“Gynaecologist is struck off for dishonesty and intention to cause distress A consultant gynaecologist who treated a neighbouring couple out of apparent friendship, then tried to bill them when the relationship turned sour, has been struck off after a fractious hearing at a medical practitioners’ tribunal in Manchester. Joseph Loze Onwude was also found to have worked for eight months without professional indemnity cover, acted as a GP in prescribing drugs for his neighbours despite lacking general practice qualifications, and failed to keep proper records of this treatment or to inform their actual GPs. Onwude, who qualified in Nigeria in 1981, trained at Dublin and Leeds before becoming a Fellow of the Royal College of Obstetricians and Gynaecologists. He was an NHS consultant until 2003, when he moved to private practice. He has published extensively, including in The BMJ. His neighbours told the hearing that for many years they had maintained a close personal relationship with Onwude and developed a business relationship. But relations deteriorated dramatically in 2012. In 2008 Onwude had treated one of his neighbours and in 2011 he provided further extensive treatment, with a good clinical outcome. He acknowledged in evidence that no payment was discussed because he then had no intention of charging. But in February 2013, after the friends had fallen out, he sent the couple two invoices totalling£69,450 for the treatment. This was followed by a statement of account two weeks later. The couple complained to the GMC, and during the investigation Onwude’s lack of indemnity cover at a private hospital came to light, leading to the withdrawal of his practising privileges. He treated 77 patients during this period. Onwude denied that the invoices were intended to cause distress, saying that he had merely wished to quantify his input into a personal and business relationship. But nothing in the bill suggested that it was not a real demand for payment, the tribunal found. It decided that attempting such billing years later for apparently free treatment was an act of dishonesty. The tribunal also rejected Onwude’s claim that his primary medical qualification allowed him to undertake GP work and that restrictions preventing doctors without a GP qualification from carrying out general practice applied only to NHS employees. Onwude, who was not legally represented at the hearing, argued repeatedly that the tribunal was treating him unfairly, compressing his case to fill the allotted time and denying him the opportunity to cross examine a telephone conference witness in person. Counsel for the GMC accused him of seeking to “derail proceedings”
“High court judge quashes decision to strike off gynaecologist for dishonesty A medical practitioners’ tribunal which decided that a doctor was dishonest in treating a couple who were friends for free and later sending them an invoice, had reached a conclusion that “no reasonable tribunal could conceivably have reached,” a High Court judge has ruled. Mr Justice Collins quashed the decision, made last December, to strike consultant gynaecologist Joseph Onwude from the medical register, subject to his right to appeal.1 Collins held that the tribunal’s decision that Onwude was not “honest and open” in giving the couple information about his charges in advance, even though he was not intending to charge, was also “a finding which no reasonable tribunal could conceivably have made”
“High Court Judge quashes decision to strike off gynaecologist for dishonesty to friends whom he treated and intention to cause distress We refer to the article entitled “Gynaecologist is struck off for dishonesty and intention to cause distress” published on22nd December 2016 with the citation BMJ 2016; 355: i6828. We are pleased to report the successful outcome of Dr Onwude’s appeal to the High Court which resulted in his reinstatement to the Medical Register as a practising consultant gynaecologist on the basis that the findings of the Medical Practitioners’ Tribunal (MPT) of the General Medical Council (GMC) in respect of the charges brought by the GMC, in its role as prosecutor, were findings which no reasonable tribunal could have found on the evidence before it, which contained no evidence of dishonesty or any evidence of an intention to cause distress to his patients. Dr Onwude represented himself at the hearing before Me Justice Collins in the High Court. He was assisted in a direct access basis by Leading Counsel, Nicholas Padfield QC. Costs were awarded by the Judge to Dr Onwude and Leading Counsel following his decision. His right of appeal to the High Court was initially denied by the GMC because his appeal was “out of time”
“Gynaecologist whose erasure was quashed in High Court is fit to practise A consultant gynaecologist who in March 2017 won a High Court ruling quashing a decision to strike him off the UK medical register has scored a further victory against the General Medical Council. After a new hearing, a medical practitioners’ tribunal has decided that Joseph Onwude’s fitness to practise was not impaired and that his conduct merited only a written warning. An earlier tribunal had decided that he had been dishonest in treating two friends and business partners free of charge and then sending them an invoice after the relationship broke down. That tribunal determined in December 2016 that he should be struck off the register. Onwude subsequently exercised his right of appeal to the High Court. But Mr Justice Collins, who heard the appeal, ruled that no reasonable tribunal would have found that his actions amounted to dishonesty. He quashed the findings of dishonesty and the decision to strike him off the register.1 Collins ruled that the tribunal’s finding that Onwude intended to cause the couple distress was unjustified, and he quashed the decision that the doctor was guilty of misconduct in treating friends. The judge sent the case back to the tribunal to determine whether the findings that had not been quashed amounted to misconduct serious enough to warrant a finding that Onwude’s fitness to practise was impaired, and, if so, what sanction to impose. He said he suspected that “the appropriate result would be no action”
“It is clear to the tribunal that Mr Onwude is a highly respected, experienced, and valued doctor with high standards of probity and integrity”, he added. “Although this was a serious failure, it was a regrettable anomaly in an otherwise very distinguished career”
“Reports, &c. protected by qualified privilege (1) The publication of any report or other statement mentioned in Schedule 1 to this Act is privileged unless the publication is shown to be made with malice, subject as follows. (2) In defamation proceedings in respect of the publication of a report or other statement mentioned in Part II of that Schedule, there is no defence under this section if the plaintiff shows that the defendant— (a) was requested by him to publish in a suitable manner a reasonable letter or statement by way of explanation or contradiction, and (b) refused or neglected to do so. For this purpose “in a suitable manner” means in the same manner as the publication complained of or in a manner that is adequate and reasonable in the circumstances. (3) This section does not apply to the publication to the public, or a section of the public, of matter which is not of public interest and the publication of which is not for the public benefit. (4) Nothing in this section shall be construed— (a) as protecting the publication of matter the publication of which is prohibited by law, or (b) as limiting or abridging any privilege subsisting apart from this section.”
“26. There are a number of authorities on what constitutes a fair and accurate report. It need not be a verbatim report. It can be selective and concentrate on one particular aspect as long as it reports fairly and accurately the impression that the reporter would have received as a reasonable spectator in the proceedings: see generally Cook v Alexander[1974] QB 279 and Tsikata v Newspaper Publishing plc[1997] 1 All ER 655 . 27. However, these appeals are principally concerned with the quality of fairness. Fairness in section 15 has been held to mean fairness in terms of presentation rather than fairness between the speaker and the subject of the statement: see per Lord Denning MR in Cook v Alexander[1974] QB 279 , 289. A report does not cease to be fair because there are some slight inaccuracies or omissions: Andrews v Chapman (1853) 3 C & K 286 , 290. It follows that if there is a substantial or material misstatement of fact that is prejudicial to the claimant's reputation, the report will not be privileged.”
“The principles are clearly stated in the following authorities, all of which I have considered in the course of preparing this judgment: Cook v Alexander[1974] QB 279 , Tsikata v Newspaper Publishing plc[1997] 1 All ER 655 , Ismail v News Group Newspapers Ltd[2012] EWHC 3056 (QB) , and Qadir…. Key points for present purposes are that fairness and accuracy are matters of substance not form. A report does not need to be verbatim. It may to an extent be impressionistic. Fairness is to be tested by reference to the impact on the claimant's reputation. Minor inaccuracies will not deprive a defendant of the privilege.”
“2. …The emphasis upon the public character of the meetings and the criterion of public concern and public benefit help to explain the true purpose of proviso (b). It is to enhance the information given to the public on a particular matter. It is also to recognise that, in the nature of the particular meetings specified, inaccurate, unfair or defamatory statements may be made which can then be published under qualified privilege. Fairness requires the balancing of that right with a provision, to those complaining about its exercise, of the opportunity to place a contradictory statement or explanation before the public. The request would have to be reasonably contemporaneous with the publication. It would not ordinarily be reasonable to expect publication of a letter or statement years or perhaps even months later. The criterion of the public's interest must be kept in mind in giving meaning to the section, including proviso (b). 3. By the terms of the proviso, any such letter or statement must be "reasonable". It was urged that this meant reasonable from the point of view of the person complaining or tendering the statement. However, in my view, "reasonable", in this context, means objectively reasonable for the purpose for which the statutory facility has been provided. That is to allow already published facts to be contradicted or explained by those claiming to be hurt by the report of them. The reference to "reasonable" is intended to control such matters as the length of the letter or statement, the terms in which it is expressed and the avoidance of gratuitous defamation of third parties. I do not regard the word "reasonable" as affording an editorial veto to the publication of a letter which is strongly expressed or contains disputable propositions or arguable inaccuracies. After all, it is always open to the publisher to have the last word. It is not uncommon, where letters of complaint are published, for an editorial note to be added expressing the publisher's reply. The sting of defamation often causes emotion and anger. That is the context in which Parliament has made provision for a letter or statement in reply to be given its statutory status. Publishers of newspapers who have considerable power to harm reputations should not be overly tender about complaints and expressions of anger when appearing in a letter or statement to which proviso (b) applies. 4. The proviso makes no express mention of editorial amendment, abbreviation or alteration. But neither does it expressly state that the letter or statement must be "accurate". In the real world, if some aspect of a letter or statement were thought to take it outside the bounds of reasonableness, it would be sensible for there to be negotiation between the publisher and the person complaining. A failure or refusal to enter into such negotiation might, in a particular case, confirm an opinion that, on the whole, the letter or statement tendered was "reasonable". Otherwise, all of the cards are stacked in favour of the publisher and against the person complaining. The purpose of the proviso is to afford the complainant a statutory means to secure the publication of a relevant contradiction or explanation. The purpose of the publication envisaged by the proviso is not to afford the complainant, or anyone else, the opportunity to insult the publisher, to extract an apology or to defame others. The ultimate purpose is to contribute to equalising the power to communicate with the audience which has already heard or seen matter considered to be defamatory where it is desired by the person affected to offer to the public other material in contradiction or explanation.”
“(1) It is a defence to an action for defamation for the defendant to show that- (a) the statement complained of was, or formed part of, a statement on a matter of public interest; and (b) the defendant reasonably believed that publishing the statement complained of was in the public interest. (2) Subject to subsections (3) and (4), in determining whether the defendant has shown the matters mentioned in subsection (1), the court must have regard to all the circumstances of the case. (4) In determining whether it was reasonable for the defendant to believe that publishing the statement complained of was in the public interest, the court must make such allowance for editorial judgement as it considers appropriate. (6) The common law defence known as the Reynolds defence is abolished.”
“The elasticity of the common law principle enables interference with freedom of speech to be confined to what is necessary in the circumstances of the case. The elasticity enables the court to give appropriate weight, in today's conditions, to the importance of freedom of expression by the media on all matters of public concern. 1. The seriousness of the allegation. The more serious the charge, the more the public is misinformed and the individual harmed, if the allegation is not true. 2. The nature of the information, and the extent to which the subject-matter is a matter of public concern. 3. The source of the information. Some informants have no direct knowledge of the events. Some have their own axe to grind, or are being paid for their stories. 4. The steps taken to verify the information. 5. The status of the information. The allegation may already have been the subject of an investigation which commands respect. 6. The urgency of the matter. News is often a perishable commodity. 7. Whether comment was sought from the plaintiff. He may have information which others do not possess or have not disclosed. 8. Whether the article contained the gist of the plaintiff's side of the story. 9. The tone of the article. A newspaper can raise queries or call for an investigation. It need not adopt allegations as statements of fact. 10. The circumstances of the publication, including the timing.”
“That is not to say however, that the matters identified in the non-exhaustive checklist may not be relevant to the outcome of a public interest defence, or that, on the facts of the individual case, the failure to comply with one or some of the factors, may not tell decisively against a defendant. However, even under the Reynolds regime, as Lord Nicholls made clear, the weight to be given to those factors, and any other relevant factors, would vary from case to case. As with Reynolds therefore, with its emphasis on practicality and flexibility, all will depend on the facts.”