The High Court has upheld an appeal by the General Medical Council against a MPTS decision in GMC v Rezk [2023] EWHC 3228.

In this case, the GMC appealed against a determination of a Tribunal of the Medical Practitioners Tribunal Service (“MPTS”), on 3 April 2023, that no action should be taken against the Respondent (“Dr Rezk”), in respect of his sexual misconduct and impairment of fitness to practise.


The allegations against the Respondent, in summary, related to a referral by a Consultant who referred the Respondent to the GMC on behalf of Ms A, a junior sister on the Medical Assessment Unit at Plymouth. She had disclosed to him that she had received from the Respondent unwanted sexually explicit messages, and pictures of his genitals, between September and December 2020. At that time, the Respondent had left Plymouth, and was contacting Ms A via social media.

A further allegation was received in relation to, Ms B, who was also a junior sister on the Medical Assessment Unit at Plymouth, received messages about sexual activity from the Respondent on social media.

MPTS Findings

The transcript recorded that the Tribunal found that the matters proved, “which they characterised as sexual harassment, amounted to serious misconduct” and consequently found the Respondent’s fitness to practise was impaired “on public interest grounds, and that such a finding was necessary to uphold proper professional standards and conduct, and to maintain public confidence in the profession.”  However, the Tribunal ” … concluded that there were exceptional circumstances in this case which justified taking no action” as outlined in paragraph 17 of the judgement.

Grounds of Appeal

In summary, the grounds of appeal were as follows:

i) The Tribunal failed to attach sufficient weight to the second and third limbs of the over-arching objective in section 1 MA 1983, namely, to promote and maintain public confidence in the medical profession and to promote and maintain proper professional standards and conduct for members of that profession.

ii) The Tribunal erred in finding that there were “exceptional circumstances” which justified a decision to take no action.

iii) In the circumstances of this case, the Tribunal ought to have imposed an appropriate sanction, namely, suspension.

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In summary, Mrs Justice Lang, in upholding the GMC’s grounds of appeal, said:

“In my judgment, I am in a position to reach a conclusion on the issue of sanctions after having heard and read extensive submissions and evidence, and I consider it is appropriate for me to do so. The misconduct occurred as long ago as 2020, and the Tribunal made its determination on 3 April 2023. If I remit the matter for reconsideration by a fresh MPT, it would have to hold a further hearing, perhaps hear evidence, and then reach a determination. That process is unlikely to be concluded until well into 2024. It would take even longer if the previous Tribunal panel has to be re-convened. In any event, in view of my findings, a fresh panel is more appropriate. The delay has been, and continues to be, detrimental to Dr Rezk. Equally importantly, it is not in the interests of the National Health Service for the training of doctors to be delayed, and it is not in the public interest for extensive resources to be spent on protracted tribunal and court hearings.”

She continued:

“Furthermore, in my judgment, taking no action in this case would not meet the overarching objective of protection of the public, in that it would not promote and maintain public confidence in the medical profession or proper professional standards and conduct for members of the profession. It would appear unduly lenient.”


Lang J concluded that a Conditions of Practice Order would be an appropriate substitute for the MPTS decision.

“In my judgment, conditions which require Dr Rezk to continue to work on his attitude towards his female colleagues, under supervision, are an appropriate way of addressing his shortcomings in this regard, and reinforcing the progress that he has already made. In my view, a period of 12 months is the minimum period required to achieve this objective. The Tribunal found that Dr Rezk has insight and has responded positively to remediation or training. In the light of his co-operation with the GMC proceedings to date, I am satisfied that he would comply with any conditions.

“Such an order would also meet the public interest in training and retaining competent doctors. The other sanctions proposed – no further action or suspension – do not provide for any remediation. Imposition of conditions does not carry with it the risk that he will lose his training contract, which I consider would be a disproportionate response to his misconduct.”

Concluding her judgement, Lang J said:

“The GMC’s appeal is allowed. The Tribunal’s determination, on 3 April 2023, that no action should be taken in respect of Dr Rezk’s misconduct and impairment of fitness to practise, is to be quashed. Instead, conditions are to be imposed on Dr Rezk’s registration, in terms of the agreed draft presented to the Court by the parties, for a period of 12 months.”

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