PUBLIC RECORD. Record of Determinations Medical Practitioners Tribunal

Transcription

1 PUBLIC RECORD Dates: 08/11/ /11/2017 Medical Practitioner s name: Dr Imran QURESHI GMC reference number: Primary medical qualification: Type of case New Conviction/Caution MB BS 1997 University of Peshawar, Khyber Medical College Outcome on impairment Impaired Summary of outcome Suspension, 12 months. Review hearing directed Immediate order imposed Tribunal: Legally Qualified Chair Lay Tribunal Member: Medical Tribunal Member: Mr Nicholas Flanagan Mr Keith Moore Dr Noel Bevan Tribunal Clerk: Mr Stuart Peachey Attendance and Representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Mr Lee Gledhill, Counsel, instructed by Mr Ikram Amin of Umbrella Legal Ms Rebecca Vanstone, Counsel, instructed by GMC Legal, represents the General Medical Council. 1

2 Allegation and Findings of Fact That being registered under the Medical Act 1983 (as amended): 1. On 3 May 2016 at Manchester Minshull Street Crown Court, you were convicted of Sexual Assault on a female - no penetration. Admitted and Found Proved 2. On 17 June 2016 you were sentenced to: a. 12 months Community Order with 20 days Rehabilitation Activity Requirement; Admitted and Found Proved b. inclusion on the Sex Offender Register for a period of five years. Admitted and Found Proved And that by reason of the matters set out above your fitness to practise is impaired because of your conviction. Attendance of Press / Public The Tribunal agreed, in accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004, that the press and public be excluded from those parts of the hearing where matters under consideration were deemed confidential. Determination on Facts - 08/11/2017 Dr Qureshi: Background 1. You were employed as a Locum Senior House Officer ( SHO ) in the Medical Admissions Unit at Trafford General Hospital at the time of the alleged of events in June You were prosecuted as a result of allegations made by Ms A. 2. It is alleged that on 3 May 2016 at Manchester Minshull Street Crown Court, you were convicted of Sexual Assault on a female no penetration. 3. It is alleged that on 17 June 2016, you were sentenced to: 12 months community order with 20 days Rehabilitation Activity Requirement; and inclusion on the Sex Offender Register for a period of five years. 2

3 Evidence 4. The Tribunal noted a Certificate of Conviction from The Crown Court at Manchester, Minshull Street, dated 14 July 2016 which stated: Concerning Imran Surname, Family name Qureshi who on 3 May 2016 in this Crown Court was convicted of Sexual Assault on a female no penetration The said Imran Qureshi was on 17 June 2016 in this Crown Court sentenced to 12 months Community Order with 20 days Rehabilitation Activity Requirement. 5 years Sex Offender Register. 60 victim surcharge, and Prosecution costs. Admissions 5. At the outset of these proceedings, Mr Gledhill, Counsel on your behalf admitted the entirety of the allegation. The Tribunal found the following paragraphs and sub-paragraphs admitted and found proved, they are as follows: 1. On 3 May 2016 at Manchester Minshull Street Crown Court, you were convicted of Sexual Assault on a female - no penetration. Admitted and Found Proved 2. On 17 June 2016 you were sentenced to: a. 12 months Community Order with 20 days Rehabilitation Activity Requirement; Admitted and Found Proved b. inclusion on the Sex Offender Register for a period of five years. Found proved Admitted and Found Proved Determination on Impairment - 09/11/2017 Dr Qureshi: 1. Having found the facts proved, the Tribunal went on to consider whether, on the basis of the facts found proved, your fitness to practise is impaired by reason of your conviction. 3

4 Background 2. You were employed as Locum Senior House Officer ( SHO ) in the Medical Admissions Unit at Trafford General Hospital in June At the time of the offence, Ms A was a Student Nurse on placement at Trafford General Hospital. You touched Ms A s chest without consent, holding her right breast with your left hand for approximately 2 seconds before she moved away. Ms A reported the incident to her mentor, who reported it to the police. 3. On 12 June 2015, you attended the police station on your own accord and you were interviewed by a Police Constable. 4. On 12 September 2015, you self-referred to the General Medical Council ( GMC ). 5. On 3 May 2016 at Manchester Minshull Street Crown Court, you were convicted of Sexual Assault on a female - no penetration. 6. On 17 June 2016, you were sentenced to 12 months Community Order with 20 days Rehabilitation Activity Requirement and inclusion on the Sex Offender Register for a period of five years. You maintained your innocence throughout the proceedings and made unsuccessful attempts to appeal. Evidence 7. The Tribunal has given consideration to all the documentary evidence adduced in this case, which included, but was not limited to: Statements provided by Ms A to the police, dated 6 May 2015 [2016 sic], 3 June 2015, 27 July 2015 and 19 April 2016; Record of interview, dated 12 June 2015; Statement of interpreter/translator provided to the police, dated 20 July 2015; Statement provided by Ms B to the police, dated 30 July 2015; Police report, dated 8 August 2015; Pre-sentence report, dated 13 May 2016; Sentencing remarks, dated 17 June 2016; Certificate of conviction, dated 14 July The Tribunal had regard to a defence bundle of documents, submitted on your behalf, which enclosed: Your written statement, dated 17 October 2017; Letter from Ms C, National Probation Service Confirmation of completion of community order, dated 21 June 2017; 4

5 Submissions Certificate of Achievement: Equality, Diversity & Inclusion, dated 10 February 2016; Safeguarding Vulnerable Adults Level 2, dated 11 February 2016; Safeguarding Children & Young People Level 1 & 2, dated 11 February 2016; Safeguarding Children & Young People Level 3, dated 11 February 2016; Certificate of Attendance: Maintaining Professional Boundaries, 5-7 June 2017; Mastering Your Risk, dated 20 July 2017 General Medical Counsel ( GMC ) Submissions 9. Ms Vanstone, Counsel on behalf of the GMC, submitted that your fitness to practise is currently impaired by reason of your conviction. She submitted that a finding of impairment would promote and maintain public confidence in the profession as well as uphold and maintain proper standards. Ms Vanstone directed the Tribunal s attention to two cases, extrapolating the following principles: CHRE v NMC and Grant [2011] EWHC 927 (Admin); Has the registrant demonstrated in the past or liable in the future a risk to members of the public. Has the registrant s conduct in the past or is liable in the future to bring the medical profession into disrepute. Has the registrant breached a fundamental tenet of the profession. Liable to act dishonestly. CHRP v (1) GDC and (2) Mr Fleischmann [2005] EWHC 87 (Admin). It would be inappropriate to have a registrant undertaking unrestricted practice whilst subject to the Sexual Offender Registration Requirements. 10. Ms Vanstone submitted that you have shown limited insight based on the evidence before the Tribunal, you have failed to fully accept your conduct and show insight sufficient to demonstrate that there would be no repetition of your behaviour. However, Ms Vanstone submitted that you have reflected on your behaviour in your witness statement. 11. Ms Vanstone submitted that despite the apologies you have expressed in your written statement, the very nature of the offence is sexual. The complainant evidently did not consent and there is a risk of repetition in this case. She submitted 5

6 that the explanations that you provided; namely that you misunderstood her willingness and acceptable boundaries sought to minimise your actions and appeared to go behind the conviction of sexual assault. Ms Vanstone submitted the second and third principles of Grant are applicable in this case. 12. Ms Vanstone submitted there is no suggestion of dishonesty in your conduct. Submissions on your behalf 13. Mr Gledhill submitted that CHRP v (1) GDC and (2) Mr Fleischmann [2005] EWHC 87 (Admin) is relevant to the Tribunal s decision in so far as the only remaining obligation on you, as a consequence of the sentence, is to abide by the terms of the Sexual Offenders Register. Due to this requirement, Mr Gledhill concedes, it would be inappropriate to allow you to return to completely unrestricted practice and therefore your fitness to practise is impaired. 14. Mr Gledhill further submitted that without the Sexual Offender Registration Requirement, the conduct resulting in the conviction would fall just short of your fitness to practise being impaired. The Tribunal s Approach 15. The issue of impairment is one for the Tribunal to determine exercising its own judgement on the basis of the facts found proved and the evidence and submissions before it. The Tribunal was conscious that it must have regard to the statutory over-arching objectives: to protect and promote the health, safety and wellbeing of the public; to promote and maintain public confidence in the medical profession; and to promote and maintain proper professional standards and conduct for members of the profession. 16. The Tribunal considered whether or not your conviction should lead to the conclusion that your fitness to practise is impaired. The Tribunal bore in mind that although the events surrounding your current conviction took place in the past, the question for it to determine was whether your fitness to practise is currently impaired. 17. The Tribunal considered the case of CHRE v NMC and Grant [2011] EWHC 927 (Admin). The Tribunal s Decision 18. The Tribunal had regard to case of CHRP v (1) GDC and (2) Mr Fleischmann [2005] EWHC 87 (Admin) and the concession made by Mr Gledhill. The Tribunal noted that you will remain on the Sexual Offenders Register for a number of years for the sexual offence committed against a colleague and a return to unrestricted 6

7 practice could bring the medical profession into disrepute. The Tribunal considers due to the ongoing obligations under the Sexual Offenders Register, it would be inappropriate to allow you to return to unrestricted practice, and therefore your fitness to practise is impaired. 19. The Tribunal further considered that the act resulting in the conviction was perpetrated on a young student nurse, a junior colleague, and the incident took place at work whilst she was carrying out her duties. 20. The Tribunal noted the guidance given in Good Medical Practice ( GMP ) (2013 edition), specifically paragraphs 36, 48, 53 which state: You must treat colleagues fairly and with respect. 36 You must treat patients fairly and with respect whatever their life choices and beliefs. 48 You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them. 53 The Tribunal considers where the GMP indicates in this instance patient, it is reasonable to apply the same standard to a colleague, particularly those in subordinate roles to a practitioner or in training. 21. The Tribunal considered the basis upon which the prosecution was brought as well as the sentencing remarks of His Honour Judge Mort ( HHJ Mort ). The Tribunal considered the effect the incident had upon Ms A - that your actions were painful for her [Ms A] and embarrassing and the Tribunal notes this HHJ Mort highlighted that she [Ms A] was 21, and You could see that perhaps as a young woman she [Ms A] might not approve of it because of her faith, but you tried it on. 22. The Tribunal was of the view that you were in a position of trust and abused your position of authority as Ms A was subordinate to you as a Student Nurse and had only been back in her placement at the hospital for a day. In Ms A s statement, she stated that as a result of the incident she had been prescribed sleeping tablets, had become wary of doctors and had to take three weeks off work impacting on her studies. The Tribunal noted that the breaches of GMP were accepted by Mr Gledhill on your behalf, during the course of this hearing, and he fully accepted the submission of Ms Vanstone in this regard. 23. In relation to insight, remediation and repetition, the Tribunal had regard to the circumstances of the conviction and the Pre-Sentence report in 2016, where it stated In interview he continued to deny having committed the offence [ ] As Mr Qureshi denies the offence there no remorse on his part. The Tribunal noted that you sought to appeal the conviction. The Tribunal considered your recent statement 7

8 of June 2017 where you apologised for the incident, indicated that it was isolated and that you expressed regret. The Tribunal also noted the extent of your understanding of the impact the incident would have had upon Ms A. In light of this evidence of steps so far taken to remediate, the Tribunal has limited evidence of developing insight. The Tribunal therefore concluded that you have so far demonstrated insufficient insight into the gravity of the offence and the impact on the individual, public confidence and the standing of the profession. 24. The Tribunal considered the conviction is liable to bring the profession into disrepute and has breached a fundamental tenet of the medical profession. The Tribunal therefore concluded that in view of the seriousness of the offence, a finding of impairment was necessary in order to promote and maintain public confidence in the medical profession and to promote and maintain proper professional standards of conduct and behaviour. 25. In all the circumstances, and for the reasons set out above, the Tribunal determined that your fitness to practise is impaired by reason of your conviction. Determination on Sanction - 10/11/2017 Dr Qureshi: 1. During the course of these proceedings the Tribunal determined that certain parts of this case should be heard in private pursuant to Rule 41 of the General Medical Council ( GMC ) (Fitness to Practise) Rules 2004 ( the Rules ). Therefore, the press and public will be excluded from those parts of the hearing XXX and this determination will be read in private. However, as this case concerns your conviction, a redacted version will be published after the hearing with those matters XXX removed. 2. Having determined that your fitness to practise is impaired by reason of your conviction, the Tribunal moved on to consider what sanction, if any, it should impose with regard to your registration. Evidence Documentary Evidence 3. The Tribunal has given consideration to all the documentary evidence adduced in this case. The Tribunal had regard to your Revalidation Services Appraisal Form submitted on your behalf: Appraiser [Ms D] Status Complete Last Modified 20/04/ :21 8

9 Appraiser Confirmation Date 20/04/ :21 Date of planned appraisal meeting 20/04/2015 Oral Evidence 4. You provided oral evidence to the Tribunal. In summary, you rehearsed your medical background. You told the Tribunal that you are a man of previous good character. You stated you have been through revalidation in 2015 and when you applied for revalidation, you submitted your 360 degree appraisal which was an authentic copy. You told the Tribunal you attempted to obtain testimonial evidence during the Criminal Court Proceedings and also for these proceedings, but that your contacts at the hospital did not provide you with references. 5. You informed the Tribunal about your marital status XXX both at the time of the offence and subsequently. 6. You told the Tribunal that you had been looking for a romantic friendship with the complainant. You stated that you had discussed personal matters with the complainant and she told you about her relationships. You had offered her advice when she told you that her parents did not know about her relationships. 7. In relation to the incident leading to the conviction, you rehearsed your recollection of the events and told the Tribunal that you accept the account given by the complainant was correct; you touched her breast and this action was not welcomed. However, in hindsight, you appreciate that while she was merely being friendly, you misconstrued her friendship with a romantic inclination. You admitted you perceived the events incorrectly and that it was a big error. You stated that you accept the evidence that she was giving you a red light not to advance further with any touching. You told the Tribunal if you see a red light in the future you will remain within in your boundaries and not act in such a manner again. You told the Tribunal you had attended the Professional Boundaries course at which you learnt where you went wrong and your mistake was a misinterpretation of the events. You stated this was an isolated case, and that you will never cross boundaries in this manner again. You stated that you understood that you have a responsibility to maintain boundaries which is important as you are in a responsible post as a doctor and it is your duty to keep your patients and the public safe. 8. In relation to the impact of your actions and the offence on the complainant, you told the Tribunal you are the main culprit, that you and your family suffered, as well as the complainant and her family. You said that you understood that she had felt anxiety, anger and depression throughout the criminal proceedings. She had lost trust in professional colleagues because of your offence and you understand it would take her a long time to trust male colleagues again and your actions had affected her studies. You told the Tribunal that you regret your offence every day. You said you would like to offer a sincere deep hearted apology to the complainant. 9

10 9. In relation to the future, you told the Tribunal that if you were permitted to return to work, you would continue with your Continuing Professional Development ( CPD ). You said you intended to apply to take the Member of Royal College of Physicians ( MCRP ) exam, as it is your ambition to work in Registrar training posts in order to become eligible to apply for a Consultant appointment. Since the conviction, you told the Tribunal you have you have completed two courses and have undertaken self-study. You said you would expect to have to undertake a clinical attachment before starting any work. 10. You told the Tribunal that what has happened has had a personal and financial impact on your family and your professional life, as you stopped work after the offence. XXX Submissions GMC Submissions 12. Ms Vanstone, Counsel, on behalf of the GMC, submitted that the appropriate and proportionate sanction regarding your registration was one of erasure. 13. Ms Vanstone referred the Tribunal to the relevant paragraphs of the Sanctions Guidance (2017 edition) ( SG ) which you suggested apply to this case, specifically paragraphs 45(a)(b)(c), 55(d)(e), 108, 109(a)(d)(f)(j), 119, 148, 151, Ms Vanstone submitted that, whilst you have accepted you should have behaved differently towards Ms A, any empathy relating to the events is not present. She submitted that your evidence referred solely to the misinterpretation of the events, misreading that the complainant was romantically interested in you. Ms Vanstone submitted your attitude and the suggestion that you reasonably believed she consented to this behaviour in fact goes behind your conviction. She submitted there has only been limited evidence of developing insight and in her submission this was insufficient. 15. Ms Vanstone submitted it is important to note that, whilst you eventually admitted touching Ms A s breast, you have not conceded that she was not consenting and that you did not reasonably believe she was consenting. Ms Vanstone further stated that, whilst there has been an admission of the facts and an apology offered, your level of insight is insufficient. 16. Ms Vanstone submitted it is important to note that whilst you eventually admitted touching Ms A s breast that you had not conceded that she had not consented, or you held a reasonable belief in her consent. Ms Vanstone submitted 10

11 whilst there has been admission of the facts and an apology offered, that level of insight is insufficient. She highlighted that the representation of this being out of character as you respect everyone is at odds with the offence itself. 17. Ms Vanstone directed the Tribunal to the case of Alhy v GMC [2011] EWCH 2277 (Admin), which differentiated between denials during criminal proceedings and those thereafter. She submitted this Tribunal can take account of denials throughout criminal proceedings, it is merely a question of how much significance this has, and further submitted that your continued lack of complete acknowledgment of the offence is a more significant aspect for the Tribunal to consider. Submissions on your behalf 18. Mr Gledhill, Counsel, on your behalf, submitted that the appropriate and proportionate sanction regarding your registration was one of suspension. He submitted that you are a person of previous good character. Mr Gledhill submitted that erasure would be a step too far on the evidence before the Tribunal and within the criminal justice sphere your offence is at the lower end of the spectrum, although of course it is very serious in the context of the profession. 19. Mr Gledhill submitted that, based on the evidence before the Tribunal, it could draw the conclusion that your offence was a moment of madness, a short, brief touching. He submitted your offence was due to your misreading of signals and he explored in evidence why you did not see a red light at the time. 20. Mr Gledhill submitted that your community sentence has been completed, and that other than your continued obligations under the Sexual Offenders Register - the probation service had no concerns. He submitted in the absence of further concerns, the Tribunal can be reassured that you have embarked on a process that shows a reduced level of risk. 21. Mr Gledhill directed the Tribunal s attention to the case of Alhy v GMC [2011] EWCH 2277 (Admin) where he submitted the Appellate Court appeared to be of the opinion that someone is entitled to fight criminal allegations as a matter of public policy, and that it would be inappropriate to consider any denials at that stage as a lack of insight in this Tribunal s determination. 22. Mr Gledhill submitted that you accept it was wrong to touch Ms A the way you did. He submitted Ms A was someone with whom you built a relationship over a period of time and you misunderstood her own views of you. Mr Gledhill submitted this offence has had a profound impact on your personal and financial life, you have had a long time to think about your actions and you are extremely remorseful. Mr Gledhill submitted that you have acknowledged the impact this had on Ms A and would like to issue a sincere apology to her and her family. He submitted this demonstrates insight. 11

12 23. Mr Gledhill submitted there was a low risk of repetition in your case. He submitted you are a man of previous good character, have not historically crossed boundaries and it is therefore highly suggestive that in the future you will not repeat your offending, as you have developed strategies to ensure you keep your behaviour professional. 24. Mr Gledhill submitted if the Tribunal imposed an order of suspension on your registration, a reviewing Tribunal would be assisted by evidence of any attempt of an apology and further evidence of insight and remediation. Mr Gledhill submitted the case of CHRP v (1) GDC and (2) Mr Fleischmann [2005] EWHC 87 (Admin) remains appropriate in your case, in that your fitness to practise is likely to remain impaired, requiring conditions to your registration, during the currency of your Sexual Offenders Registration requirement. He submitted that if the Tribunal were to form a view that your insight has not fully developed, you can return to a review Tribunal and seek to demonstrate that you have in fact developed more insight. The Tribunal s Approach 25. The Tribunal has taken into account your evidence and all the documents adduced during the course of these proceedings as well as the submissions on your behalf and those of GMC. 26. The decision as to the appropriate sanction is a matter for this Tribunal s own independent judgment. In reaching its decision, the Tribunal has taken account of the SG and the statutory overarching objective, which includes protecting and promoting the health, safety and wellbeing of the public, promoting and maintaining public confidence in the profession, and promoting and maintaining proper professional standards and conduct. 27. The Tribunal recognises that the purpose of a sanction is not to be punitive, although it may have a punitive effect. Furthermore, the purpose behind the sanction is not to punish the clinician for a second time (as per SG, paragraph 116) but to consider whether registration should be restricted to maintain the high standards and reputation of the profession. Throughout its deliberations, the Tribunal has applied the principle of proportionality, balancing your interests with the public interest. 28. The Tribunal has already provided a detailed determination on Facts and Impairment and it has taken those matters into account during its deliberations on sanction. 29. In reference to the case of Alhy v GMC [2011] EWCH 2277 (Admin), the Tribunal was directed that there are factual and legal issues that need to be determined in relation to the question of insight. In relation to the factual questions, 12

13 the Tribunal needs to consider whether the registrant has demonstrated appropriate insight at this Tribunal through evidence, including any documentation adduced and it is appropriate for the Tribunal to consider the level or extent of that current insight in the context of the conduct concerned. 30. In relation to the legal issue raised, a more significant aspect to consider is the insight shown at this Tribunal and that demonstrated after the conclusion of the Criminal Justice process, including any appeals. A registrant is entitled to maintain his or her innocence throughout the criminal process and indeed at this Tribunal. However, as Her Honour Judge Belcher in the Judgment at paragraph 48 states: there is a significant difference between maintaining innocence prior to the conviction or the final resolution of the criminal process and maintaining innocence thereafter. The Tribunal may, where it is appropriate, take some, albeit limited account of any denials made throughout the criminal process, although this will have less significance than any denials that are maintained at the Tribunal, when determining what insight has been demonstrated. Aggravating and Mitigating Factors Aggravating Factors 31. The Tribunal took account of the following aggravating features: You abused a position of trust; The complainant was subordinate to you, as a Student Nurse; The significant disparity in age; You committed a sexual assault which justified a Community Order and registration on the Sexual Offenders Register for five years; You committed the offence at work whist the complainant was undertaking a work activity; Your response to managing a future scenario by isolating yourself and avoiding engagement, rather than seeking support. Mitigating Factors 32. The Tribunal balanced the aggravating features of your case with the mitigating features: It was a single isolated incident; No previous concern about your behaviour in a criminal format or the GMC; The length of time since the incident; 13

14 You have shown some acceptance of the events; You have shown some recognition of the impact of what Ms A went through at the time, including the effect on her family and studies; Whilst this is a conviction for sexual assault, the sentence imposed is towards the lower end of seriousness as indicated by the sentencing remarks; You fully complied with the order imposed and the Sexual Offenders Requirement; You expressed a willingness to apologise; You self-referred to the GMC promptly. The Tribunal s Decision 33. In deciding what sanction, if any, to impose, the Tribunal reminded itself that it must consider each of the sanctions available, starting with the least restrictive, in order to establish the most appropriate and proportionate sanction in this case. No Action 34. The Tribunal first considered whether to conclude the case by taking no action. 35. The Tribunal determined that, given the seriousness of your conviction, taking no action would not be appropriate, given that it would neither promote and maintain public confidence in the profession nor promote and maintain proper professional standards and conduct. Conditions 36. The Tribunal next considered whether an order of conditions would be appropriate. It has borne in mind that any conditions imposed should be appropriate, proportionate, workable and measurable. 37. The Tribunal concluded that a period of conditional registration would not be appropriate in this case. In addition, it would be difficult to formulate conditions to address the concerns in this case. Any conditions for this offence would necessitate the provision of a chaperone which is unlikely to be workable. Furthermore, in light of the severity of the offence, the imposition of conditions would be inconsistent with the maintenance of public confidence in the medical profession and the promotion and maintenance of proper professional standards and conduct. 14

15 Suspension 38. The Tribunal went on to consider whether suspension would be an appropriate sanction in this case. The Tribunal had regard to paragraph 93 and 97(a)(e)(f)(g) of SG which states: Suspension may be appropriate, for example, where there may have been acknowledgement of fault and where the tribunal is satisfied that the behaviour or incident is unlikely to be repeated. The tribunal may wish to see evidence that the doctor has taken steps to mitigate their actions. 93 Some or all of the following factors being present (this list is not exhaustive) would indicate suspension may be appropriate. a. A serious breach of Good medical practice, but where the doctor s misconduct is not fundamentally incompatible with their continued registration, therefore complete removal from the medical register would not be in the public interest. However, the breach is serious enough that any sanction lower than a suspension would not be sufficient to protect the public or maintain confidence in doctors. e. No evidence that demonstrates remediation is unlikely to be successful, eg because of previous unsuccessful attempts or a doctor s unwillingness to engage. f. No evidence of repetition of similar behaviour since incident. g. The tribunal is satisfied the doctor has insight and does not pose a significant risk of repeating behaviour. 97(a)(e)(f)(g) 39. The Tribunal noted that you ignored signs from Ms A that she did not welcome your behaviour. The Tribunal considered, given the length of time you had been in the United Kingdom at that stage and the fact you were fully aware of the differences in culture, because of your experiences with your wife, you should have recognised Ms A s reluctance in light of your shared cultural understanding. The Tribunal concluded you showed a lack of empathy towards Ms A and ignored her objections to your behaviour. 40. The Tribunal considered that you have only indicated a wish to make an apology at this point, and it has not seen any evidence to show you have taken steps to do this. It heard your evidence of the practical difficulties of doing so, as you were no longer a member of the Medical Protection Society (by whom you had been represented, but then lost that avenue). Whilst the Tribunal appreciates the 15

16 practical difficulties, it was more concerned about your reasons for wanting to give an apology to Ms A and her family. The Tribunal heard in your evidence that you want to obtain forgiveness which would relieve the burden on you. The Tribunal was of the view that this demonstrated your limited insight and lack of understanding of the impact your behaviour had on Ms A and concluded that the primary purpose of such an apology should be to assuage the feelings of Ms A and her family, rather than yourself. The Tribunal determined that this is evidence that there is insufficient insight as you have not fully understood the effect the offence and the trial had on Ms A and her family. 41. The Tribunal noted His Honour Judge Mort s sentencing remarks where he stated There is, in my judgment, no risk for the future. I think you have learnt a very, very, hard lesson indeed. The Tribunal noted however, that you abused your position of trust in the workplace as a doctor, and had been required to register on the Sexual Offender Register for five years and therefore considered your offending behaviour to be serious, requiring action commensurate with the gravity of the offence. The Tribunal bore in mind its independent duty and obligations to uphold and maintain the standards of the profession and maintain and uphold public confidence in the profession. The Tribunal concluded there is a low but nevertheless not insignificant risk of harm to another individual by a repetition of your behaviour. 42. Having had regard to all the circumstances of this case, the Tribunal is just satisfied that the limited insight you have begun to develop in relation to your conviction justifies the determination that your impairment is not fundamentally incompatible with continued registration. The Tribunal determined that erasing your name from the Medical Register would be disproportionate, punitive and not in the public interest, having balanced the need to uphold confidence and trust in the profession with depriving the public of a clinically competent doctor in the longer term. 43. The Tribunal therefore determined that a period of suspension is necessary in order to mark the seriousness of your action and to promote and maintain public confidence in the medical profession, which would give you further opportunity to reflect and demonstrate further insight and remediation. The Tribunal determined that the maximum period of 12 months suspension would be appropriate and proportionate in your case. In determining this period the Tribunal took into account the need to declare and reaffirm the standards expected of all registered practitioners. It considered that this period would provide you with the opportunity to demonstrate that you are fit to return to practise either unrestricted or under conditional registration. Review Hearing Directed 44. Before the end of the period of suspension, a will review your case and a letter will be sent to you about the arrangements for the 16

17 review hearing, which you will be expected to attend. A future Tribunal would need to consider the remaining period of the Sexual Offenders Registration in light of Fleischmann and to consider whether your fitness to practise remains impaired. At the review hearing that Tribunal may be assisted by the following: Evidence that you have kept your clinical skills and medical knowledge up to date; Evidence of reflection on this Tribunal s findings; Evidence of remediation; Further evidence of remorse; Evidence of steps you have taken to develop further insight; Any other information you consider will assist the review Tribunal. Determination on Immediate Order - 10/11/2017 Mr Gledhill: 1. Having determined that Dr Qureshi s name be suspended from the Medical Register for a period of 12 months, the Tribunal has now considered whether to impose an immediate order of suspension on Dr Qureshi s registration in accordance with Section 38 of the Medical Act 1983, as amended. Submissions 2. Ms Vanstone invited the Tribunal to consider the principles set out in Fleischmann. She submitted that, given the Tribunal s findings at the impairment stage, it was both necessary and proportionate to impose an immediate order of suspension in order to uphold public confidence in the medical profession. 3. On behalf of Dr Qureshi, you did not oppose the imposition of an immediate order. The Tribunal s Decision 4. In reaching its decision, the Tribunal has exercised its own judgment, and has taken account of the principle of proportionality. The Tribunal has borne in mind that it may impose an immediate order where it is satisfied that it is necessary for the protection of members of the public, is in the public interest, or is in the best interests of the practitioner. It has also borne in mind the guidance given in the relevant paragraphs of the SG. 5. The Tribunal took account of paragraph 173 of the SG. The Tribunal determined that in light of the gravity of its findings, and in the particular circumstances of this case, an immediate order of suspension is appropriate and 17

18 necessary. It noted that the order was unopposed, and determined that an order was otherwise in the public interest. 6. The effect of this order is that Dr Qureshi s registration will be suspended from the date when written notice of this decision is deemed to have been served upon him. 7. Unless Dr Qureshi exercises his right of appeal, the substantive order of suspension, as already announced, will take effect 28 days after notice of the outcome of this hearing is deemed to have been served upon him. If Dr Qureshi does lodge an appeal, the immediate order of suspension will remain in force until the outcome of any appeal is known. 8. The interim order in place on Dr Qureshi s registration will be revoked when notice of the immediate suspension is deemed to have been served upon him. 9. That concludes Dr Qureshi s case. Confirmed Date 10 November 2017 Mr Nicholas Flanagan, Chair 18