Details of the case
Mr Karim worked as a consultant urological surgeon at Heatherwood and Wexham Park Hospitals NHS Foundation Trust, later the Frimley Health NHS Foundation Trust (“the Trust”).
The events that span this case started in 2013, when the GMC received allegations of concern against Mr Karim. The complaints were deemed not to meet the required threshold and were closed, with no further action.
In October 2014 the GMC received a copy of an external review commissioned by the Trust into the operation of the Urology Department. The Trust had excluded Mr Karim, among others, in July 2014, while that investigation was being carried out. Mr Karim was reinstated two weeks after its conclusion.
But a further investigation was then commissioned after which Mr Karim was again suspended by the Trust in January 2015 and never returned to work at the Trust, having resigned on 22 May 2015. In the meantime, in 2014, the Trust had referred Mr Karim to the GMC.
On 3 March 2015, the Interim Orders Panel of the MPTS (Medical Practitioners Tribunal Service) imposed restrictions on Mr Karim’s practice, pending the outcome of the GMC’s investigation. These restrictions had catastrophic life-changing consequences on Mr Karim’s surgical practice.
It was not until August 2015 that the restrictions on Mr Karim’s practice were lifted. His case was then referred to a full hearing before the Medical Practitioners Tribunal but not until some three years later.
None of the allegations put against Mr Karim related to his clinical performance or his competence. The FTP (Fitness to Practice) hearing took place in April 2018 at which Mr Karim’s evidence was accepted in full, and Mr Karim was found not to have committed any act of misconduct at all.
There was less favourable treatment of Dr Karim in the way that he was treated as compared to a white doctor.
The Tribunal came to the following conclusions:
- Though the GMC argued that Mr Karim lacked credibility, the Employment Tribunal rejected this offensive suggestion. As the Employment Tribunal found, Mr Karim was honest and credible.
- There was less favourable treatment of Dr Karim in the way that he was treated as compared to a white doctor.
- The GMC undertook an investigation into Mr Karim when the same allegation was made against a white doctor whom they decided not to investigate and looked for material to support allegations against Mr Karim, rather than fairly assessing matters presented.
- The GMC continued the investigation against Mr Karim where the investigation into the white doctor was terminated and referred back to the Trust.
- Taking into account all the evidence including the statistical evidence about race which shows a higher proportion of adverse outcomes for BME doctors the Tribunal found that the difference in treatment of Dr Karim in comparison with a white doctor and the significant delay in the investigation of him were on the grounds of his race.
- The Employment Tribunal stated that they were not able to accept the explanations provided by the GMC for the difference in treatment between Mr Karim and the white doctor such as to show that the Claimant’s race did not form part of their considerations.
- The Employment Tribunal also expressed the fact that it was concerned about the level of complacency shown by the GMC about the possibility of the operation of discrimination in the referral made by the Trust to the GMC.
- There was a significant delay of some four years in the GMC’s handling of Mr Karim’s case, which was not necessary for justice to be done.
- The Employment Tribunal expressed the view that there was a level of complacency about the operation of discrimination in the work of the GMC and that there might be discrimination infecting the referral process. The Tribunal formed this view after considering the answers given to the questions around the Respondent’s equal opportunity policy, training around equality and diversity issues and the failure of all the witnesses to express how if at all the awareness of the overrepresentation of BME doctors in complaints to the GMC was considered in the investigation process at any stage, or whether discrimination may have been a factor consciously or unconsciously in the allegations faced by the Claimant.
- BME doctors are 29% of all UK doctors but 42% of complaints by employers are made against BME doctors. UK graduate BME doctors are 50% more likely to get a sanction or warning than white doctors. Other evidence illustrated the adverse position of BME doctors when compared to white doctors. In carrying out its work in respect of the complaints about Dr Karim, the GMC should have been conscious and aware of this background.