Haris v General Medical Council

Factual and Procedural Background

The appellant, a medical doctor qualified since 2008 and a GP since 2014, faced complaints in 2017 from two female patients alleging non-clinically indicated intimate examinations without informed consent and without gloves. These incidents occurred in separate locations within weeks of each other, one during an out-of-hours locum GP service in Lancashire and the other at a Minor Injuries Unit in a Yorkshire hospital.

The Medical Practitioners Tribunal ("MPT") found the patients' accounts credible and determined that the appellant had committed the acts described. However, the MPT did not find that the appellant's conduct was sexually motivated, relying in part on expert psychiatric evidence diagnosing the appellant with Asperger's syndrome and his professed lack of sexual interest.

The General Medical Council ("GMC") appealed this finding under section 40A of the Medical Act 1983. The High Court judge allowed the appeal, concluding that the only rational inference from the facts was that the touching was sexually motivated and substituted that finding. The judge also found the appellant lacked insight and quashed the original sanction, remitting the matter back for reconsideration. The appellant was granted permission to appeal the judge's conclusion on sexual motivation.

The sanctions hearing was stayed pending determination of the appeal before this Court.

Legal Issues Presented

1. Whether the High Court judge was correct in concluding that the only rational inference from the MPT’s factual findings was that the appellant’s conduct was sexually motivated.
2. Whether the MPT erred in law or acted irrationally in finding no sexual motivation behind the appellant’s conduct.
3. Whether the appellate court should defer to the MPT’s advantage as primary fact-finder in assessing credibility and motivation.

Arguments of the Parties

Appellant's Arguments

• The judge failed to give proper deference to the MPT’s findings, particularly their assessment of witness credibility and expert evidence.
• The MPT’s finding of no sexual motivation was a factual conclusion based on evidence including the appellant’s diagnosis and statements of asexuality, which the judge did not adequately consider.
• The allegations could be consistent with non-sexual clinical activity, and the judge’s conclusion was irrational and failed to apply the relevant legal principles on appellate review.
• The judge did not properly acknowledge the MPT’s advantage in seeing and hearing witnesses firsthand.

Respondent's Arguments (GMC)

• The MPT’s approach was fundamentally flawed because it ignored the obvious inference from the facts that the touching was sexually motivated.
• There was no clinical justification or plausible innocent explanation for the appellant’s conduct.
• The appellant’s denials and inaccurate contemporaneous records undermined his credibility and supported the inference of sexual motivation.
• The judge correctly applied the law and was entitled to substitute her own finding where the MPT’s conclusion was irrational and outside the bounds of reasonable decisions.

Table of Precedents Cited

Court's Reasoning and Analysis

The court carefully reviewed the factual findings of the MPT, which accepted the complainants’ evidence and rejected the appellant’s denials and contemporaneous records. The MPT found the touching to be intimate, non-clinically indicated, and without consent or gloves, yet concluded it was not sexually motivated based on the appellant’s diagnosis and supporting evidence from family and an expert psychiatrist.

The court identified a fundamental error in the MPT’s approach: it failed to consider that the best evidence of the appellant’s motivation was his conduct itself. The court held that the absence of any plausible innocent explanation, combined with the appellant’s false denials and inaccurate records, made the inference of sexual motivation overwhelming and the only rational conclusion.

The court rejected the appellant’s argument that the judge failed to show sufficient deference to the MPT’s advantage as primary fact-finder. While acknowledging the MPT’s role in assessing credibility, the court noted that the question of what inferences to draw from established facts is less constrained by deference and that the judge was entitled to intervene where the MPT’s conclusion was irrational.

The court also rejected attempts to frame the allegations as potentially clinically motivated, emphasizing that the nature of the conduct and the appellant’s defense were inconsistent with any innocent clinical explanation.

Overall, the court agreed with the High Court judge that the MPT’s finding of no sexual motivation was not reasonably open and that the judge was justified in substituting a finding of sexual motivation.

Holding and Implications

The court DISMISSED the appellant’s appeal, affirming the High Court judge’s substituted finding that the appellant’s conduct was sexually motivated.

This decision confirms that appellate courts may overturn a tribunal’s fact-finding on motivation where the inference drawn is irrational, especially when the conduct itself overwhelmingly supports a particular motive and no plausible innocent explanation exists. The ruling underscores the importance of considering the totality of the evidence, including conduct and credibility, in determining motivation in professional misconduct cases.

The matter of sanction will proceed before the MPT with the sexual motivation finding in place. No new precedent was established beyond the application of well-established appellate principles to the facts of this case.