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GMC erasure overturned by High Court for failing to assess impact of doctor's mental health

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Landmark legal ruling changes the way professional bodies deal with their members

The recent successful appeal by Dr. Brookman following his erasure from the register of medical practitioners by the Medical Practitioners Tribunal (Brookman v General Medical Council [2017] EWHC 2400 (Admin)), highlights the importance of addressing any concerns regarding a registrant’s mental health during fitness to practise proceedings.

The General Medical Council (‘GMC’) opened an investigation into an allegation against Dr. Brookman that he had carried out an inappropriate and sexually motivated examination of a female patient at the hospital where he had been working in October 2013. The GMC also investigated Dr. Brookman’s later dismissal in January 2016 from the University of Bournemouth following complaints by students. The Interim Orders Tribunal (‘IOT’) imposed conditions on the doctor’s practise on 1st July 2014 which included conditions to be supervised whilst examining women and to inform employers and others of the conditions.

After a lengthy and complex hearing, the tribunal rejected all significant allegations made by the patient. However, the tribunal decided that the appellant had failed to notify a number of prospective employers about the conditions which had been imposed by the IOT. This was said to amount to misleading and dishonest conduct which was sufficiently serious to warrant a finding that his fitness to practise was impaired.

The tribunal had considered whether to postpone the remainder of the hearing and order a further health assessment prior to deciding the facts. However, they decided not to do so and proceeded to conclude that there was impairment and the tribunal decided on 24th February 2017 that the appropriate sanction was erasure.

Dr. Brookman subsequently appealed to the High Court who overturned the tribunal’s decision to erase him from the medical register. The High Court held that the tribunal had erred in failing to postpone the hearing and determined that a further health assessment of Dr. Brookman was of fundamental importance to assess not only the Appellant’s evidence regarding dishonesty but also its consequential implications for misconduct, impairment and sanction.

The GMC’s “Sanctions Guidance” states at paragraph 47 that: ‘The tribunal should be aware that cultural differences and the doctor’s circumstances (e.g. their ill health) could affect how they express insight. For example how they frame and communicate an apology or regret’. Given the significance of a registrant’s insight in any fitness to practise proceedings, this guidance highlights the importance of fully assessing the impact that a registrant’s mental health may have had and/or continues to have on their conduct. 

It appears that the GMC are consequently attempting to address the issue of medical professional’s mental health before their careers have even commenced. The GMC launched a consultation on 4th October 2017 on the knowledge, skills and professional behaviours required by newly-qualified doctors in order to help shape the future development of undergraduate medical education.

The GMC’s outcomes for graduates (what doctors must know and be able to do by the time they graduate from medical school) have been updated as part of the consultation to better reflect modern medical education and practice. The GMC have introduced new outcomes stressing the importance of doctors’ personal wellbeing, helping them to incorporate self-care into their personal and professional lives. The consultation runs until 10th January 2018.

This goes hand in hand with increasing attempts to encourage medical professionals to be more open about their mental health and seek help if necessary. For example the &me campaign (#AndMe), which was launched at the House of Commons in January 2017, has taken a new approach to the de-stigmatisation of mental ill-health within the healthcare professions by encouraging senior professionals to speak out about their personal experiences of mental health issues.

If you require assistance in dealing with a referral to the GMC please contact our team for expert advice. For more information, visit our GMC page or call 01616 966 229.

By Brea Carney-Jones, graduate paralegal in the regulatory department.