Fitness to Practise Panel Hearing 1-2 October 2008
GMC v Dr Hainsworth
GMC: Mr Tom Kark, Counsel instructed by GMC legal represented the General Medical Council
Doctor: Dr Hainsworth was present and was represented by Mr Philip Gaisford, Counsel instructed by RadcliffeLeBrasseur Solicitors
The allegations faced by the doctor stated:
That being registered under the Medical Act 1983, as amended,
- On 27 March 2007 at Leicester Magistrates’ Court, following your plea of Not Guilty, you were convicted of an offence of Common Assault, contrary to section 39 of the Criminal Justice Act 1988, upon Ms A, which took place on 7 August 2006;
Admitted and Found Proved
- You were fined £500, ordered to pay £200 compensation to Ms A, and ordered to pay Crown Prosecution Service costs in the sum of £450; Admitted and Found Proved
And that by reason of the matters set out above your fitness to practise is impaired because of your conviction.
Determination on impaired fitness to practise
At the outset of these proceedings you made a number of admissions and the Panel recorded allegations 1 and 2 as admitted and found proved.
The Panel next considered on the basis of the allegations admitted and found proved, whether your fitness to practise is impaired pursuant to Section 35C (2) (c) of The Medical Act 1983, as amended, by reason of your conviction. In doing so, it has taken into account the Indicative Sanctions Guidance, in so far as it deals with the meaning of Fitness to Practise, and has noted the advice of the legal assessor that a finding of impairment is a matter for the professional judgement of the Panel.
The Panel has borne in mind that it has a duty to protect the public interest, which includes the protection of patients, the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.
The Panel has considered all the evidence that has been presented to it, including the submissions made by Mr Kark on behalf of the General Medical Council and those made by Mr Gaisford on your behalf. Mr Kark made submissions regarding your fitness to practise in the light of your conviction. Mr Gaisford acknowledged that a conviction of assault reflects on the reputation of the profession and your fitness to practise.
The Panel has been informed that on 27 March 2007 at Leicester Magistrates’ Court, following your plea of not guilty, you were convicted of an offence of Common Assault, contrary to section 39 of the Criminal Justice Act 1988, upon Ms A. The assault took place on 7 August 2006. You were fined £500, ordered to pay £200 compensation to Ms A, and ordered to pay Crown Prosecution Service costs in the sum of £450.
The Panel has considered the circumstances of your conviction and takes a serious view of your conduct. Doctors occupy a position of privilege and trust in society and are expected at all times to act with integrity. Your conduct and behaviour towards a colleague brings the medical profession into disrepute and undermines the confidence and trust that the public is entitled to have in medical practitioners. Doctors must make sure that their conduct at all times justifies both their patients’ and the public’s trust in the profession.
In view of the nature of the offence for which you have been convicted and the submissions made by both counsel, the Panel has concluded that your fitness to practise is impaired by reason of your conviction.
The Panel will now invite further submissions, under Rule 17(2)(l), from Mr Kark and Mr Gaisford, as to the appropriate sanction, if any, to be imposed on your registration. Submissions on sanction should include reference to the Indicative Sanctions Guidance, using the criteria as set out in the guidance to draw attention to the issues which appear relevant to this case.
Determination on sanction
The Panel has already determined and announced that your fitness to practise is impaired by reason of your conviction. The Panel has considered what action, if any, to take in relation to your registration. It has noted the submissions made by Mr Kark on behalf of the General Medical Council and those made by Mr Gaisford, on your behalf. Mr Kark has invited the Panel to consider making a direction suspending your registration whilst Mr Gaisford has submitted that this is an exceptional case and it would be appropriate to conclude the case without imposing any sanction. He further submitted that in the event that this is not deemed to be sufficient, written undertakings have been provided to the Panel by you, dated 1 October 2008.
The Panel has borne in mind that any sanction imposed must be proportionate and appropriate, and that its purpose is not to be punitive, but to protect members of the public and the public interest. The public interest includes not only the protection of patients, but also the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour. The Panel has taken into account the Indicative Sanctions Guidance published by the General Medical Council.
The Panel has also taken into account the oral and documentary evidence that you have provided in mitigation. It has had regard to all the supportive testimonials submitted including those of Ms A, professional colleagues, practice staff members and by your patients. These suggest that your actions were completely out of character and that you are held in the highest regard by colleagues and members of your local community. It is clear that you are considered to be a highly competent, hardworking, dedicated, reliable and well-respected doctor.
You also told the Panel that you deeply regret the conviction, have apologised and accept responsibility for your actions. You confirmed that you have learnt a valuable lesson and have assured the Panel that such conduct will not be repeated. You have indicated that you have sufficient techniques in place to control any anger in the future in addition to the support of professional colleagues and mentors.
The Panel has not been informed of any previous proceedings against you by the General Medical Council nor has it been informed of any issues regarding the performance of your medical duties and the care of your patients.
The Panel has considered carefully all the relevant issues in this case. There is a requirement to send a clear message to the medical profession and the public that behaviour such as yours is unacceptable. There is also a need to recognise the important role that you have played and still do play in providing healthcare to your local community, a deprived inner city area. The Panel is impressed by the high regard in which you are held in the local medical and general communities, and recognises that you have made a significant contribution to local healthcare organisation, delivery, governance and training.
Nevertheless, the needs of your practice population in relation to this case are different to those of the wider public. The Panel is acutely aware that even in the presence of impressive mitigation, the wider public interest is served best by the maintenance of proper standards of conduct and a message to the profession that conduct such as yours is not the behaviour expected of a doctor.
Balancing the wider public interest, your interests and those of your local community has been at the forefront of the Panel’s deliberations and achieving a decision that delivers this balance has been its aim.
The Panel first considered whether it would be appropriate and proportionate to conclude your case without imposing any sanction. The Panel determined that, in the light of the serious nature of your conviction, such a course of action would be insufficient and inappropriate.
The Panel considered the written undertakings that you offered. It determined that they were not suitable because they do not address adequately the seriousness of the case. They would also be impossible to monitor and are not measurable or realistic.
The Panel next considered whether placing conditions on your registration would be a sufficient and appropriate response. The Panel recognises that any conditions imposed must be proportionate, measurable and workable. The Panel determined that it would not be possible to formulate appropriate and practical conditions which would address your misconduct, and the placing of conditions on your registration would not adequately address the seriousness of the case.
The Panel then went on to consider whether a period of suspension would be an appropriate and proportionate sanction. It recognises that this sanction deprives a doctor of the right to practise and deprives a local community of, in your case, a valued general practitioner. However, the Panel considers that your unacceptable behaviour was in breach of the professional standards with which all doctors are expected to comply.
The Panel has had in mind Lord Bingham’s observation in the case of Bolton v The Law Society, adopted in the case of Dr Gupta, as noted in the Indicative Sanctions Guidance:-
“The reputation of the profession is more important than the fortunes of an individual member. Membership of a profession brings many benefits, but that is part of the price.”
The Panel considers that allowing you to continue practising as a doctor is not fundamentally incompatible with its findings, as this was an isolated incident and was out of character. You have shown insight into your wholly inappropriate conduct and have assured the Panel it will not be repeated. The Panel is satisfied that you show no evidence of any harmful deep-seated personality or attitudinal problems.
The Panel has balanced all of these factors and has determined that it is sufficient and proportionate to suspend your registration.
The Panel then considered what period of suspension would be appropriate. Any period imposed must be sufficient to mark the seriousness of the case, maintain public confidence, and send to the public and the profession a clear message about the standard of behaviour required from doctors.
The Panel has given considerable weight to all the mitigation that you have put forward. The Panel is mindful that you have been open and honest with colleagues and patients regarding your conduct and believes that you have shown contrition and remorse for your actions and that you have learnt from this experience. The Panel has also noted that despite the incident you have a good professional working relationship with Ms A.
Having considered all the circumstances of your case the Panel has determined that it is appropriate and proportionate to direct the Registrar to suspend your registration for a period of two months. The Panel finds that a suspension for a longer period would be disproportionate and would deprive the public, and in particular your local community, of the services of an otherwise competent and dedicated doctor who has shown remorse and insight into his actions. It is the Panel’s opinion that this conveys a clear message both to you and to the public and is sufficient to maintain public confidence in the profession.
The Panel considered whether it would be necessary to review your case before the end of the period of suspension. The Panel does not find that there are any patient safety issues or that any useful purpose would be served by reviewing your case at the end of this period.
The effect of the foregoing direction is that, unless you exercise your right of appeal, your registration will be suspended for a period of two months commencing twenty-eight days after formal notice of this direction is deemed to have been served upon you. A note explaining your right of appeal will be given to you.
The Panel has not heard any evidence to suggest that it is necessary for the protection of the public, in the public interest or in your best interests that your registration be suspended forthwith. It is therefore not minded to direct that your registration be suspended forthwith but if there are any submissions that either Mr Kark or Mr Gaisford would wish to make with regard to immediate suspension the Panel will hear them.