Stefan v. The General Medical Council (Medical Act 1983) [1999] UKPC 48 (22nd November, 1999)
Privy Council Appeal No. 24 of 1999
Dr. Marta Stefan
Appellant
v.
The
General Medical Council
Respondent
FROM
THE HEALTH COMMITTEE OF THE
GENERAL MEDICAL COUNCIL
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JUDGMENT OF THE LORDS OF THE JUDICIAL
COMMITTEE
OF THE PRIVY COUNCIL,
Delivered
the 22nd November 1999
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Present at
the hearing:-
Lord Slynn of
Hadley
Lord Nicholls of Birkenhead
Lord Hoffmann
[Delivered
by Lord Slynn of Hadley]
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1. Dr. Stefan appeals from a decision of
the Health Committee of the General Medical Council on 27th May 1999 that her
registration as a doctor should be suspended for a period of twelve months
pursuant to section 37(1)(a) of the Medical Act 1983 and that such suspension
should have immediate effect pursuant to section 38(1) of that Act.
2. Dr. Stefan was given temporary
registration as a medical practitioner in the United Kingdom from 1967, limited
registration from 1979 and provisional registration from 1985. From 1993,
however, she appeared before the Health Committee for them to consider whether
her fitness to practise was "seriously impaired by reason of [her] physical
or mental condition". On 21st June 1993 and on 20th June 1994 her
registration was made subject to conditions for periods respectively of eight
months on the basis that her fitness to practise was seriously impaired.
Subsequently on 23rd February 1995 when she refused to agree to conditions her
registration was suspended for eight months and on 21st February 1996 and 24th
February 1997 respectively further suspensions of twelve months were ordered.
Appeals to the Board against the decisions of 21st June 1993, 23rd February 1995
and 24th February 1997 were dismissed.
3. On 23rd February 1998 the Committee
ordered indefinite suspension but on 8th March 1999 her appeal was allowed by
the Board since reasons for indefinite suspension on the ground of unfitness to
practise were not given.
4. In the decision now challenged the
Committee said that having considered the written and oral evidence "the
Committee have judged your fitness to practise to be seriously impaired by
reason of paranoid personality disorder". They continued:-
"In reaching this finding the
Committee have had regard to paragraph 24(2) of their procedure rules. The
Committee do not consider that your cardiac condition is relevant to your
fitness to practise.
The Committee have carefully
considered whether it would be sufficient to direct that your registration
should be subject to conditions, so that you could return to medical
practice. However, they take the view that your medical condition could
seriously affect your ability to make sound professional judgments.
They are concerned in particular by
the evidence that your condition is a continuing and episodic one.
Accordingly, whilst noting Dr.
Adams opinion on your fitness to practise, the Committee have felt bound
to direct that your registration be suspended for a period of 12 months.
The Committee have further
determined that it is necessary for the protection of members of the public,
and would be in your own best interests, to order that your registration be
suspended forthwith."
5. Rule 24(2) of the Procedure Rules
provides:-
"In reaching their judgment
the Committee shall be entitled to regard as current serious impairment
either the practitioner's current physical or mental condition, or a
continuing and episodic condition, or a condition which, although
currently in remission, may be expected to cause recurrence of serious
impairment."
6. Dr. Stefan in her case set out many
criticisms of the Health Committee, of things which she contended had been said
about her and the way the proceedings had been conducted. In addition she set
out her contentions as to the merits of the decision. At the hearing before the
Board she challenged the accuracy and honesty of the transcript of the hearing
before the Committee and denied that she was in any way suffering from paranoia.
7. In the written evidence given by Dr.
Adams, a psychiatrist who examined her, it was said that she was now able to
control the expression of her opinions about her colleagues and minority groups
but that "any emotional disturbance that might occur would be liable to
precipitate paranoid comments". In his written opinion he wrote that
"Dr. Stefan is able to practise on a limited basis in her chosen speciality
under Consultant supervision and with medical supervision from the GMC". In
his oral evidence he said that he thought "perhaps she could [practise]
under supervision" but that the condition was a continuum and that problems
could occur under stress. Members of the Committee and the clinical assessor of
the Committee, a psychiatrist, asked many questions. On the basis of the answers
to those questions and the written report, it cannot be said that there was no
evidence on which the Committee could conclude as it did.
8. The remainder of Dr. Stefans
submissions go to the correctness of the decision and as to the way events of
the past had been taken out of context. They raise matters for the Committee but
they do not show any question of law either as to the decision to suspend
registration or as to the decision that the suspension should take immediate
effect.
9. Accordingly since by section 40(5) of
the Act of 1983 an appeal lies to the Board only on a question of law, their
Lordships will humbly advise Her Majesty that this appeal ought to be dismissed.
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