Bux v The General Medical Council [2021] EWHC 762 (Admin) (31 March 2021)

Doctor accused of involvement with a medico-legal scheme deemed to have all the “hallmarks of a corrupt practice” lose appeal against erasure.

On 9 October 2019 the Medical Practitioners Tribunal Service (MPTS) made findings of fact that Dr Zuber Bux, the appellant, had acted in a state of conflict of interest, dishonestly and for financial gain. Based on those findings the MPTS found that the appellant’s fitness to practise was currently impaired by reason of misconduct and erased his name from the Medical Register.

The facts found proved fell into four categories, namely:

i) that the appellant acted in a state of conflict of interest by accepting instructions through an agent, Medico Legal and Litigation Services Ltd, to prepare medico-legal reports in respect of holiday sickness claims, from a firm of solicitors in which his wife was a salaried partner;

ii) that in one case he gave a deliberately false answer;

iii) that he made diagnoses without proper evidence and had in his reports failed to follow the requirements; and

iv) that he improperly performed a circumcision procedure in the community and in so doing failed to recognise or advise in terms of the risk of doing so.

Appeal

Dr Bux appealed the MPTS decision om the grounds that:

  1. there was no conflict of interest, that issue having been decided in the appellant’s favour by a preliminary-issue judgment given by HHJ Gregory in the County Court at Liverpool in one of the claims where the appellant was acting as an expert witness;
  2. as there was no conflict of interest, there was no duty on the appellant as expert to disclose anything;
  3. the flawed finding by the MPT that there was a conflict of interest, and a breach of the duty to disclose it, contaminated the findings on improper diagnoses, dishonesty and financial motive;
  4. the MPT applied an incorrect legal test to the question of dishonesty, and its finding in that regard was thereby vitiated; and
  5. the sanction of erasure was disproportionate, unduly harsh and unreasonable.

Judgement

Mr Justice Mostyn said in his judgement of Dr Bux:

“As an expert witness the appellant owed to the court a duty of independence and objectivity.”

“On the other hand, the defendant had a personal interest in keeping up to speed the lucrative throughput of medical reports the benefit from which accrued not only to himself but also to his wife. She was a co-shareholder in the company to which the proceeds of the work were paid, and was a partner in the firm of solicitors providing him with the work.

“In 2016 it was abundantly clear to the appellant that he had to disclose his marital relationship not only to the defendant’s insurers but also to the court. This was clear to the appellant not only from the terms of the codes of guidance to which he was subject, but also as a result of the letter written in 2011 by the MDU. But he made no disclosure.

” The appellant had on 12 May 2017 signed replies to CPR 35.6 questions, endorsed with a statement of truth, which were completely false.”

Mostyn J concluded that:

“In such circumstances, in my judgment, it would have been perverse and wrong for the MPTS to have decided anything other than that the appellant had an actual, serious, conflict of interest of the first type. I am satisfied, notwithstanding the presence of some linguistic confusion, that this is what the MPTS decided.

“Having made the findings of dishonesty, the finding of impairment of fitness to practise and the sanction of erasure were inevitable.”

 

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