Ramaswamy v General Medical Council [2021] EWHC 1619 (Admin) (15 June 2021)

The High Court has quashed a MPTS decision to suspend a doctor for not complying with a GMC health assessment direction.

This appeal relates to two determinations by a Medical Practitioners Tribunal dated 12 January 2021.

By the determinations, the Tribunal found that Dr Sheela Ramaswamy (the Appellant) had failed to comply with a direction made by the General Medical Council (GMC) that she undergo a health assessment for the purposes of a fitness to practise investigation (“the Non-Compliance Determination”) and further directed that her registration be suspended for a period of nine months (“the Sanction Determination”). 

Dr Ramaswamy challenged these determinations and further decisions of the tribunal to refuse to postpone the hearing and to proceed in her absence specifically that: 

  • The three decisions refusing to adjourn the non-compliance hearing were procedurally unfair. (The unfair refusal to adjourn was compounded by the unreasonable refusal to accept additional information from the Appellant which she wished to place before the Tribunal).
  • The Tribunal’s determination of non-compliance was wrong and seriously flawed.
  • The Tribunal’s determination on sanction was unnecessary, excessive and disproportionate.

On the first point, Dr Ramaswamy submitted that it was procedurally unfair to refuse to adjourn the non-compliance hearing to allow the Appellant to be legally represented by the same counsel as had been representing her since September 2019 at what, for her, was a critically important hearing. 

Mr Justice Morris found that the MPTSs decision not to adjourn the hearing was “open to a number of legitimate criticisms” principally for the reasons set out in paragraphs 117 and 120 of his judgement. Consequently, Morris J conclude that the Non-Compliance Determination and the Sanction Determination were both unjust because of a serious procedural irregularity.

One the second grounds, Dr Ramaswamy submitted that there were a number of matters not properly considered by the tribunal and the finding of non-compliance was seriously flawed because she had “had good reason not to comply.”

Morris J found that “on the basis of the material that was before it, the Tribunal’s assessment in the Non-Compliance Determination was seriously flawed.” This ruling principally surrounds the evidence submitted by an expert witness for the GMC whose assessment “was itself not based on the complete picture and did not support the conclusion that the GMC was “unable to proceed” with an assessment.”

The final ground of appeal fell in light of the determination on grounds 1 and 2 because both the Sanction Determination, as well as the Non-Compliance Determination was quashed and the matter remitted to the MPTS for a fresh full determination.

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