Hasan v. General Medical Council (GMC) [2003] UKPC 5

Judicial Committee of the Privy Council
Case No Privy Council Appeal No. 52 of 2002Venue FROM THE PROFESSIONAL CONDUCT COMMITTEE OF THE GENERAL MEDICAL COUNCIL
Between
HasanAppellantGeneral Medical Council (GMC)Respondent
Before
Lord Hope of CraigheadLord Scott of FoscoteSir Andrew LeggattDate 21 January 2003
[1]:- Lord Hope of Craighead Lord Scott of Foscote Sir Andrew Leggatt [Delivered by Lord Hope of Craighead ] The appellant, Naveed Hasan, was formerly a registered medical practitioner. The Professional Conduct Committee of the General Medical Council determined on 20 June 2002 after an inquiry that he was guilty of serious professional misconduct and directed that his name be erased from the Medical Register. It also decided that it was necessary for the protection of members of the public that his registration be suspended immediately. He had previously appeared on several occasions before the Interim Orders Committee, which had imposed conditions on his registration. The effect of these conditions was that he was not to undertake any medico-legal work and that he was to give notice of any medical work which he applied for or undertook requiring registration with the General Medical Council. The conditions imposed by the Interim Orders Committee were revoked and replaced by an order for his immediate suspension. The appellant has now appealed against these decisions to this Board.[2]The charge of serious professional misconduct contained three principal heads of charge. The first head related to the appellant's financial dealings with Mrs Algailani by whom he was consulted in June 1999 about her father's heart condition. On 23 June 1999, having referred her father to a consultant at the Heart Hospital for an angiogram and a possible heart operation, he obtained £2,500 from Mrs Algailani as a deposit for his treatment from which he agreed to pay the costs of the initial treatment and to refund any balance to her. He asked that all bills be sent to him for payment, and two invoices from the consultant and one invoice from the hospital were duly sent to him. He later returned £1,000 of the deposit to Mrs Algailani. But it was alleged that he had failed to pay the consultant's invoices until after the proceedings had been referred for inquiry to the Professional Conduct Committee, that he had failed to pay the invoice from the hospital and that he had failed to return the balance of the deposit to Mrs Algailani.[3]The second and third heads of charge alleged that the appellant had agreed to provide bogus medical reports to undercover journalists. In the second head it was alleged that on 10 March 1999 he was consulted by a man calling himself Mohsin Ali Khan but whose real name was Mahzeer Mahmood and that, for a fee of £1,000 and in the belief that it would be submitted to the immigration authorities, he produced a report for him in which he gave details of Mr Khan's history, claimed to have examined him, gave a diagnosis of acute on chronic renal failure and stated that investigations were under way to confirm the diagnosis and that he had made arrangements for him to be admitted to a clinic, none of which was true. It was also alleged that on 12 March 1999 he offered to write a letter at a later date falsely claiming that Mr Khan had been admitted to hospital. In the third head it was alleged that on 19 March 1999 he was consulted by Mahmood Qureshi who told him that he was fit but required a false medical report to assist him in obtaining increased damages in a road traffic accident claim and that he agreed to provide a false or misleading report for £1,000, being aware that such a report might be submitted to an insurance company or to a court.[4]The appellant maintained in answer to the first head of charge that he had mislaid the two invoices which were paid late, that he had paid the invoice which had been sent to him by the hospital and that he had repaid the balance of the deposit to Mrs Algailani. He said that any defects in his handling of the matter were due to mismanagement and not to dishonesty. His answer to the second head of charge was that Mr Khan had been referred to him by a firm of solicitors, that he had prepared a genuine report after conducting an examination of him in his consulting room and that he had no knowledge that Mr Khan was an asylum seeker. His answer to the third head of charge was that he knew all along that Mr Qureshi's request for a false medical report was not genuine, that he played along with the man for a while before asking him to go away and that he did not agree to supply any report to him.[5]The Professional Conduct Committee heard evidence from Mrs Algailani and a financial accountant from the Heart Hospital. Statements were read without objection from the consultant, his secretary and the office manager of the hospital. It also heard evidence from Mahzeer Mahmood, the investigations editor of the News of the World newspaper, and Mahmood Qureshi, who worked from time to time as his assistant. They described their visits to the appellant which formed the basis for the second and third heads of charge. They had taken with them video and audio equipment which they had used to record their conversations with the appellant. Their evidence was supported by that of a freelance journalist who had set up the equipment for them and retrieved and held the tapes in safe keeping afterwards, and by a translator who had produced a transcript of Mahzeer Mahmood's conversation with the appellant which was conducted in the Punjabi language. A statement was also read from Tariq Malik, another freelance journalist who worked for Mahzeer Mahmood and accompanied him on his visit to the appellant as his concerned relative. Evidence had been given by an investigator employed by the respondent's solicitors who had taken Mr Malik's statement that he had been unable to contact him with a view to his giving evidence and that he was believed to have gone to Pakistan. The appellant's counsel objected to the reading of this statement, but the Committee held that its reception was desirable under rule 50 of the Professional Conduct Rules 1988. The appellant gave evidence on his own behalf, and his counsel also led evidence from an accountant named Imdad Hussein who said that he had made inquiries into Mr Malik's whereabouts.[6]The Professional Conduct Committee found that all the heads of charge had been either admitted or proved, with only two minor alterations in their wording which it is not necessary to repeat. Having been addressed under rule 28 of the Professional Conduct Rules they found it proved that he had been guilty of serious professional misconduct. When he came to give the Committee's reasons on the matter of sanction the Chairman included these words in statement of them:
"The Committee carefully considered whether reprimand, conditions or suspension would be sufficient in this case. The Committee considered whether these sanctions would be proportionate to the gravity of the offences and the need to protect the public and safeguard its trust in the profession. In so doing they have balanced the interests of patients and the public against your own. It is the duty of this Committee to protect patients and maintain public confidence in the medical profession. The Committee were left in no doubt that the seriousness of the findings means that only erasure could satisfactorily protect patients and maintain public confidence in the profession."
[7]The appellant, who represented himself in the appeal, confined his oral submissions to the following points. He said the allegation that he was dishonest was untrue. He had simply been duped by the two journalists who had come to him in disguise and entrapped him. On neither occasion had he acted of his own volition to harm anybody, and nobody had benefited from what he had done. In any event there was no independent witness to corroborate the journalists' allegations. The written statement by Tariq Malik should have been disregarded, as he had been found on the streets of London and his barrister had not had an opportunity of questioning him. As for the sanction which the Professional Conduct Committee had imposed on him, it was too harsh. He had given up all medico-legal work since 1999 and he was willing to undertake never to do such work again. He had given long service to the profession as a clinician and a surgeon both in this country and abroad and his patients had complete confidence in him and his ability. He will be 63 in February next year. He asked to be allowed to continue this work until his retirement, subject to the conditions which had been imposed on his registration by the Interim Orders Committee. The appellant also made submissions in writing which their Lordships have taken into account in their consideration of his appeal.[8]Their Lordships are not persuaded that there are any grounds for interfering with the decision of the Professional Conduct Committee that the appellant was guilty of serious professional misconduct. There was ample evidence to support the allegations which were made against him in all three heads of charge. He accepted in his evidence to the Committee that the balance of the deposit had not been returned to Mrs Algailani. He said that this was a fee due to him, but Mrs Algailani's evidence was that no mention had been made to her of any arrangement or other fees. He also said that any delay in the payment of the consultant's invoices was due to incompetence on the part of the consultant's secretary. The issues which the Committee had to resolve here were all issues of credibility, and the appellant did not suggest in his oral submissions that it was not entitled to find him guilty on this head of the charge. His main argument, which amounted to little more than a plea in mitigation when it was presented by him orally, was directed to the other two heads of charge which, in comparison with the first, are without doubt much the most serious.[9]There is some force in the appellant's complaint that he was duped by the journalists. They admitted that they were not what they held themselves out to be, and it is plain that the appellant was taken in by them. But that does not remove the sting from these two heads of charge. The essence of the complaint against him was that he was willing, when approached, to enter into transactions in his professional capacity which were profoundly dishonest and potentially very damaging. This was amply demonstrated by the conversations which took place when he was approached, of which both video and audio recordings were before the Professional Conduct Committee. Attempts were made to suggest that these recordings were unreliable and that the translation of the first conversation which was in Punjabi was inaccurate. But Ms Plaschkes for the respondent was able to show that these criticisms were without substance, and there is no doubt that the Committee was entitled to accept this evidence. The appellant's version of what took place was irrefutably contradicted by the contents of these recordings, as some deft questions by members of the Committee clearly demonstrated. The written statement by Tariq Malik was of little consequence against the background of all the other evidence. But the Committee were entitled to reject the appellant's contention that he was in London and should have been called to give his evidence, as his witness was unable to say that the person with the same name of whom he was speaking was the same man. In the light of its findings of fact and the nature of the conduct disclosed by these charges a finding by the Committee that the appellant was guilty of serious professional misconduct was inevitable.[10]The main point which the appellant sought to make in the submissions which he presented to the Board orally was directed to the fact that his name had been ordered to be erased from the Medical Register. He said that the sanction which had been imposed on him was too harsh. Their Lordships disagree. The choice of the sanction which is required to protect the public and maintain its trust and confidence in the medical profession is a matter which lies primarily within the province of the Professional Conduct Committee. It has often been said by the Board that it will be slow to interfere with a decision of the Committee as to the sanction which is appropriate. So it is not enough that the Board, if it had been left to it to decide this question, might have acted differently. But in this case their Lordships are in no doubt whatever that the sanction of erasure which was resorted to in this case was entirely justified.[11]The gravity of the appellant's conduct when he was approached by the journalists cannot be over-emphasised. The relationship between the medical profession and those liable to be affected by such conduct is one of trust. The work of the immigration authorities and of insurers in personal injury cases would be seriously impeded if investigations had to be conducted in every case about the probity of all the medical reports that are put in front of them. It is a tribute to the high regard in which the profession is held that these reports are normally accepted and acted on without any questions being asked as to whether or not they are genuine. The appellant showed by his conduct that he was prepared to abuse that relationship for personal reward in the most cynical manner without any regard to the consequences. His response to the findings which were made against him reveals a disturbing lack of insight into their gravity. If public trust in the profession is to be maintained, conduct of this kind must be rooted out wherever it is found. Erasure from the register coupled with immediate suspension was the only appropriate sanction in these circumstances.[12]Their Lordships will humbly advise Her Majesty that the appeal should be dismissed with costs.

Cited in 1 later judgment