Can domestic violence warrant regulatory and professional conduct proceedings?
1 June 2023
Yes – according to the recent High Court appeal in Ibrahim v GMC [2022] EWHC 2936 (Admin).
In the case of Ibrahim v GMC, a Medical Practitioners Tribunal, convened on behalf of the General Medical Council (GMC), determined that Dr Ibrahim’s name should be erased from the medial register. This meant that he could not practice as a doctor. Dr Ibrahim appealed the decision to the High Court.
The conduct that led to the erasure of his name from the medical register related to conduct that took place outside of his work environment, and related to domestic violence. Dr Ibrahim was convicted of assaulting his wife by a Magistrates’ Court and sentenced to a community order with a fine. Dr Ibrahim made a self-referral to the GMC.
In the tribunal’s analysis, the facts demonstrated that Dr Ibrahim had engaged in a course of abusive behaviour towards his ex-wife, which had included violence, verbal threats and coercive behaviour. This behaviour had occurred over a number of years and had culminated in Dr Ibrahim’s conviction for assault. Upon determining that the facts were found proved, the tribunal concluded that Dr Ibrahim’s fitness to practice was impaired, and decided that a period of suspension would not be appropriate, proportionate or meet the public interest concerns. It therefore determined that the sanction of erasure was appropriate.
Dr Ibrahim appealed, asserting that erasure was wholly disproportionate and wrong, and that the tribunal was in error by placing any substantial weight on the second limb of the overarching objective – promoting and maintaining public confidence in the medical profession. Dr Ibrahim asserted that the conduct in question took place in a domestic setting; was of a non-sexual nature; it had been the subject of criminal proceedings and a criminal sentence which had been served.
This appeal raised an interesting question as to whether a sanction of erasure could ever be “necessary” for the protective purposes of the overarching objective of the regulatory body, in a context of “domestic” violence and abuse. The Honourable Mr Justice Fordham was inno doubt that it could be. Referring to the earlier decision in the case of Khan v GMC [2016] UKSC 64 [2017] 1 WLR, Justice Fordham stated as follows:
“True, sanctions are not concerned with “punishment” but rather with “protection”. But the protective limbs of the “overarching objective” can be engaged by what a doctor does in their “personal life”; and erasure may be appropriate even where the doctor “does not present a risk to patient safety”. Khan was a case where erasure was unjustified and disproportionate. It arose in a domestic setting. But the Supreme Court did not say that erasure was, in principle and for that reason, always inappropriate in such a setting. [Para 27]
“The Tribunal assessed that this was conduct so serious that it crossed the undoubtedly very high threshold of being conduct fundamentally incompatible with continued registration, which characterisation supported the finding that suspension would not be appropriate, proportionate or meet the public interest concerns. This seriousness underpinned the Tribunal’s conclusion that erasure was the only necessary and proportionate sanction; it was necessary in terms of the overarching objective in the context of behaviour fundamentally incompatible with continued registration where the need to retain good competent doctors in the public interest was outweighed by the need to promote and maintain public confidence and uphold proper professional standards in the profession, balancing the interests of the Appellant as a good and valued clinician against the public interest.”
In addition, as to the public confidence limb of the overarching objective, Justice Fordham did not accept the contention that this important limb is capable of only being a “very small element” in the context of a domestic (non-sexual) conduct case where the criminal law is applicable and has been applied. Justice Fordham recognised that a number of regulatory bodies accept that a criminal conviction is a recognised basis for a finding of misconduct, whichitself indicates that “public confidence” and the “public interest” are not left to, or exhausted by, a criminal process.
This judgment therefore confirms that conduct that takes place in an individual’s personal life may be relevant to their suitability to practice in their professional life. The fact the individual has been subject to criminal proceedings, and served a criminal sentence, will not preclude a regulator from concluding that there remains a need to protect the public confidence in the profession.
The content of this article is for general information only. It is not, and should not be taken as, legal advice. If you require any further information in relation to this article please contact the author in the first instance. Law covered as at June 2023.