General Medical Council v Mok [2022] EWHC 1651 (Admin) (29 June 2022)

The Appellant in this case, the GMC, appealled against the determination of the Medical Practitioners Tribunal (“the MPT”) on 23 December 2021 to suspend the Respondent, Dr Mok, from the Register for 12 months, following a determination that his fitness to practise was impaired by reason of misconduct, namely, sex without consent with his male partner. The GMC appealed on the ground that this sanction is not sufficient to protect the public.

Dr Mok qualified as a doctor in 2018. In August 2019, when the misconduct occurred, he was completing his Foundation Year 1. He subsequently completed his Foundation Year 2 training between August 2020 and August 2021 before commencing GP training. At the time of the MPT’s determination he was undertaking his Speciality Year 1 Training as a specialist registrar.

The MPT concluded that Dr Mok’s actions were sexually motivated and took the view that Dr Mok’s behaviour “was an incident of serious sexual misconduct which would be considered deplorable by fellow practitioners.”

Applying the test set out by Dame Janet Smith in the report of the Shipman Inquiry, the MPT concluded “Dr Mok’s actions in the past had brought the profession into disrepute and he had breached a fundamental tenet of the profession” and “conduct had undermined public confidence in the profession.”

The MPT considered the Sanctions Guidance and detailed submissions from both counsel. It decided that the appropriate and proportionate sanction was to suspend Dr Mok’s registration for the maximum period of suspension of 12 months. It directed that a review should take place prior to the expiration of the suspension, at which Dr Mok would be responsible for demonstrating how he has addressed the MPT’s concerns.

Grounds of appeal

The GMC appealed on three grounds:

  1. the MPT had regard to irrelevant considerations in its determination on sanction;
  2. the MPT failed to apply the SG and give adequate reasons for its decision on sanction; and
  3. the sanction of suspension fell outside the range of reasonable decisions open to the MPT on these facts.

Mrs Justice Lang turned down all three grounds.  In her ruling, she noted that, in her opinion, “the MPT exercised its evaluative judgment when it identified the considerations which it considered were relevant, and that judgment was informed by its assessment of the evidence and the issues.”

On the second ground of appeal, the GMC argued that the MPT did not apply the Sanctions Guidance (SG) and failed to give sufficient reasons for its decision.  However, Lang J concluded that:

The SG is a lengthy document, and in my view, the MPT was not required to set out every relevant paragraph.

“It is reasonable to assume that the members of this specialist panel would have been well aware of the provisions of such a key document. They receive training on the SG, and it is routinely used at MPT hearings.”

and that:

In my judgment, the reasons that the MPT gave on these matters were sufficient and intelligible.

Finally, under Ground 3, the GMC submitted that the order of suspension was unreasonable, as it failed rationally to reflect the gravity of the misconduct and its own findings.

However, Lang J commented:

“…the context in which the findings of fact were made in this case was nuanced and complex. The MPT, having heard and seen Person A and Dr Mok give evidence, was best placed to weigh the misconduct in that context. The MPT carefully considered the relevant competing considerations in respect of sanction. It appears from the terms of the determination that the choice between 12 months’ suspension or erasure was finely balanced in the minds of the MPT. However, the MPT concluded that Dr Mok’s misconduct fell just short of being fundamentally incompatible with continued registration, and that erasure would be disproportionate in the circumstances of this case.

“As the Court of Appeal observed in Bawa-Garba, the decision of a tribunal that suspension rather than erasure is the appropriate sanction constitutes an evaluative decision based on many factors, and a kind of jury question about which reasonable people may disagree.”

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