Doctor fail to overturn erasure – Joseph v General Medical Council

A doctor has failed to overturn a MPTS decision to erase him from the GMC register in the case of Joseph v GMC.

Dr Joseph was erased from the medical register following allegations about his conduct towards another doctor, a female colleague more junior than him and significantly younger, between January 2013 and August 2014. The MPT’s findings of fact included that (in summary):

a) on 20^th January 2013, Dr Joseph searched for and accessed a CT scan of the complainant, without her consent and without a clinical reason, and told her it indicated a brain pathology that resulted in sexual disinhibition;

b) on 26^th April 2013, Dr Joseph sexually abused the complainant by administering a substance without her knowledge and raping her while she was unconscious, causing her physical injuries; and

c) over a period between March 2013 and August 2014, Dr Joseph pressured the complainant to live with him, and sent her unwanted and inappropriate texts and emails that were sexually motivated and caused harassment, alarm and distress.

Grounds of Appeal

The transcript noted that:

Dr Joseph’s formal grounds of appeal are that the MPT’s decision on the facts were wrong and/or irrational, and that the determination on impairment and sanction was wrong as being based on these erroneous findings of fact. He says the MPT misdirected itself and was wrong to accept the complainant’s uncorroborated evidence, particularly as the complainant claimed no memory of the alleged sexual abuse and did not report it until many years later. Such evidence as was before the MPT was incapable of supporting its findings. And in particular, the MPT failed to give any or any adequate consideration to the evidence that the complainant had locked her bedroom door from the inside, or to deal with the question of how, in those circumstances, Dr Joseph could have entered the bedroom as alleged.

At the appeal hearing, Dr Joseph’s counsel asked the court to concentrate on the bedroom door issue.  Mrs Justice Collins Rice observed that:

A rationality challenge is a challenge that the MPT’s primary fact finding was ‘wrong’ – radically unsupported, out of tune with, or misunderstanding, the evidence, outside the reasonable range available, or defective on the basis of any of the other descriptions in the caselaw. A challenge based on inadequacy of reasons is a challenge that the fact finding was ‘unjust by reason of procedural irregularity’ – a failure either properly to evaluate the evidence or sufficiently to explain its conclusions. The hurdle to be overcome by an appellant on either basis is a relatively high one, on the authorities. I am warned to be circumspect before disturbing primary fact finding, especially where, as here, it is highly dependent on assessment of the credibility and evidence of witnesses I have not seen or heard.

She carefully considered the evidence before the MPTS and the truthfulness of Dr Joseph’s account and evidence.  She concluded that “It is right to say the determination places heavy weight on the truthfulness of the complainant’s account. But it does not place exclusive, unsupported or unexamined weight on it” and:

Reading the determination of the drugged rape allegation as a whole and in context then, I find it to be apparently scrupulous, fair, reasoned and within the range properly available to the MPT for the reasons it gave. It addressed itself properly to the task of determining whether the core allegations were true. It had the advantage of having seen and heard the complainant and Dr Joseph give evidence under sustained cross examination. It made some important choices between their accounts and said why. Its findings are not ‘out of tune’ with the evidence or indicative of misreading. They are not unreasonable or suggestive of error or defect, and were reached following the guidance of the decided authorities. They do not appear ‘wrong’. That is the general overview I had reached.

Notwithstanding the above, Dr Joseph’s counsel argued that “the entire architecture of the decision comes crashing down over the matter of the locked door” explaining that, in brief, “there is a fundamental gap or fault-line in the narrative because of this: unless an explanation appears clearly of how it is said Dr Joseph got through a locked door, the whole account of the alleged rape makes no sense.”

However, Rice J concluded that:

It is entirely possible to see the chain of reasoning which led to this ultimate conclusion. Dr Joseph cannot be in any real or fair doubt about how the MPT squared the locked door issue with its conclusions. It accepted the complainant’s evidence that the key was, in his plain view, left in a place where he could easily find it. It rejected his bare denial that he found it and used it. Considering all the material before it, and reading the determination fairly and as a whole, it made a sustainable and supported – I might say ‘obvious‘ – narrative inference, inevitably implicit in its other findings.

She subsequently turned down the appeal, saying “I am unable to conclude that the decision challenged in this case is either wrong, or unjust by reason of procedural irregularity. The MPT discharged its duties carefully in sensitive circumstances. The appeal is dismissed.”