"That being registered under the Medical Act, 1. On a number of occasions between6 June 2000 and17 October 2001 , [Mr R] consulted you about the removal of his tattoo. a. You failed to make an adequate assessment of his condition, b. You made inappropriate and inaccurate claims about the likely efficacy of the treatment, c. You failed to provide him with sufficient pre-operative information to enable him to give properly informed consent, d. You provided inadequate and inappropriate treatment, e. You failed to provide adequate and/or appropriate post-operative care, f. You failed to keep adequate records; 2. On5 January 2000 , Miss A consulted you about the pigmentation marks on her legs ..."
"And that in relation to the facts alleged you have been guilty of serious professional misconduct."
"Dr Mahfouz was struck off in 1987 when working as a GP's assistant and failed to refer a patient he knew to be in a critical condition to hospital."
"Dr Fayez Abu Mahfouz, who claimed to be the only man in Europe able to turn a black person white, was exposed by BBC investigative reporter Paul Kenyon, the General Medical Council was told."
"Dr Abu Mahfouz was struck off the register in 1987 when he was working as a GP's assistant and failed to refer a patient he knew to be in a critical condition to hospital. The GMC accused him of a 'lamentable standard of professional care and attention'. He was reinstated 1992."
"Question 1 'In the circumstances of this case, would those circumstances lead a fair minded and informed observer to conclude that there was a real possibility that the tribunal was biased (consciously or unconsciously)?' 'Real' means 'not without substance' Question 2 'Is there in fact a real possibility that the matters relied upon by the practitioner in his application could have a prejudicial effect on the minds of the Committee unconsciously and thus insidiously?'"
"One essential element in a fair hearing is the requirement that the decision-maker should be impartial. But while the proposition is easy to state the analysis and the application of it is more difficult. Impartiality calls for a state of mind which is free from any influences extraneous to the merits of the particular case, which is capable of a dispassionate inquiry and an objective judgment, and which is not turned aside by any motivation to favour one side as against the other. But the actual state of a person's mind is not always readily discoverable and absolute perfection may not be readily attainable. More subtly the decision-maker may be influenced quite unconsciously in the one direction or the other by extraneous considerations in ways which may be evident to or suspected by others but of which he is unaware. The insidious nature of bias makes its identification elusive. The law does what it can by recognising that bias may be apparent as well as actual. Thus proof of an appearance of bias may be as fatal as proof of a state of mind which is actually partial."
"The apparent position is then as important as the reality and may be effective regardless of the reality."
"103. I respectfully suggest that your Lordships should now approve the modest adjustment of the test in R v Gough set out in that paragraph. It expresses in clear and simple language a test which is in harmony with the objective test which the Strasbourg court applies when it is considering whether the circumstances give rise to a reasonable apprehension of bias. It removes any possible conflict with the test which is now applied in most Commonwealth countries and in Scotland. I would however delete from it the reference to 'a real danger'. Those words no longer serve a useful purpose here, and they are not used in the jurisprudence of the Strasbourg court. The question is whether the fair-minded and informed observer, having considered the facts, would conclude that there was a real possibility that the tribunal was biased. "104. Turning to the facts, there are two points that need to be made at the outset. The first relates to the auditor's own assertion that he was not biased. The Divisional Court said, at p 174A-B, that it had had particular regard to his reasons for declining to recuse himself in reaching its conclusion that he had an open mind and was justified in continuing with the subsequent hearings. I would agree that the reasons that he gave were relevant, but an examination of them shows that they consisted largely of assertions that he was unbiased. Looking at the matter from the standpoint of the fair-minded and informed observer, protestations of that kind are unlikely to be helpful. I think that Schiemann LJ adopted the right approach in the Court of Appeal when he said that he would give no weight to the auditor's reasons: ante, p 400C. The second point relates to the emphasis which the respondents place on how the auditor's conduct appeared from the standpoint of the complainer. There is, as I have said, some support in the jurisprudence of the Strasbourg court for the proposition that the standpoint of the complainer is important. But in Hauschildt v Denmark 12 EHRR 266, 279, para 48 the court emphasised that what is decisive is whether any fears expressed by the complainer are objectively justified. The complainer's fears are clearly relevant at the initial stage when the court has to decided whether the complaint is one that should be investigated. But they lose their importance once the stage is reached of looking at the matter objectively. "105. I think that it is plain, as the Divisional Court observed, at p 174B, that the auditor made an error of judgment when he decided to make his statement in public at a press conference. The main impression which this would have conveyed to the fair-minded observer was that the purpose of this exercise was to attract publicity to himself, and perhaps also to his firm. It was an exercise in self-promotion in which he should not have indulged. But it is quite another matter to conclude from this that there was a real possibility that he was biased. Schiemann LJ said, at p 1457D-E, that there was room for a casual observer to form the view after the press conference that the auditor might be biased. Nevertheless he concluded, at p 1457H, having examined the facts more closely, that there was no real danger that this was so. I would take the same view. The question is what the fair-minded and informed observer would have thought, and whether his conclusion would have been that there was a real possibility of bias. The auditor's conduct must be seen in the context of the investigation which he was carrying out, which had generated a great deal of public interest. A statement as to his progress would not have been inappropriate. His error was to make it at a press conference. This created the risk of unfair reporting, but there was nothing in the words he used to indicate that there was a real possibility that he was biased. He was at pains to point out to the press that his findings were provisional. There is no reason to doubt his word on this point, as his subsequent conduct demonstrates. I would hold, looking at the matter objectively, that a real possibility that he was biased has not been demonstrated."
"The question is whether the fair-minded and informed observer, having considered the facts, would conclude that there was a real possibility that the tribunal was biased."
"To the basic requirement of fair mindedness is added the need to be properly informed ..." and he then went on to give illustrations of that. At paragraph 21, the conclusion was that the Privy Council felt that they could safely say that there was no danger there of any prejudice to the doctor. It was said: "... this was a well-established quasi-professional tribunal which had been directed in plain terms to pay no attention to the previous conviction because it would give them no assistance, a direction reinforced by the fact that it dealt with events more than 20 years before."
"This is not a case of apparent bias. There was no abuse of process calling for the stay of the disciplinary proceedings before the committee. The committee are an independent and impartial tribunal, and there are no grounds for quashing the finding of serious professional misconduct on the basis that these proceedings should have been stopped or the determination set aside for abuse of process. The onus is on the appellant to establish a prima facie case of apparent bias, and in their Lordship's judgment he has failed to do so."
"Public perception of the possibility of unconscious bias is the key. It is unnecessary to delve into the characteristics to be attributed to the fair-minded and informed observer. What can confidently be said is that one is entitled to conclude that such an observer will adopt a balanced approach."
"The principle to be applied is that stated in Porter v Magill, namelywhether a fair-minded and informed observer, having considered the given facts, would conclude that there was a real possibility that the tribunal was biased. Concretely, would such an observer consider that it was reasonably possible that the wing member may be subconsciously biased?"