PUBLIC RECORD Date: 05/12/2017 Medical practitioner s name: Dr Wladyslaw Stanislaw STANEK GMC reference number: 7344756 Primary medical qualification: Type of case Review - Non-compliance with an English language assessment Lekarz 1970 Akademia Medyczna w Krakowie Outcome on non-compliance Non-compliance found Summary of outcome Suspension for 6 months Review hearing directed Tribunal: Legally Qualified Chair Lay Tribunal Member: Medical Tribunal Member: Mr Dharmesh Patel Ms Lindsey Rose Dr Dawn Black Tribunal Clerk: Ms Jennifer Hatch Attendance and representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Not present and not represented N/A Ms Shirlie Duckworth, Counsel Attendance of press / public The hearing was all heard in public. 1
Determination on consideration of non-compliance 05/12/2017 Background 1. Dr Stanek was referred to the General Medical Council ( GMC ) by Tooting Medical Centre following concerns relating to a clinical incident which occurred in January 2016, when Dr Stanek saw a patient in a Polish clinic regarding an early pregnancy. Concerns were also raised by the centre about Dr Stanek s command of the English language, as the GMC were informed that the whole consultation was conducted in Polish. 2. When asked about the concerns regarding Dr Stanek s English language skills, Dr A, from Tooting Medical Centre, responded that I have never observed Dr Stanek speaking English language and I found out that his all medical records are in Polish language which is unacceptable. Concerns were also raised about Dr Stanek s English language skills by his Responsible Officer. 3. On 7 July 2016, the GMC were made aware of further concerns regarding Dr Stanek s English language when a hearing before the Interim Orders Tribunal ( IOT ) was adjourned to allow Dr Stanek to engage the services of an interpreter and seek legal advice due to concerns about his ability to understand proceedings. 4. On 19 July 2016, the GMC wrote to Dr Stanek directing him to undertake the International English Language Testing System (IELTS) test and submit the results to the GMC by 17 October 2016. Reminders were sent by email to Dr Stanek on 24 August 2016 and 3 October 2016. On 23 October 2016, Dr Stanek notified the GMC that he had booked an IELTS test for 3 December 2016. On 24 October 2016 and 1 November 2016, Dr Stanek was asked via email to provide a copy of the booking confirmation for the IELTS test. On 2 November 2016, he provided a reference number for the booking of the IELTS test. On 6 December 2016 and 15 December 2016 Dr Stanek was asked to submit his IELTS test result. Dr Stanek did not provide his IELTS results despite the chasers. The GMC contacted the British Council but were advised that a test report form could only be shared if the participant authorises them to do so. 5. Dr Stanek s case was first considered for non-compliance by a Medical Practitioners Tribunal (MPT) on 8 May 2017 (the May 2017 Tribunal). The May 2017 Tribunal found that, given the level of concern raised about Dr Stanek s English language skills, the GMC s direction for him to undergo the IELTS test was reasonable and was made in accordance with the GMC s powers laid out in the Medical Act 1983 (as amended) and the Rules. 6. The May 2017 Tribunal determined that Dr Stanek had failed to comply with a reasonable direction without providing any reason and that his failure to comply was not unavoidable or otherwise excusable. It determined that there had been non-compliance 2
with the GMC s direction of 19 July 2016 to undergo an IELTS test and submit the results. 7. The May 2017 Tribunal suspended Dr Stanek s registration for a period of six months. It directed a review hearing and noted that a reviewing tribunal would be assisted by receiving: The IELTS test results; Any further information Dr Stanek considers will assist the Tribunal. The Outcome of Applications Made during the Non-Compliance Stage 8. The Tribunal granted Ms Duckworth s application to proceed in Dr Stanek s absence, pursuant to Rule 31 of the General Medical Council (Fitness to Practise Rules) 2004 as amended ( the Rules ). The Tribunal s full decision on service and proceeding in absence is included at Annex A. Today s Review Hearing 9. Today s Tribunal has met to review Dr Stanek s case. It has considered, under Rule 22A of the Rules, whether there has been a failure to comply with an assessment under Schedule 3 of the Rules. Evidence 10. In reaching its decision, the Tribunal has given careful consideration to the documentary evidence adduced in this case. This included various correspondence between the GMC and Dr Stanek and the determinations of the May 2017 Tribunal. Submissions 11. Ms Duckworth, on behalf of the GMC, submitted that there is evidence that Dr Stanek has still not complied with the original direction to undergo the IELTS test and submit the results, and has not provided a good reason why he has not done so. 12. Ms Duckworth drew the Tribunal s attention to an email from Dr Stanek to the GMC, dated 4 December 2017, in which he states that he has booked an IELTS test for 8-9 December 2017. She reminded the Tribunal that, in an email dated 23 October 2016, Dr Stanek said that he had booked an IELTS test, but he did not then go on to submit his results to the GMC, as directed. Also in the email dated 4 December 2017, Dr Stanek refers to a very recent bereavement. Ms Duckworth submitted that, although there may be tragic circumstances, it is not a good reason for non-compliance given the amount of time Dr Stanek has now had to comply. 3
The Tribunal s Determination on Non-Compliance 13. Whilst the Tribunal has borne in mind the submissions made, the decision regarding non-compliance is one for it to reach exercising its own judgement. 14. The Tribunal noted that Dr Stanek has been written to on more than one occasion since his May 2017 hearing, reminding him of the May 2017 decision and the requirement to undergo the IELTS test and submit his results. 15. Although Dr Stanek stated that he has booked an IELTS test for 8-9 December 2017, he has not yet taken the test or submitted the results. The Tribunal also bore in mind that Dr Stanek has previously stated that he had booked an IELTS test, but did not then go on to submit any results to the GMC. Further, whilst the Tribunal has taken into account Dr Stanek s circumstances and bereavement, it noted that this appears to have been very recent (a matter of days ago). It was not satisfied that there is good reason for not yet having undergone the IELTS test. The Tribunal determined that Dr Stanek s failure to comply was not unavoidable or otherwise excusable. 16. In all the circumstances, the Tribunal determined that Dr Stanek has continued to fail to comply with the direction of the GMC. It therefore determined that there has been non-compliance with the direction to undergo the IELTS test and submit his results to the GMC. Determination on sanction 05/12/2017 1. Having determined that there is non-compliance by reason of Dr Stanek s failure to undertake the IELTS test and submit the results to the GMC, the Tribunal has considered the appropriate sanction, if any, that should be imposed on Dr Stanek s registration. 2. The appropriate sanction, if any, to impose on Dr Stanek s registration is a matter for this Tribunal exercising its own judgment. In reaching its decision, the Tribunal has taken account of the Non-compliance hearings guidance for medical practitioner tribunals. It has borne in mind that the purpose of a sanction is not to be punitive, but to protect patients and the wider public interest, although it may have a punitive effect. 3. Throughout its deliberations, the Tribunal considered its overarching objective which includes the protection of the public, the maintenance of public confidence in the profession, and the promotion and maintenance of proper professional standards and conduct for members of the profession. 4
Submissions 4. The Tribunal considered the submissions made by Ms Duckworth on behalf of the GMC. She submitted that the written and oral correspondence from Dr Stanek is evidence that there is a continuing cause for concern in terms of his English language skills. She submitted that an order is necessary to protect the public. 5. Ms Duckworth stated that the Tribunal may infer from Dr Stanek s email dated 5 December 2017 that he invites the Tribunal to revoke the suspension and impose conditions on his registration. She submitted that there is insufficient evidence that conditions would be workable or measurable, and, in any case, they would not be a proportionate response. She invited the Tribunal to impose a further period of suspension for 12 months in order to ensure that the public are protected and so that the public interest is not adversely affected. She reminded the Tribunal that, if Dr Stanek does undergo the IELTS test and submit his results, he could seek an early review. The Tribunal s Decision No Action 6. In reaching its decision as to the appropriate sanction, if any, to impose in Dr Stanek s case, the Tribunal first considered whether to conclude the case by taking no action. It determined that, given the concerns raised about Dr Stanek s English language skills, and his failure to comply with the GMC direction to undertake the IELTS test and submit his results, taking no action would not be sufficient to protect the public. Conditions 7. The Tribunal next considered whether it would be appropriate to impose conditions on Dr Stanek s registration. It bore in mind that any conditions imposed should be appropriate, proportionate, workable and measureable. 8. Given the lack of information about Dr Stanek s intentions to work in the UK, the Tribunal could not be satisfied that conditions would be workable. It also did not have sufficient evidence to be sure whether Dr Stanek would comply with conditions. In any case, the Tribunal was not satisfied that conditions would adequately protect the public Suspension 9. The Tribunal then went on to consider whether extending the period of suspension on Dr Stanek s registration would be appropriate and proportionate. 10. The Tribunal was satisfied that, in light of the nature of the concerns raised and Dr Stanek s failure to undergo the IELTS test, the suspension of Dr Stanek s registration 5
was the appropriate sanction for the protection of the public and otherwise in the public interest. 11. The Tribunal determined to suspend Dr Stanek s registration for a period of six months. The Tribunal was of the view that a 12 months suspension would be disproportionate, given that he has stated that he has an IELTS test booked. It considered that six months would allow Dr Stanek sufficient time to comply with the GMC s direction. 12. If Dr Stanek feels that he has fully complied with the direction to undergo the IELTS test before then, he can apply for an early review. However, in the absence of such application, a Tribunal will review Dr Stanek s case at a hearing to be held before the end of the period of suspension. It will then consider whether it should take any further action in relation to his registration. Dr Stanek will be informed of the date of that hearing. The Tribunal reviewing Dr Stanek s case would be assisted by receiving the following: The IELTS test results; Any further information Dr Stanek considers will assist the reviewing Tribunal. 13. The effect of this direction is that, unless Dr Stanek exercises his right of appeal, the decision will take effect 28 days from when written notice of this determination is deemed to have been served upon him. If he does decide to appeal against this decision, the suspension currently imposed on his registration will remain in force until the appeal is determined. A note explaining his right of appeal will be provided to Dr Stanek. Confirmed Date 05 December 2017 Mr Dharmesh Patel, Chair 6
ANNEX A Service and proceeding in Dr Stanek s absence 05/12/2017 Service 1. Dr Stanek was neither present nor represented at these proceedings. The Tribunal therefore considered whether notice of this hearing had been properly served upon him in accordance with the Rules. 2. The Tribunal had regard to the letter from the GMC which was sent via special delivery to Dr Stanek s registered postal address on 7 November 2017 and via email on 6 November 2017. The letter informed Dr Stanek that his noncompliance review hearing would take place on 5 December 2017. 3. The Tribunal also had regard to the Notice of Hearing letter, dated 6 November 2017, which was sent via special delivery to Dr Stanek s registered address and via email by the Service ( MPTS ). This letter included the date, time and location of this hearing. 4. The Tribunal noted that the posted letters were returned undelivered. However, it had regard to emails from Dr Stanek to the GMC sent at 05:23 on 4 December 2017 and at 05:02 on 5 December 2017, in which he makes reference to correspondence. The latter of these emails was in response to the GMC s email dated 7 November 2017. 5. In the circumstances, the Tribunal was satisfied that the appropriate notice has been properly served upon Dr Stanek in accordance with the Rules, and that Dr Stanek is aware of today s hearing. Proceeding in Absence 6. Having been satisfied that notice of this hearing has been properly served, the Tribunal went on to consider whether to exercise its discretion to proceed with the case in Dr Stanek s absence, under Rule 31 of the Rules. 7. The Tribunal has borne in mind that the discretion to proceed in the absence of a doctor should be exercised with the utmost care and caution. It also bore in mind the need to balance Dr Stanek s interests with the public interest. 8. Given the information provided, it was clear to the Tribunal from his email communications that Dr Stanek has received and understood that this hearing was due to take place. The Tribunal was satisfied that Dr Stanek had voluntarily waived his right to attend this hearing. It noted that he had not requested a postponement. 9. The Tribunal concluded that, given concerns about English language, it would be both fair and in the public interest for this hearing to proceed expeditiously. The 7
Tribunal was satisfied that it could proceed without risk of injustice to Dr Stanek. It exercised its discretion to proceed in Dr Stanek s absence. 8