GMC v Dr Townsley

Fitness to Practise Panel Hearing January 2009

GMC v Dr Townsley

Representation:

Mr J Macadam, Counsel, instructed by GMC Legal appeared on behalf of the GMC and the doctor was unrepresented.
Doctor: present but not represented.

The allegations faced by the doctor stated:

“That being registered under the Medical Act 1983

1. On 28 February 2007, at Newcastle-upon-Tyne Magistrates’ Court, you were convicted of driving a motor vehicle on a road after consuming so much alcohol that the proportion of it in your breath exceeded the prescribed limit, contrary to section 5(1) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended); and on 14 March 2007 you were fined £600.00, ordered to pay prosecution costs in the sum of £43.00 and disqualified from driving for fifteen months in relation to that offence; Admitted and found proved
2. On 28 August 2007, at South East Northumberland Magistrates’ Court, you were convicted of:
   1. driving whilst disqualified from holding or obtaining a driving licence, contrary to section 103(1)(b) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended); Admitted and found proved
   2. using a motor vehicle on a road when there was not in force in relation to its use a policy of insurance or such security in respect of third party risks as complied with the requirements of Part VI of the Road Traffic Act 1988, contrary to section 143(2) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended); Admitted and found proved

And you were made subject to a Community Order for a period of 12 months with a requirement to perform 120 hours of unpaid work, fined £400.00 and disqualified from driving for fifteen months.” Admitted and found proved

And that by reason of the matters set out above your fitness to practise is impaired because of convictions.”

Determination by the Panel on impaired fitness to practise

“Dr Townsley:

At the start of these proceedings you admitted the facts in relation to your convictions as set out in paragraphs 1 and 2 of the allegation. Furthermore, the Panel has been presented with two Memoranda of Conviction dated 14 March 2007 and 28 August 2007. The Panel is satisfied that these Memoranda of Conviction are sufficient to prove the convictions, in accordance with Rule 34(3). Accordingly it has found proved the facts in paragraphs 1 and 2 of the allegation.

The facts are as follows:

• On 28 February 2007, at Newcastle-upon-Tyne Magistrates’ Court, you were convicted of driving a motor vehicle on a road after consuming so much alcohol that the proportion of it in your breath exceeded the prescribed limit, contrary to section 5(1) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended). On 14 March 2007 you were fined £600.00, ordered to pay prosecution costs in the sum of £43.00 and disqualified from driving for fifteen months in relation to that offence.
• On 28 August 2007, at South East Northumberland Magistrates’ Court, you were convicted of driving whilst disqualified from holding or obtaining a driving licence, contrary to section 103(1)(b) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended). You were also convicted of using a motor vehicle on a road when there was not in force, in relation to its use, a policy of insurance or such security in respect of third party risks as complied with the requirements of Part VI of the Road Traffic Act 1988, contrary to section 143(2) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988 (as amended). You were made subject to a Community Order for a period of 12 months with a requirement to perform 120 hours of unpaid work, fined £400.00 and disqualified from driving for fifteen months.
• The Panel has been informed of the background to your convictions. It has heard that on 18 February 2007 you were charged with driving whilst above the prescribed limit. This followed you being observed driving through a red light and nearly colliding with a marked police car. You provided two samples of breath, the lower of which registered 76 micrograms of alcohol in 100ml of breath. (The legal limit is 35 micrograms).
• On 8 August 2007 you were stopped by police close to a motor vehicle, and a short while later they observed you driving that same vehicle. The police subsequently discovered your disqualification from driving. On 14 August 2007, you were therefore arrested and charged with driving whilst disqualified and without insurance. You told the Panel of the circumstances leading up to your second and third convictions. You said that you needed to get in touch with your sister urgently to communicate some good news that you had received from your mother. You said that you were unable to reach your sister by telephone and so you decided to drive to see her as she was not far away, and that you would only be in the car a short while.

The Panel has considered whether, on the basis of the facts found proved, your fitness to practise is impaired because of your convictions. In doing so, it has taken into account all the evidence received and the submissions made by Mr Macadam on behalf of the General Medical Council (GMC) and those made by you.

Mr Macadam directed the Panel to the GMC’s publication the Indicative Sanctions Guidance, and in particular to the section dealing with the public interest. He submitted that your fitness to practise is impaired because of the seriousness of the offences that led to your convictions.

You stated that you were “sincerely sorry” for your behaviour and that it was “not acceptable or professional”. You submitted that your fitness to practise is not impaired by reason of your convictions.

In reaching its decision on impairment of fitness to practise, the Panel has taken account of the Indicative Sanctions Guidance. In particular, paragraph 11 states:

“Neither the Act nor the Rules define what is meant by impaired fitness to practise but for the reasons explained below, it is clear that the GMC’s role in relation to fitness to practise is to consider concerns which are so serious as to raise the question whether the doctor concerned should continue to practise either with restrictions on registration or at all”.

The Panel has also taken account of paragraphs 12 and 13 of the Indicative Sanctions Guidance. It notes that in addition to the protection of the public, the public interest includes, amongst other things:

• Maintenance of public confidence in the profession
• Declaring and upholding proper standards of conduct and behaviour.

The Panel is concerned about the gravity of your actions that resulted in three convictions. You were first convicted of driving whilst more than twice over the legal alcohol limit of 35 micrograms in 100ml of breath. The Panel takes a serious view of such behaviour as it could have endangered the lives of yourself and others, and it finds it totally unacceptable.

However, the Panel notes, to your credit, that you informed the GMC of your first arrest on the following day, in a letter dated 19 February 2007. In that letter you also expressed concern about the consequences of your actions upon your medical career.
The Panel notes that you agreed to undertake a rehabilitation course, although you did not complete it following your further convictions. It also notes that you have now completed your community service.

However, the Panel is concerned that you breached the court order in that you chose to drive whilst disqualified, thereby demonstrating that you did not appreciate the seriousness of the restriction that the court had placed on your driving.

The Panel has taken into account that doctors hold a privileged position in society but such a position brings with it responsibilities.

The Panel has borne in mind its responsibilities to fulfil its role in protecting members of the public and to consider the public interest. The Panel is in no doubt that your convictions represent a serious and repeated failure to uphold the proper standards of conduct and behaviour expected of a registered medical practitioner. Furthermore, it considers that your convictions undermine the confidence that the public places in the medical profession.

In all the circumstances, the Panel has determined that your fitness to practise is impaired by reason of your three convictions.

The Panel will now invite further evidence and submissions under Rule 17(2)(l) from Mr Macadam and from you as to the appropriate sanction, if any, to be imposed on your registration.”

Determination on sanction

“Dr Townsley:

The Panel has already determined that your fitness to practise is impaired by reason of your convictions. It has next considered what sanction, if any, should be imposed upon your registration. In doing so it has considered the submissions made by Mr Macadam on behalf of the General Medical Council (GMC) and your own evidence and submissions.

Mr Macadam submitted that your drink driving offence was serious and the matter was made worse by your second offence, that of driving whilst disqualified and with no insurance, which occurred only a few months later. He submitted that this represented a pattern of serial offending and it involved you breaching a court order not to drive.

He submitted that conditions in this case would not be appropriate or workable, and that no conditions could be devised to prevent you from re-offending. He further submitted that your convictions are evidence of serious misconduct, and so a lesser sanction than suspension would not be sufficient. He submitted that in these circumstances, and in the public interest, the appropriate sanction would be a period of suspension.

You said that you had considered the public interest and the seriousness of your offences. You also said that the occurrence of these events was out of character and that you were unlikely to repeat this behaviour. You addressed the Panel on the issue of proportionality and you said you had already been suspended by your employer without pay for five months because you were not allowed to progress to full registration. For this reason you asked the Panel to be lenient and to consider imposing conditions.

The Panel noted that, under cross-examination by Mr Macadam, you accepted that the imposition of conditions in your case would be considered as lenient, and this would not be sufficient to send out a signal to the public that the high standards of the profession were being upheld. Mr Macadam congratulated you for being honest and open in acknowledging that the public perception of the sanction of conditions would be that you had been “let off lightly”.

You explained to the Panel the chronology of events regarding your postgraduate medical training. You said that you started your F1 year in August 2006 but, following your conviction in February 2007, you then took leave of absence for three and a half months because of stress. Subsequently you were allowed to repeat the F1 year starting in August 2007, and you completed this in August 2008. Following notification of your convictions to the GMC, you were not allowed to progress to full registration, and so you were to remain on provisional registration until the outcome of this hearing was known. This prevented you from progressing on to the F2 year.

Following enquiries made by the GMC into the implications of any sanction upon your provisional registration, Mr Macadam informed the Panel that a period of conditions would, in your case, have the same effect as a period of suspension, in that you would not be allowed to progress to full registration whilst your fitness to practise is impaired.

In the light of this information you said that suspension would be more appropriate. In considering the length of suspension, you asked the Panel to be lenient given your circumstances. Furthermore you said that you are keen to get back to medical work, to complete the F2 year, and to progress your career.

The decision as to the appropriate sanction, if any, to impose on your registration is for this Panel to determine exercising its own independent judgment.

The Panel has noted your apology and expressions of regret regarding your convictions, and your acknowledgment that your behaviour fell below the standards to be expected of a registered medical practitioner. It has taken into account that you are now aware that your behaviour will have implications on your future medical career, and that you have reflected upon the hard work that you have put in to obtain the privilege of being a registered medical practitioner.

In reaching its decision on sanction, the Panel has taken account of the GMC’s Indicative Sanctions Guidance. The purpose of sanctions is not to be punitive, but to protect patients and the public interest. The public interest includes the protection of patients, the maintenance of public confidence in the profession, and declaring and upholding proper standards of conduct and behaviour.

The Panel notes that your professional competence has not been called into question and it has heard no evidence that you have caused any harm to patients. Nevertheless, the Panel has to consider how, in your case, it can maintain public confidence in the profession.

The Panel has also borne in mind the principle of proportionality. In doing so, it has balanced the protection of patients, the public interest, and public confidence in the profession, against your own interests in being able to practise medicine.

The Panel has taken account of paragraph 7 page S2 – 2 of the Indicative Sanctions Guidance, which states in respect of a case of conviction, that:

“The purpose of the hearing therefore, is not to punish a doctor a second time for the offences of which he or she was convicted, but to protect the public who might come to the doctor as patients and to maintain the high standards and good reputation of the profession. The Panel’s role is therefore to balance the nature and gravity of the offences and their bearing on the doctor’s fitness to practise as a doctor against the need for the imposition of a sanction and its consequences upon the ability of the doctor to practise his profession…”

The matters before the Panel relate to your three convictions. You were first convicted in February 2007 of driving whilst more than twice over the legal alcohol limit. You were then disqualified from driving for 15 months. However, in August 2007, you breached this court order and, as a result of this you received two further convictions, namely for driving whilst disqualified and for driving without insurance.

In view of the serious findings made against you, the Panel has determined that it would not be appropriate or sufficient to conclude your case without applying a sanction.

The Panel next considered whether it would be sufficient to conclude your case with a period of conditional registration. Any conditions must be appropriate, proportionate, workable and measurable. The Panel has taken account of the Indicative Sanctions Guidance at page S1–13 that sets out the criteria under which conditions may be appropriate.

The Panel notes that conditions are usually only useful and relevant where there are identifiable areas of a doctor’s practice in need of retraining. The Panel acknowledges that there is no allegation that has questioned your clinical competence. Moreover, when the matter under consideration relates to criminal convictions, it is difficult to formulate conditions that can provide remedial help to prevent repeat offending.

The Panel takes a serious view of your dangerous behaviour. Drink driving is unacceptable in any circumstances, but particularly when it involves being twice over the alcohol limit. Your behaviour resulted in a criminal conviction, and the problem was later compounded by your disregard of that court’s order of disqualification, and this resulted in two further criminal convictions. Your behaviour has therefore repeatedly breached the standards that patients and the public are entitled to expect from a registered medical practitioner.

The Panel is not satisfied that you have demonstrated full insight into your behaviour. Whilst it acknowledges that you have been honest, co-operated with the GMC and accepted the GMC’s views on your behaviour, you have focused on not working for five months and not receiving a salary. The Panel is concerned that you may not have fully appreciated the gravity of your offences.
The Panel is therefore of the view that conditions would not be sufficient to reflect the serious nature of the matters for which you were convicted, they would not satisfy the public interest, and they would not prevent re-offending. The Panel has therefore determined that the imposition of conditions would not be appropriate in your case.

The Panel next considered whether suspension would be a sufficient sanction.

It has taken account of paragraph 27 page S1 – 6 of the Indicative Sanctions Guidance, which states that:

“Suspension can be used to send out a signal to the doctor, the profession and public about what is regarded as unacceptable behaviour. Suspension from the register also has a punitive effect, in that it prevents the doctor from practising (and therefore from earning a living as a doctor) during the period of suspension. It is likely to be appropriate for misconduct that is serious, but not so serious as to justify erasure (for example where there may have been acknowledgement of fault and where the panel is satisfied that the behaviour or incident is unlikely to be repeated).”

Having regard to this guidance and all the circumstance referred to above, the Panel has concluded that it is appropriate and proportionate to suspend your registration. Given the serious view it takes of your case, the Panel considers that a period of suspension approaching the maximum available to it is appropriate. It has therefore determined that the suspension will be for a period of nine months. The Panel considers that this period of suspension will send out a signal to you, to members of the medical profession, and to the public, that such conduct is unacceptable for a registered medical practitioner, and that it will not be tolerated. The Panel considers that this is a proportionate response.

The Panel acknowledges that you were a talented student with a promising career ahead of you. It hopes that this period of time will allow you to recover from your serious mistakes and to make plans to resume your medical career at a later date.
In order to assess whether you are fit to practise unrestricted, shortly before the end of the period of suspension a Fitness to Practise Panel will review your case, and you will be expected to attend. A letter will be sent to you about the arrangements for this hearing. At the hearing the Panel will expect you to provide the following:

1. evidence that you have kept your medical knowledge up-to-date;
2. professional and personal testimonial evidence regarding your conduct during the nine months period of suspension;
3. your Professional Development Plan;
4. reports from any employers in the interim; and
5. evidence of your future career plan.

The next Panel would find it helpful if you could also obtain and submit written advice from a Post Graduate Dean regarding a way forward in which you could progress your medical career.

The effect of the foregoing direction is that, unless you exercise your right of appeal, your registration will be suspended for a period of nine months beginning 28 days from the date when notice is deemed to have been served upon you.
Having reached this decision, the Panel will now invite parties to make submissions on whether it is necessary for your registration to be suspended with immediate effect.”

Panel determined that it was not necessary for the protection of members of the public, in the public interest or in Dr Townsley’s own interests to make an order immediately suspending his registration.

Confirmed 27 January 2009
Chairman

Find out more about the GMC’s fitness to practise process.