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1 PUBLIC RECORD Dates: 15/05/ /05/2018 Medical Practitioner s name: Dr Martin GEORGE GMC reference number: Primary medical qualification: Type of case New - Conviction / Caution New - Misconduct MB BS 2002 Lagos Outcome on impairment Impaired Impaired Summary of outcome Suspension, 4 months. Review hearing directed Tribunal: Legally Qualified Chair Lay Tribunal Member: Medical Tribunal Member: Mr Hassan Khan Ms Elizabeth Daughters Dr Pamela Crawford Tribunal Clerk: Mr John Poole Attendance and Representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Mr Selva Ramasamy QC, directly instructed Mr David Birrell, Counsel Allegation and Findings of Fact Paragraph 1 You failed to notify the General Medical Council ( GMC ) without delay that you had been charged on 7 June 2016 with the following offences, which occurred on 17 April 2016: 1

2 a. commit an act/ series of acts with intent to pervert the course of public justice; b. driving a motor vehicle (Mercedes) with excess alcohol; c. driving a motor vehicle (Range Rover) with excess alcohol; d. failing to stop after a road accident. Paragraph 2 On 20 December 2016 at Inner London Crown Court you were convicted of: a. driving a motor vehicle (Mercedes) with excess alcohol; b. driving a motor vehicle (Range Rover) with excess alcohol; c. failing to stop after a road accident; d. wasting police time. Paragraph 3 On 20 December 2016 you were sentenced to a total: a. monetary order in the sum of 2,370.00; b. driving disqualification period of 16 months. Paragraph 4 You failed to notify the GMC without delay that you had been convicted of the criminal offences detailed in paragraphs 2b-d. Paragraph 5 Yours actions as described at paragraphs 1 and 4 were dishonest. Disputed and found proved 2

3 Attendance of Press / Public The hearing was all heard in public. Determination on Facts - 17/05/2018 Background 1. Dr George qualified from the University of Lagos, Nigeria, in He has worked as a doctor in the United Kingdom in various capacities since Since 2015, he has been practising as an Accident and Emergency Department Speciality Doctor at St Richards Hospital, Chichester. 2. The allegation that has led to Dr George s hearing relates to criminal convictions and alleged misconduct. Dr George is alleged to have failed to notify without delay the GMC that he had been charged with various criminal offences on 7 June 2016 and of failing to notify the GMC without delay of all the offences for which he was subsequently convicted on 20 December The GMC allege that, in so doing, Dr George s actions were dishonest. 3. The events leading up to the criminal charges and convictions can be summarised as follows. On the evening of 17 April 2016, Dr George had been involved in a road traffic incident in which he crashed a Mercedes vehicle into traffic bollards and a metal pole. He then walked away from the accident and left the vehicle behind. 4. The police report states that, while waiting with the Mercedes for vehicle recovery, they stopped a Range Rover which drove past. This vehicle was driven by Dr George, who was accompanied by XXX Mrs A in the passenger seat. Mrs A told the police that she had been driving the Mercedes vehicle at the time of the collision. This account was maintained by Mrs A and uncorrected by Dr George. This was inconsistent with eye witness accounts and caused the police to arrest them both and they were taken to Bexley Police Station. Mrs A was bailed XXX. Dr George was breathalysed by the police and found to have drunk alcohol in excess of the prescribed limit. His reading was 41 microgrammes per 100 millilitres. 5. On 18 April 2016 Dr George was interviewed by the police. During that police interview Dr George made an admission that he was in fact the driver of the Mercedes that was involved in the collision. 6. On 7 June 2016, Dr George was charged with four offences. This included two charges of driving a motor vehicle with excess alcohol, one charge of failing to stop after a road accident and a charge of committing an act/ series of acts with intent to pervert the course of public justice. At a hearing at the Magistrates Court on or around 21 June 2016, Dr George indicated guilty pleas to all charges except in 3

4 relation to the allegation of perverting the course of public justice for which a not guilty plea was entered. His case was sent to the Crown Court. Dr George s trial was scheduled for 20 December At that hearing the charge of perverting the course of public justice was not proceeded with and Dr George pleaded guilty to an alternative charge of wasting police time. That meant that Dr George pleaded guilty to and was convicted of four separate offences. 7. Recorder B J Argyle sentenced Dr George on the same day as follows: - Failing to stop after an accident, for which he received a fine of 200 and his driving licence endorsed - Driving a motor vehicle with excess alcohol for which he received a fine of 600 and disqualification from driving for 12 months and his driving licence endorsed - Driving a motor vehicle with excess alcohol for which he received a fine of 600 and a disqualification from driving for 16 months (concurrent). A drink drive rehabilitation course was offered and he was disqualified from driving until a further ordinary driving test was passed - Wasting police time for which he received a fine of Recorder Argyle said in relation to the basis upon which he sentenced Dr George for drink driving:.. on 17 April this year you caused wasteful employment of the police by knowingly making a false report in informing the police that XXX was the driver of a silver Mercedes that had been involved in an accident.. 9. The initial concerns were brought to the GMC s attention following Dr George s self-referral by way of on 21 December 2016, in which he informed the GMC he had been convicted of drink driving. The Allegation and the Doctor s Response 10. The Allegation made against Dr George is as follows: Paragraph 1 You failed to notify the General Medical Council ( GMC ) without delay that you had been charged on 7 June 2016 with the following offences, which occurred on 17 April 2016: a. commit an act / series of acts with intent to pervert the course of public justice; b. driving a motor vehicle (Mercedes) with excess alcohol; 4

5 c. driving a motor vehicle (Range Rover) with excess alcohol; d. failing to stop after a road accident. Paragraph 2 On 20 December 2016 at Inner London Crown Court you were convicted of: a. Driving a motor vehicle (Mercedes) with excess alcohol; b. driving a motor vehicle (Range Rover) with excess alcohol; c. failing to stop after a road accident; d. wasting police time. Paragraph 3 On 20 December 2016 you were sentenced to a total: a. monetary order in the sum of 2,370.00; b. driving disqualification period of 16 months. Paragraph 4 You failed to notify the GMC without delay that you had been convicted of the criminal offences detailed in paragraphs 2b-d. Paragraph 5 Yours actions as described at paragraphs 1 and 4 were dishonest. To be determined The Admitted Facts 11. At the outset of these proceedings, through his representative, Mr Selva Ramasamy QC, Dr George made admissions to the first four paragraphs of the Allegation, as set out above, in accordance with Rule 17(2)(d) of the Rules. In accordance with Rule 17(2)(e) of the Rules, the Tribunal announced these paragraphs and sub-paragraphs of the Allegation as admitted and found proved. 5

6 The Facts to be Determined 12. In light of Dr George s response to the Allegation made against him, the Tribunal is required to determine whether his actions as set out in paragraphs one and four, were dishonest. Factual Witness Evidence 13. The Tribunal heard oral evidence from Dr George and XXX Mrs A. It also had regard to their witness statements. 14. The Tribunal also received evidence from the GMC in the form of witness statements from the following witnesses who were not called to give evidence: Ms I, GMC Investigation Officer (statement dated 18 December 2017) Mr B, Responsible Officer (redacted statement dated 19 March 2018) 15. The Tribunal also received evidence from Dr George in the form of witness statements from the following witnesses who were not called to give evidence: Mr C, Director, Mylocum Medical Staffing Agency Dr D, Consultant at the Accident and Emergency Department, St Richards Hospital, Chichester. Sister E, Sister in charge at the Accident and Emergency Department, St Richards Hospital, Chichester (2 February 2018) Mr F, Senior Site Nurse Practitioner for Western Sussex NHS Foundation Trust Ms G, Head of the Accident and Emergency Department, St Richards Hospital, Chichester (26 February 2018) Documentary Evidence 16. The Tribunal had regard to the following documentary evidence provided by the parties. This evidence included, but was not limited to: from Dr George notifying the GMC of his drink drive conviction, dated 21 December 2016 A letter from the GMC to the Metropolitan Police requesting further information, dated 7 February 2017 An from the Metropolitan Police providing documents to the GMC, including the case file summary Police report, 13 March 2017 An from Dr George to the GMC, dated 21 December 2016 Telephone file note of call between the GMC and Dr George, dated 28 April

7 Police Record of Interview of Dr George, dated 18 April 2016 Court Transcript sentencing remarks, dated 20 December from the Metropolitan Police to the GMC confirming the date Dr George was charged with the offences, dated 22 December 2017 Further s from Dr George to the GMC on 26 January, 31 May & 22 June 2017 Dr George s 2017 Medical Appraisal from April 2017 Dr George s Curriculum Vitae Dr George s Certificate of Completion for Drink Drive Course, dated 4 August 2017 Evidence of CPD completed from February-March 2018 The Tribunal s Approach 17. In reaching its decision on facts, the Tribunal has borne in mind that the burden of proof rests on the GMC and it is for the GMC to prove the Allegation. Dr George does not need to prove anything. The standard of proof is that applicable to civil proceedings, namely the balance of probabilities. 18. The Tribunal has considered all the evidence, both oral and documentary, together with the submissions made by Mr Birrell, Counsel, on behalf of the GMC and those of Mr Ramasamy QC, on behalf of Dr George. 19. When considering the issue of dishonesty, the Tribunal took account of the principles set out in the case of Ivey v Genting Casinos UK Ltd (t/a Crockfords Club) [2017] UKSC 67, first ascertaining the actual state of Dr George s knowledge or belief, and then going on to consider whether his actions were dishonest by the standards of ordinary decent people. The Tribunal s Analysis of the Evidence and Findings 20. The Tribunal first considered the oral evidence provided by Dr George. It did not find him to be an entirely credible witness. It noted that he was forthcoming in answering some questions but was often evasive when asked questions on key points. He was particularly evasive in questioning by the GMC Counsel and the Tribunal questions about whether he thought he was over the limit to drive, whether it was he or XXX Mrs A who was driving the car, and why he did not tell his supervising consultant about the perverting the course of justice charge. 21. The Tribunal also heard oral evidence from XXX Mrs A. The Tribunal did not consider her to be a credible witness, firstly she admitted that she had lied to the police, as to who was driving the Mercedes. Furthermore, there were a number of areas where the Tribunal found her account unconvincing. She stated that the reason she didn t drive Dr George back to the scene of the accident was that they had previously discussed that she was XXX. However, on further questioning, she 7

8 admitted that she had driven the car that morning. When she was questioned about when she went to the hospital as she was assumed to be driver by the police, she avoided this by suggesting that she needed to go to the hospital in any event XXX. She eventually conceded that the main reason for going to the hospital was because of her false report that she was driving the vehicle, involved in a collision XXX. Further XXX Mrs A was asked by the Tribunal whether she had a conversation with Dr George in relation to reporting the charges to the GMC. She accepted that she XXX would tend to discuss important matters with him. She accepted that she knew XXX that he was obligated to inform the GMC of the charges. She went on to say that there was no real discussion XXX as to whether he should inform the GMC but that she was confused as to whether informing the GMC should have taken place on conviction or charge. 22. The Tribunal next sought to ascertain Dr George s state of mind during the relevant period. The Tribunal noted that Dr George had spoken with his Medical Defence Union (MDU) on the 19 April 2016, two days after he had been arrested by the Police. In his witness statement, Dr George stated that when he contacted the MDU they advised him to contact the GMC should he be charged and he accepted this in his oral evidence. The Tribunal considered that Dr George should have known following this conversation, that he had a duty to report any subsequent charges to the GMC. 23. On 7 June 2016 Dr George was formally charged with four offences by the police. At that stage, he was charged with: - Driving a motor vehicle when alcohol above limit (relating to the Mercedes) - Driving a motor vehicle when alcohol above limit (relating to the Range Rover) - Commit an act/series of acts with intent to pervert the course of public justice - Failing to stop after a road accident 24. At this stage it was clear to Dr George that he had been charged with criminal offences, one of which was very serious, namely perverting the course of justice which attracted a custodial sentence. The Tribunal considered that given the advice he had previously received from the MDU, Dr George would have been cognisant of his obligation to report the charges to the GMC. 25. Following 7 June 2016, during a six month period before the listed trial, Dr George had several opportunities to disclose his charges to the GMC but failed to do so. The Tribunal was assisted in this regard by the schedule of admissions in which Dr George agreed that his first appearance before the Magistrates court was on or around 21 June 2016 and that there was a further hearing before the Crown Court on 19 July The Tribunal considered that these were key dates which ought to have reminded Dr George of the gravity of the charges he was facing and his obligation to report matters to his regulator. Further Dr George had legal 8

9 representation at this time and it is reasonable to infer that he would have been given advice as to the implications of the charges he was facing. 26. The Tribunal was troubled by the inconsistent accounts provided by Dr George for failing to inform the GMC of the charges. 27. The Tribunal first considered Dr George s witness statement. It found that it was internally inconsistent. On the one hand he said that he was aware of his obligation to inform the GMC of the charges after receiving advice from the MDU but later in his statement said I do accept that I should have informed the GMC of my charges at this stage or shortly after but I wrongly assumed that that could be done after the court hearing when the matter was concluded. 28. The Tribunal next considered Dr George s assertion that he failed to disclose the charges due to poor prioritisation at the time. On 19 April 2016 Dr George accepts that he was informed by the MDU that he should contact the GMC in the event of charge. He said this: I understood this advice but I regretfully admit that I did not give it sufficient priority as I was dealing with several things at the time such as XXX which occurred on 6 June 2016, which was the day before my charge on the 7 of June 2016, corresponding with criminal defence lawyers for the first time, resolving post accident car matters with my insurance company XXX 29. The Tribunal rejected this and considered it to be an unconvincing explanation for his failure to inform the GMC. Dr George was well aware of the seriousness of the charges, particularly the charge of perverting the course of justice, and his duty to report these matters to the GMC. Although he may not have immediately prioritised reporting the charges in light of XXX, he had ample time thereafter to do so. Indeed Dr George was able to attend at the police station the day after XXX on 7 June 2016, continued his employment and fully engaged in criminal proceedings which continued until 20 December On 21 June 2016 Dr George entered a not guilty plea to pervert the course of justice and guilty pleas to the remainder of the charges. In light of this the Tribunal concluded that Dr George s explanation did not provide a reasonable excuse for his failure to inform his regulator of the charges he was facing between 7 June 2016 and 20 December On 28 April 2017 Dr George telephoned the GMC in which he referred to his self referral by way of dated 21 December The GMC note also records that: He explained that any delays were not of his making, that he had understood the matter was initially not be heard by the Magistrates Court but that the police had wanted it referred to the Crown Court to consider. This had caused 9

10 delays, especially when the Crown Court had felt that the matter could have been adequately dealt with by the Magistrates 31. When asked about this Dr George said that he thought that the charges would be swift and quick and that it would not continue into December. The Tribunal considered that this did not provide an excuse for failing to report the charges to the GMC until 21 December Although the hearing did not conclude until 20 December 2016 the charges had remained in existence throughout the period between 7 June and 20 December. 32. The Tribunal further considered Dr George s explanation that he could not inform the GMC of the charges because they had not been made clear to him. In his to the GMC Investigation Officer on 22 June 2017, he had stated that I am completely uncertain what delay the GMC refers to. I could not possibly have informed the GMC of the incident any sooner simply for the lack of certainty of information as you can see that the original charges differ slightly from the final convictions and this would mean providing the GMC with insufficient and inconclusive information. 33. The Tribunal was wholly unconvinced by this explanation. Dr George attended the Police Station on 7 June 2016 and was charged. Those charges did not change until 20 December The Tribunal also considered that the charges would have been read out to Dr George at the Magistrates Court on 21 June 2016 and been made clear to him. The Tribunal therefore rejected this account. 34. Taking all these matters into account the Tribunal considered that it could be reasonably inferred that Dr George, an experienced doctor, was well aware of the charges against him, his duty to report the charges to the GMC without delay and the likely consequences that may flow from reporting the charges to the GMC. The Tribunal finds that Dr George chose not to inform the GMC until after his trial and it is reasonable to infer that he may have done this to avoid adverse consequences on his practice from the GMC and from his employers. 35. The Tribunal considered Mr Ramasamy s submissions that Dr George was disorganised rather than dishonest. In light of the findings made above the Tribunal discounted this. In any event it appeared that Dr George carried on his employment and fully engaged with the criminal proceedings. The Tribunal found no evidence to explain why Dr George could not inform the GMC at that time. The Tribunal noted that Dr George was in possession of the charge sheet and it would have been a simple matter to provide that information to the GMC. 36. The Tribunal also considered the submission that Dr George informed his colleagues and employers at the time and that far from concealing his charges, this was evidence of him being open and honest. The Tribunal did not find this to be 10

11 convincing after a careful consideration of the statements provided by his colleagues and employers. In fact upon scrutinising those statements it became clear that Dr George had not been open and honest with these individuals and was minimalistic and selective about what he told them. For example it is striking that he consistently did not inform his colleagues of the charge of perverting the course of justice. In none of the statements was there mention of the full nature of the charges Dr George faced. 37. The Tribunal further considered Dr George s 2017 Appraisal in which he had ticked I have nothing to declare in relation to suspensions, restrictions on practice or being subject to an investigation of any kind since his last appraisal, despite him being aware of the GMC investigation starting in January The Tribunal considered this to be another example of Dr George not being fully candid and providing full information to professionals concerned with his practise. Therefore, the Tribunal rejected his oral evidence that the answers he gave referred to his clinical practise rather than his probity. 38. Taking all things into consideration, the Tribunal was satisfied that on the balance of probabilities, it was more likely than not, applying objective standards, that Dr George had been dishonest in failing to notify the GMC of the offences for which he was charged on 7 June Accordingly the Tribunal found Paragraph 5 of the Allegation proved in relation to Paragraph The Tribunal next considered if Dr George had been dishonest in relation to Paragraph 4 of the Allegation. 40. The Tribunal had regard to Dr George s to the GMC on 21 December 2016, following his convictions on 20 December The Tribunal accepted that Dr George informed the GMC in relation to one offence of drink driving the day after being convicted on 21 December 2016 and therefore there was no delay in reporting it. 42. The Tribunal next considered Dr George s state of mind in relation to his failure to disclose the remainder of the charges against him. One of those charges included an element of dishonesty, namely the wasting of police time. 43. The Tribunal carefully considered the dated 21 December The Tribunal considered this to be a well drafted in which Dr George used technical terms such as strict liability and that this conduct did not have any relationship with my fitness to practise as a Doctor. In the Dr George made a false statement which was that he was now informing the GMC because the issue was only finalised yesterday as there was a serious delay in charging me by the police. This was incorrect as Dr George had been charged with four offences in June 2016 and these did not change until the date of his trial on 20 December Further in the 11

12 full details of what occurred during the incident on 17 April 2016 were not provided, notably that he left the scene of the accident and later returned with XXX Mrs A, whereupon false statements were made as to who was driving the Mercedes. 44. When Dr George gave oral evidence he said that he thought that all of the charges related to his drink driving. The Tribunal did not accept this in light of the fact that Dr George knew that the only reason this matter was sent to the Crown Court was because he was charged with a serious offence of perverting the course of justice and he pleaded not guilty to this charge. This matter would therefore be considered by a jury in December If Dr George s case was solely about driving with excess alcohol this matter would have been resolved by the Magistrates court as he had pleaded guilty to these offences on or around 21 June The Tribunal considered, in light of its earlier findings, that similar themes emerged where Dr George sought to minimise his actions and withhold relevant important information. In particular Dr George was selective about what he told the GMC as to his convictions and at no point did he attempt to correct this. It was the GMC who conducted its own investigations to ascertain the true nature of Dr George s convictions. Dr George had a number of opportunities to correct the false impression that he had given, for example when he was informed by the GMC on 26 January 2017 as to the next steps in their investigation. 46. Taking all these matters into account, the Tribunal considered that it could reasonably be inferred that Dr George was well aware of the convictions against him, his duty to report all the convictions to the GMC and the likely consequences that may flow from his failure to report them. The Tribunal finds that Dr George chose not to inform the GMC of the full nature of the convictions and it is reasonable to infer that in doing so, he sought to avoid a full investigation by the GMC into his convictions. 47. Taking all these matters into account, the Tribunal determined that on the balance of probabilities, and by objective standards, it was more likely than not that Dr George was dishonest in failing to notify the GMC without delay of his other convictions received 20 December Accordingly, the Tribunal has found Paragraph 5 in relation to Paragraph 4 proved. It has found Paragraph 5 proved in its entirety. The Tribunal s Overall Determination on the Facts 48. The Tribunal has determined the facts as follows: Paragraph 1 You failed to notify the General Medical Council ( GMC ) without delay that you had been charged on 7 June 2016 with the following offences, which occurred on 17 April 2016: 12

13 a. commit an act/ series of acts with intent to pervert the course of public justice; b. driving a motor vehicle (Mercedes) with excess alcohol; c. driving a motor vehicle (Range Rover) with excess alcohol; d. failing to stop after a road accident. Paragraph 2 On 20 December 2016 at Inner London Crown Court you were convicted of: a. driving a motor vehicle (Mercedes) with excess alcohol; b. driving a motor vehicle (Range Rover) with excess alcohol; c. failing to stop after a road accident; d. wasting police time. Paragraph 3 On 20 December 2016 you were sentenced to a total: a. monetary order in the sum of 2,370.00; b. driving disqualification period of 16 months. Paragraph 4 You failed to notify the GMC without delay that you had been convicted of the criminal offences detailed in paragraphs 2b-d. 13

14 Paragraph 5 Yours actions as described at paragraphs 1 and 4 were dishonest. Disputed and found proved Determination on Impairment - 18/05/ The Tribunal now has to decide in accordance with Rule 17(2)(l) of the Rules whether, on the basis of the facts found proved as set out before, Dr George s fitness to practise is impaired by reason of his convictions and/or misconduct. 2. In reaching its decision, the Tribunal has borne in mind the statutory overarching objective which is to protect the public. This includes: 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. The Evidence 3. The Tribunal has taken into account all the evidence received during the facts stage of the hearing, both oral and documentary, as well a further statement from Dr George s Responsible Officer provided at this stage of the hearing. 4. The Tribunal has also had regard to the submissions made by Mr Birrell on behalf of the GMC, and those made by Mr Ramasamy QC on behalf of Dr George. Submissions 5. On behalf of the GMC, Mr Birrell submitted that Dr George s fitness to practise is currently impaired by reason of his convictions and by reason of his misconduct. 6. Mr Birrell submitted that this was a particularly serious case as it involved criminal convictions and Dr George being dishonest with his regulator. Mr Birrell submitted that Dr George had contravened a fundamental principle of the profession. He referred the Tribunal to Paragraph 65 of Good Medical Practise (2013 edition) which states that You must make sure that your conduct justifies your patients trust in you and the public s trust in the profession. Mr Birrel submitted that Dr George had undermined public trust in the profession and brought the profession into disrepute. 7. Mr Birrell submitted that the convictions in this case were particularly serious. He stated that this was not an average drink drive case as in addition to being involved in a collision, Dr George left the scene and proceeded to drive a second vehicle while under the influence of alcohol. Mr Birrell suggested that Dr George knew he was over the limit and was risking his safety and that of others. He stated that it was astonishing that Dr George, despite having been involved in a collision, drove again, but this time 14

15 accompanied by XXX Mrs A. Mr Birrell submitted that he risked his XXX Mrs A s safety XXX. Mr Birrell also reminded the Tribunal of the sentencing judge s comments who had described Dr George s offences as a disgraceful episode. 8. Mr Birrell addressed the Tribunal as to the consequences of Dr George s actions. He stated that Dr George had wasted police time and contributed to XXX Mrs A s arrest XXX. XXX. Mr Birrell also stated that as a result of Dr George s actions, valuable NHS resources were wasted as she was unnecessarily taken to hospital as the police had been led to believe she had been in an accident. 9. Mr Birrell submitted that Dr George s dishonesty had been prolonged and persistent. He submitted that Dr George had first been dishonest with the police in knowingly making a false report. He further submitted that with regard to failing to inform the GMC of the charges, Dr George s dishonesty endured for a 6 month period. Mr Birrell stated that this was not passive dishonesty or dishonesty by omission, but calculated dishonesty. Mr Birrell further stated that Dr George was dishonest when he informed the GMC of his convictions and reminded the Tribunal of its comments that this had been a well drafted . Mr Birrel submitted that this had been carefully designed to mislead the GMC. 10. Mr Birrell submitted that it could be argued that Dr George s dishonesty has persisted until this week and reminded the Tribunal that it had not found Dr George an entirely credible witness. Mr Birrell submitted that if Dr George has been dishonest with the Tribunal, then his dishonesty has persisted for two years. 11. Mr Birrell submitted that Dr George s dishonesty with the GMC points to limited insight. He also suggested that the Tribunal may take the view that Dr George has sought to minimise his actions. He referred to parts of Dr George s interview with the police in which he had stated it was a silly mistake and it s not like I ve killed anyone. Mr Birrell stated that while the police interview was 2 years, it was still relevant. Mr Birrell also submitted that in Dr George s s to the GMC he had sought to minimise and downplay his offending. 12. Mr Birrell submitted that this was a very serious matter and that Dr George had brought the profession into disrepute and undermined public confidence. He submitted that a finding of impairment is essential to maintain public confidence in the profession. 13. Mr Ramasamy QC, on Dr George s behalf, reminded the Tribunal of various case law to consider in this case, in particular the following guiding set of questions as set out by Dame Janet Smith in the Fifth Shipman Report, as set out at paragraph 76 of CHRE v NMC & Grant [2011] EWHC 927 (Admin): Do our findings of fact in respect of the doctor's misconduct show that his/her fitness to practise is impaired in the sense that s/he: 15

16 a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or d. has in the past acted dishonestly and/or is liable to act dishonestly in the future." 14. Mr Ramasamy QC also invited the Tribunal to consider the case of Cohen v GMC [2008] EWHC 581 (Admin) with regards to the need to uphold the standards of the profession and public interest concerns. 15. Mr Ramasamy QC submitted that Dr George accepts he failed to notify the GMC of his charges and the totality of his convictions and recognises the impact that his case may have on the profession. 16. Mr Ramasamy QC stated that Dr George does not resist the submission that the proven facts in this case may amount to misconduct. He submitted that if so, the Tribunal must carefully consider the matter of impairment in this case and consider whether Dr George is impaired as of today. 17. Mr Ramasamy QC invited the Tribunal to consider that Dr George s convictions arose out of lapses in judgement in a narrow window of time. He stated that Dr George s lapse in judgment in not correcting XXX Mrs A when she made a false claim to the police was a moment of stupidity for which XXX Mrs A had paid a heavy price. He invited the Tribunal to consider Dr George s actions set against a long career in medicine in which he has been doing good for the public and the profession. 18. Mr Ramasamy QC noted Dr D s statement in which he described Dr George as one of the most reliable, hardworking doctors I have worked with he is keeping our night staffing going almost single handedly. The Relevant Legal Principles 19. The Tribunal reminded itself that at this stage of proceedings, there is no burden or standard of proof and the decision of impairment is a matter for the Tribunal s judgement alone. 20. In approaching the decision, the Tribunal was mindful of the two stage process to be adopted: first whether the facts as found proved amounted to misconduct which was 16

17 serious and whether that misconduct amounted to a finding of impairment. The Tribunal was mindful of the contents of Good Medical Practice (2013 edition). 21. The Tribunal must determine whether Dr George s fitness to practise is impaired today, taking into account Dr George s conduct at the time of the events and any relevant factors since then such as whether the matters are remediable, have been remedied and any likelihood of repetition. Impairment by reason of Convictions 22. The Tribunal first considered whether Dr George s fitness to practise is impaired by reason of his criminal convictions. 23. The Tribunal was mindful of paragraph 1 of Good Medical Practice that doctors must be honest and trustworthy, and act with integrity and within the law. 24. The Tribunal found that Dr George s convictions were serious. There were features of this case which made the incident more serious than may otherwise have been the case. Although Dr George was marginally over the drink drive limit, following the collision he left the scene and later drove a second vehicle with XXX Mrs A as a passenger. After being stopped by the police, Dr George knowingly made a false report in informing the police that XXX Mrs A had been the driver of the Mercedes as was stated by the sentencing judge, Recorder Argyle. The Tribunal found the dishonesty element to the wasting police time charge an aggravating feature in this case. 25. While the Tribunal recognised that Dr George did admit to being the driver of the Mercedes during the police interview the following day, he did not tell the truth to the police when given the opportunity to do so at the roadside. As a result of this, police time was wasted. 26. The Tribunal considers that Dr George has shown limited insight into the effect that his convictions have had on the reputation of the medical profession and it noted the passage of Dr George s statement in which he suggested that his actions were potentially' damaging to the reputation of the medical profession. 27. Taking all things into consideration, the Tribunal has determined given the serious nature of the convictions, there has been damage to the reputation of the medical profession and public confidence in the profession would be undermined if a finding of impairment was not made. Accordingly, the Tribunal has determined that Dr George s fitness to practise is impaired by reason of his convictions. 17

18 Impairment by reason of Misconduct 28. The Tribunal first considered whether Dr George s actions amounted to misconduct. 29. The Tribunal relies on its findings in relation to dishonesty. Dr George s behaviour was dishonest, in that he failed to inform the GMC of his charges without delay, and failed to inform the GMC of all of his criminal convictions. In failing to do so, Dr George breached paragraph 75(b) of Good Medical Practice, namely informing the GMC without delay that he had been charged with or found guilty of a criminal offence. 30. Furthermore, the Tribunal also took account of the paragraphs 65, 68 and 71 of Good Medical Practice relating to the requirement for a doctor to act with honesty and integrity. In particular he failed to be honest and trustworthy and was misleading in his communications with colleagues and the GMC. In light of the findings made it cannot be said that Dr George had acted with honesty or integrity, such that would justify the trust of the public in the profession. 31. Accordingly, the Tribunal found that Dr George s dishonest behaviour amounted to misconduct. 32. The Tribunal next considered the question of current impairment. In undertaking this exercise the Tribunal had regard to its earlier findings in relation to dishonesty. It considered that Dr George s dishonesty was serious. It was prolonged in that he did not report the matter for a six month period. When Dr George did disclose his convictions he compounded his dishonesty by concealing the full extent of the convictions against him. He was also not entirely candid with his professional colleagues about the charges against him and his convictions. 33. Although Dr George appears to have remediated his conduct in relation to the drink driving charges by attending a course for drink driving offenders and undertaking a further driving test, this cannot be said for the dishonesty findings made by this Tribunal. Dr George denied the dishonesty charge at the outset of this hearing and findings have been made that Dr George behaved dishonestly. Whilst the Tribunal accepts that Dr George, through Mr Ramasamy QC accepts the Tribunal s decision, Dr George is not in a position to have developed insight into the findings made or to provide any evidence of remediation at this stage. 34. Having said that, the Tribunal considered that Dr George had demonstrated some limited insight when he recognised that he should have informed the GMC of his charges at that time or shortly thereafter. He also accepted that his convictions could be potentially damaging to the reputation of the profession. He expressed a great deal of remorse for his actions, and that on reflection he realised that he should have said more to be as open as possible. 18

19 35. In light of this the Tribunal considered that Dr George does have some capacity and willingness to develop further insight into his conduct and the findings made by this Tribunal, namely to reflect on his dishonest conduct in failing to report his charges to the GMC and not reporting the full extent of his convictions and consider how he might behave in the future. 36. Given Dr George s previous behaviour and limited insight the Tribunal was unable to exclude the risk of Dr George repeating elements of his dishonest behaviour. 37. With regard to Dr George s character witnesses statements the Tribunal does not have any concerns about Dr George s clinical practice or expertise, in so far as the character witness statements refer to issues of probity, the Tribunal relies on its earlier finding that Dr George was less than candid with his character witnesses about the full extent of the charges and convictions. 38. The Tribunal had regard to the CPD courses undertaken by Dr George. However, it considered that none of these were relevant in relation to probity and mainly related to his clinical practice or to the offence of drink driving. 39. Taking all these matters into consideration, the Tribunal has determined that given the serious nature of the misconduct, Dr George s limited insight and the lack of remediation, there would be damage to the reputation of the medical profession and public confidence in the profession would be undermined if a finding of impairment was not made. Accordingly, the Tribunal has determined that Dr George s fitness to practise is impaired by reason of his misconduct. Determination on Sanction - 21/05/ Having determined that Dr George s fitness to practise is impaired by reason of his convictions and misconduct, the Tribunal now has to decide in accordance with Rule 17(2)(n) of the Rules on the appropriate sanction, if any, to impose. 2. The Tribunal has taken into account all the evidence received during the earlier stages of the hearing where relevant in reaching a decision on sanction. Submissions 3. On behalf of the GMC, Mr Birrell submitted the appropriate and proportionate sanction in this case is one of suspension. Mr Birrell submitted that Dr George s convictions and dishonesty were both serious and that Dr George only has limited insight into his actions. Mr Birrell submitted that only an order of suspension would uphold the need to promote and maintain public confidence in the medical profession, 19

20 and promote and maintain proper professional standards and conduct for the members of the profession. 4. Mr Birrell referred the Tribunal to various parts of the Sanctions Guidance (SG) pertaining to cases involving dishonesty. He invited the Tribunal to consider paragraph 124 which states that evidence of clinical competence cannot mitigate serious and/or persistent dishonesty. He also invited the Tribunal to consider paragraph 128 which states that Dishonesty, if persistent and/or covered up, is likely to result in erasure. Mr Birrell submitted that while the GMC do not seek an order of erasure in this case, this paragraph illustrates the gravity of this case. 5. Mr Birrell submitted that taking no action would be entirely inappropriate. He submitted that given the serious nature of Dr George s actions and his limited insight into them, conditions of practice would not be appropriate and there were no exceptional circumstances in his case. Mr Birrell referred the Tribunal to the parts of the SG which provide examples of when conditions may be appropriate and submitted that Dr George s case does not fall into any of those categories. Mr Birrell submitted that the appropriate sanction would be suspension and that this case would be appropriate for a review by a future Tribunal. 6. Mr Ramasamy QC, on behalf of Dr George, submitted that a sanction of conditions would reflect the seriousness of the circumstances of this case given all that has happened already, including the findings of misconduct and impairment. Mr Ramasamy QC submitted that conditions would be workable and pointed to the Tribunal s finding that Dr George has some capacity and willingness to develop further insight into his conduct. 7. With regard to mitigating factors, Mr Ramasamy QC reiterated that Dr George does have some insight and has accepted from the outset that he should have informed the GMC of the charges and the full details of the convictions. Mr Ramasamy QC stated that Dr George accepts these are failures and that they are something for which he should be criticised. Mr Ramasamy QC also invited the Tribunal to consider the positive testimonials on behalf of Dr George which evidence adherence to good practice. 8. Mr Ramasamy QC invited the Tribunal to consider Dr George s actions in the context of a long career in medicine in which he has been doing good for patients and the profession. Mr Ramasamy QC stated that there was a public interest in keeping Dr George working and reminded the Tribunal to consider Dr George s interests, in that he is the sole breadwinner in his family. Mr Ramasamy QC submitted that conditions could be workable and provided the Tribunal with a list of various MDU courses that he submitted could address the concerns in this case. 9. Mr Ramasamy QC submitted that if the Tribunal felt that suspension is the only appropriate outcome in this case, then it should be a short one, bearing in mind the 20

21 public interest in not keeping him away from patients and practise for too long. Mr Ramasamy QC also submitted that a review would be appropriate in this case. The Tribunal s Determination on Sanction 10. The decision as to the appropriate sanction to impose, if any, is a matter for this Tribunal exercising its own judgment. 11. In reaching its decision, the Tribunal has had regard to the Sanctions Guidance (February 2018). It has borne in mind that the purpose of sanctions is not to be punitive, but to protect patients and the wider public interest, although sanctions may have a punitive effect. 12. Throughout its deliberations, the Tribunal has applied the principle of proportionality, balancing Dr George s interests with the public interest. It has taken account of the statutory overarching objective, namely 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 the members of the profession. The Tribunal Decision 13. The Tribunal gave careful consideration to the various aggravating and mitigating factors present in Dr George s this case. Aggravating factors Probity issues in relation to the offences themselves and in relation to Dr George s failure to report the criminal charges against him in a timely manner to the GMC, and his later failure to disclose the full nature of the convictions. Mitigating factors Some limited insight as identified at paragraphs of the Tribunal s determination on impairment No adverse history with the GMC Dr George s apology and expressions of remorse and regret in his own written and oral evidence and confirmed to his Responsible Officer. 14. The Tribunal recognised that there were numerous positive testimonials from Dr George s professional colleagues. These mainly related to Dr George s clinical skills and reliability as a doctor. The Tribunal attached little weight to these testimonials in relation to the findings of dishonesty as Dr George was not completely candid with the authors of those testimonials about the charges and convictions. 21

22 No action 15. The Tribunal first considered whether it would be sufficient to conclude Dr George s case by taking no action. The Tribunal was of the opinion that this case was too serious and involved dishonesty issues, and considered that there were no exceptional circumstances that would justify it taking no action on his registration. Conditions 16. The Tribunal next considered whether it would be sufficient to impose conditions on Dr George s registration. It has borne in mind that any conditions imposed need to be appropriate, proportionate, workable and measurable. 17. The Tribunal was of the view that conditions would be inappropriate given the serious nature of its findings. It considered that a period of conditions would not satisfy the public interest in this case, namely to maintain public confidence in the profession and to promote and maintain proper professional standards and conduct for the members of the profession. 18. The Tribunal considered that it was difficult to formulate conditions to address the findings of dishonesty made. Mr Ramasamy QC, on behalf of Dr George, proposed a number of courses, only one of which was relevant, namely open disclosure and duty of candour. Whilst this may go some way to assisting Dr George in understanding his behaviour, the Tribunal considered that participation on this short course was unlikely to lead to adequate remediation in his case. In any event, the Tribunal considered that the findings of this Tribunal are simply too serious for conditions of practice to be imposed. Suspension 19. The Tribunal then went on to consider whether suspending Dr George s registration would be appropriate and proportionate. The Tribunal found the following paragraphs of the SG particularly relevant in this case: 91 Suspension has a deterrent effect and can be used to send out a signal to the doctor, the profession and public about what is regarded as behaviour unbefitting a registered doctor. Suspension from the medical 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 suspension, although this is not its intention. 120 Good medical practice states that registered doctors must be honest and trustworthy, and must make sure that their conduct justifies their patients trust in them and the public s trus t in the profession. 22

23 123 Although it may not result in direct to harm to patients, dishonesty related to matters outside the doctor s clinical responsibility (eg providing false statements or fraudulent claims for monies) is particularly serious. This is because it can undermine the trust the public place in the medical profession. Health authorities should be able to trust the integrity of doctors, and where a doctor undermines that trust there is a risk to public confidence in the profession. Evidence of clinical competence cannot mitigate serious and/or persistent dishonesty. 20. The Tribunal also found the following paragraph of Good Medical Practice (2013 edition) to be engaged in this case: 1. Patients need good doctors. Good doctors make the care of their patients their first concern: they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy, and act with integrity and within the law. 21. Taking all things into consideration, the Tribunal is satisfied that suspension is the appropriate and proportionate sanction in the circumstances of this case. The Tribunal was of the view that a period of suspension is necessary to mark the seriousness of Dr George s actions and send the appropriate message to the profession, and the public, about what is regarded as behaviour unbefitting of a registered medical practitioner. The Tribunal also considered that a period of suspension would give Dr George an opportunity to develop his insight and undertake reflection. 22. In deciding on the length of the period of suspension, the Tribunal considered that a period of 4 months would allow Dr George time to undertake the required reflection and remediation in order to demonstrate to a future Tribunal that he has developed sufficient insight into the concerns and that there is unlikely to be a risk of repetition. 23. The Tribunal determined to direct a review of Dr George s case. A review hearing will convene shortly before the end of the period of suspension, unless an early review is sought. At the review hearing, the onus will be on Dr George to demonstrate how he has developed his insight and remediated the concerns identified by this Tribunal. The reviewing Tribunal may therefore be assisted by the following: A detailed reflective statement in relation to the findings made by this Tribunal, as well as any courses he has attended specifically relating to the findings of dishonesty The Tribunal also considered that as part of Dr George s remediation he could benefit from undertaking coaching and/or mentoring. 23