committee had, therefore, referred the matter to The Professional Conduct Committee. However, a hearing before that Committee had not yet taken place.
Mr Horne maintained today that these proceedings before the Preliminary Proceedings Committee could not have taken place without the Respondent being aware of them and the allegations. Mr Horne maintained, therefore, that, as the allegations were considered by the Preliminary Proceedings Committee on 11th February 2002, the Respondent must have been aware of the investigation when he signed his declaration on 20th March 2002. That declaration, the Applicant contends, was, therefore, false.
Consequently, having refused the Respondent’s application for inclusion on the supplementary list (a decision which the Respondent has not appealed), the Applicant now applies to the Panel for a national disqualification to be imposed pursuant to Section 49N (4) (b) of The National Health Service Act 1977. Any such disqualification would, of course, disqualify the Respondent from being included in not just the supplementary list held by the Applicant for its area but in any other lists, which we might specify, held by all other Health Authorities in England.
Mr Horne makes his application to us today on two specific grounds:-
Firstly, he referred us to paragraphs numbered 5 and 6 in the letter of 12th April 2002 from The General Medical Council. These paragraphs state that, on 30th September 1999, an Order was made against the Respondent in the Leeds County Court to the effect that he should indemnify Bradford Health Authority in the sum of £250,000 plus costs. This was a sum which the Health Authority had incurred in seeking to defend an action against the Respondent and the Health Authority brought by a patient of the Respondent in respect of matters also set out in the letter. The Respondent had “failed to respond to this Order or to correspondence from the Health Authority.”
Mr Horne contended, therefore, that the Respondent should not be permitted to practise anywhere in the country whilst this debt remained undischarged.
Secondly, the fact that the Respondent made a false declaration, to which we have referred above, in his application for inclusion on the list.
Mr Horne contends, therefore, that we should now impose a national disqualification on the Respondent because there is a risk that he may apply for inclusion on the lists of other Health Authorities and could be accepted. The imposition of a national disqualification would ensure that this did not happen.
We have not, of course, received any evidence, written or oral, from the Respondent. However, having carefully considered the written evidence from the Applicant and the representations made to us today by Mr Horne and Mr Coulter, we find as a fact that the Respondent has failed to respond in any way to the Order made against him in the Leeds County Court on 30th September 1999 in the sum of £250,000 plus costs and that that amount remains outstanding. We further find that, when the Respondent made his application to the Applicant for inclusion on their supplementary list, the accompanying declaration that he was not the subject of an investigation into his professional conduct was a false one and that he knew it to be false.
Section 49N of The National Health Service Act 1977 does not set out any grounds of which we must be satisfied before we are entitled to impose a national disqualification. In our opinion, however, such a disqualification ought to be considered if the conduct complained of and found proved amounts to something more than an issue which is only relevant to an applicant Health Authority.
We do not seek to pre-judge the outcome of the proceedings against the Respondent before The Professional Conduct Committee of The General Medical Council. That is not an issue before us today. However, the allegations made against the Respondent are of a serious nature and it concerns us greatly that the Respondent made a material and significant false declaration to the Applicant in his attempt to be included on the Applicant’s supplementary list. This leads us to the inevitable conclusion that the Respondent’s conduct and intentions were dishonest. Furthermore, his failure to even acknowledge the Court Order against him demonstrates a complete lack of responsibility and probity on his part.
Honesty, integrity, probity and an acceptance of responsibility are clearly qualities which the public anywhere are entitled to expect from members of the medical profession. In our opinion, therefore, it would be wrong to allow a situation to exist where applications could be made to other Health Authorities, which may be accepted. We are satisfied, therefore, that this is not simply a local issue between the Applicant and the Respondent but that it has national implications, which are just as important elsewhere in the country. Issues of dishonesty, integrity and probity do not, in our opinion, have boundaries and the Respondent’s omissions, which we have found proved, are of a grave and serious nature.
In these circumstances, we grant the Applicant’s application for a national disqualification of the Respondent on both grounds and we disqualify the Respondent from inclusion on the general medical lists, the supplementary medical lists and the personal medical services lists (when introduced) of all Health Authorities.
Mr Horne accepted before us today that it appeared that the Respondent did not have the usual insurance cover in respect of all aspects of the claim made against him and the proceedings brought against him in the Leeds County Court, to which we have referred above. We accept that the primary responsibility for effecting such cover lies with the Respondent. However, Mr Horne conceded that appropriate checks by The Bradford Health Authority “may well not have been undertaken.” If no or inadequate checks were made, we would respectfully suggest that the Applicant reviews its administrative procedures.
Finally, in accordance with Rule 42(5) of the Rules, we hereby notify the Respondent that he may have rights relating to appeals under Section 11 of The Tribunals and Inquiries Act 1992.
Chairman of the Panel
18th November 2002.