PUBLIC RECORD. Record of Determinations Medical Practitioners Tribunal

Transcription

1 PUBLIC RECORD Dates: 14/11/ /11/2016 Medical Practitioner s name: Dr Mohamad KATAYA GMC reference number: Primary medical qualification: Type of case Restoration following disciplinary erasure Vrach 2003 Kursk State Medical University Outcome on impairment Summary of outcome Restoration application granted. Restore to Medical Register. Tribunal: Lay Tribunal Member (Chair) Medical Tribunal Members: Dr Nigel Westwood Dr Jane Cowan, Dr Chris Simpson Legal Assessor: Tribunal Clerk: Mr Nigel Parry Ms Jennifer Hatch Attendance and Representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Miss Mary O Rourke, QC, instructed by Ryan Solicitors Mr Hugh Barton, Counsel 1

2 Attendance of Press / Public The hearing was all heard in public. Determination on Application for Restoration - 15/11/2016 Dr Kataya: 1. You have applied to the General Medical Council (GMC) for the restoration of your name to the Medical Register after its erasure on 19 January 2010 following fitness to practise proceedings in December The Tribunal has considered your application in accordance with Section 41 of the Medical Act 1983 (as amended) and Rule 24 of the GMC (Fitness to Practise) Rules 2004 (as amended). 3. In doing so, the Tribunal has taken account of all the evidence, both oral and documentary. It has also taken account of the submissions made by Mr Hugh Barton, Counsel, on behalf of the GMC and those made by Miss Mary O Rourke, QC, on your behalf. Background 4. In December 2009, a Fitness to Practise Panel considered a misconduct allegation made against you. 5. On 16 April 2006, you applied to Causeway Health and Social Services Trust (Causeway) for the post of SHO-Paediatrics. You stated in your application form that you were a Senior House Officer (SHO) in the paediatric ward at Sahel General Hospital (Sahel), Beirut from 7 July 2004 to 6 June You also stated that you were an intern on rotation in all departments at Sahel between 1 July 2003 and 7 July In your curriculum vitae (CV), you stated that you were an SHO in the paediatric ward at Sahel between July 2004 and May 2006, and you were an intern on rotation in all departments at Sahel between July 2003 and June That Panel found that you did not hold the post of SHO, or its Lebanese equivalent, in the paediatric ward at Sahel between 2004 and 2006, and that you were not an intern on rotation in all departments at Sahel between 2003 and In support of your application to Causeway you sent a letter of recommendation that purported to originate from, and to have been signed by, 2

3 Dr B, Medical Director and Dr A, Head of Paediatric Division of Sahel. In reality, Dr B did not sign the letter of recommendation. Similarly, Dr A was not in fact the head of the Paediatric Division and he did not sign the letter of recommendation. 9. That Panel found that your actions in relation to the application form, CV and the letter of recommendation submitted to Causeway were misleading and dishonest. 10. That Panel found that your actions represented clear and repeated breaches of the GMC s guidance in relation to standards of conduct and behaviour and fell seriously short of the standards of conduct that the public and patients are entitled to expect from all registered medical practitioners. It determined that your actions amounted to misconduct that was serious. It considered the repeated and persistent nature of your dishonesty, and your complete lack of insight into any wrongdoing, and determined that it could not be satisfied that your misconduct would not be repeated in the future. It determined that your fitness to practise was impaired by reason of your misconduct. 11. That Panel concluded that the necessary and proportionate sanction in order to protect patients, to maintain public confidence in the profession and to uphold and declare proper standards of conduct and behaviour, was to erase your name from the Medical Register. Evidence 12. This Tribunal took account of the documentary evidence provided, which includes your application for restoration, the minutes of your Fitness to Practise hearing which took place in December 2009, transcripts and exhibits relating to that hearing, a witness statement signed by yourself on 11 October 2016, along with various documents in support of your restoration application. 13. You gave oral evidence to the Tribunal. The Tribunal took into account that English is not your first language, and that this, along with your cultural background, could have affected the way in which you presented your evidence. It considered your oral evidence to be readily understandable even though you have not been using English on a day-to-day basis for a number of years. Submissions 14. In his submissions, Mr Barton, on behalf of the GMC, reminded the Tribunal of the scale of your previous dishonesty; you breached a number of principles of Good medical practice (GMP), your dishonesty was persistent and repeated, you put your own interests before patient safety, and you lied whilst under oath and had a total lack of insight at the 2009 hearing. Erasure was the only option to mark the seriousness in your case. 3

4 15. Mr Barton submitted that you have clearly shown that you regret what you did, but that regret does not constitute insight. It is for the Tribunal to assess what you now truly believe. He pointed out that your reflective statement does not include reference to the admissions and expressions of regret which you made during your oral evidence. He acknowledged that you had attended an ethics course, but submitted that it is unrealistic to be transformed by a five day ethics course. He recommended that the Tribunal consider the level and authenticity of your insight, and whether or not you grasp the seriousness of your previous misconduct. 16. Mr Barton went on to submit that the Tribunal should consider the timing of your remediation; the earliest proper engagement with ethics only being in October 2015, which is quite late in the process. 17. Miss O Rourke, on your behalf, submitted that the Tribunal should look at whether you are fit to practise today. 18. She submitted that the Tribunal should take into consideration that English is your fourth language, and that this, and your cultural background, may have affected the way you gave evidence. 19. In relation to your insight, Miss O Rourke submitted that you have made clear that you are aware that you let down patients, colleagues and doctors, that you destroyed your reputation and that you ignored the privilege of being a doctor. Additionally, the ethics course you attended was a well-recognised course. Furthermore, although your reflective diary did not deal with insight into your initial misconduct, that was because you knew you would be giving oral evidence and would be able to express this face-to-face to the Tribunal. 20. You did not previously know that you would need to produce evidence of insight and remediation, nor how to present this. It was only upon legal advice that, in 2015, you withdrew a previous application for restoration in order to focus upon gathering the evidence, which is why the evidence is relatively recent. 21. Miss O Rourke concluded by stating that, based upon the documentary evidence and what you said during your oral evidence, you will not repeat your misconduct. You have learned lessons and have shown your dedication to remain within medicine by paying for your own training in Romania. The Tribunal s Approach 22. The Tribunal bore in mind the advice given by the Legal Assessor. This included him reminding the Tribunal that an applicant is not to be restored to the Register unless, in the Tribunal s judgement, the doctor is fit to return to unrestricted medical practice. He referred the Tribunal to Guidance for doctors on 4

5 restoration following erasure by a medical practitioners tribunal, in particular to paragraph 10(a) (e) which sets out a number of factors which the Tribunal will take into account when considering your application. 23. In reaching its decision in respect of your application, the Tribunal has given careful consideration to all the circumstances of your case. These include your application for restoration dated 12 May 2016, the circumstances which led to your erasure, the determination of the previous Panel, any development of your insight, any remedial action you have undertaken since your erasure, including steps you have taken to keep your knowledge and skills up to date, and the evidence you have given and the representations you have made to the Tribunal. 24. Throughout its deliberations, the Tribunal has taken account of the statutory overarching objective of protecting the public, which includes protecting the health, safety and wellbeing of the public, maintaining public confidence in the profession, and promoting and maintaining proper professional standards and conduct for the members of the profession. The Tribunal has also borne in mind its duty to apply the principle of proportionality, weighing the interests of the public with your own interests. 25. The Tribunal has borne in mind that, should it determine to restore your name to the Medical Register, there is no provision for this to be on the basis of anything other than unrestricted registration. The onus of persuading the Tribunal that you are fit to practise and should be returned to the Medical Register is on you. 26. The Tribunal has considered all the evidence provided by you to demonstrate the steps you have taken to remedy your wrongdoings and to keep your medical knowledge up-to-date. The Tribunal s View of your Credibility as a Witness 27. The Tribunal noted that you have now admitted that in 2009 before a Panel of the GMC, you lied on oath. The Tribunal has therefore given very careful consideration as to your credibility as a witness during this hearing convened to consider your application for restoration. 28. The Tribunal noted that you acknowledged your wrongdoings, and considered your answers to questions to be genuine. You answered questions directly, including those that were probing, and those that had the potential to make you uncomfortable. You were consistent in your answers and gave plausible explanations when asked to account for inconsistencies. The Tribunal found that your performance as a witness during the present hearing appeared to contrast with that at the previous hearing, transcripts of which revealed a tendency for you then to be unclear and inconsistent. Above all, this Tribunal noted from your demeanour as a witness that you appeared to be doing your utmost to be open and honest about 5

6 your past wrongdoings and to accept your responsibility for your misleading and dishonest actions. 29. The Tribunal bore in mind that the first piece of evidence to demonstrate your remediation is the Imperial College London ethics course dated October This was almost six years after your name was erased from the Medical Register. The Tribunal considered that the explanation for the relatively recent evidence of remediation was plausible; you were previously unfamiliar with the framework and processes in the UK, and that upon legal advice, you learnt that the onus was on you to gather evidence and present it in order to convince a tribunal that your name should be restored to the Register. The Tribunal also acknowledged that it can take time for a person to come to terms with their previous misconduct, accept their responsibility and to formulate a plan to rehabilitate. The Tribunal therefore did not regard the relatively recent timing of your tangible efforts at remediation to be a factor that undermined your credibility. The Tribunal s Decision 30. The Tribunal determined that it was not necessary to direct a Health, Performance or English language assessment in your case. No issues had been raised about any of these matters. 31. In reaching its decision as to whether or not to grant your application for restoration, the Tribunal has considered a number of factors, including the following: Circumstances that led to erasure 32. The Tribunal were of the view that your initial misconduct was very serious and that your dishonesty was maintained up to and during the 2009 hearing, in which you lied under oath and sought to blame others. Your actions were selfcentred and you put patients at risk of harm. Whilst involving one incident of dishonesty, namely a false application for a job, the deception was sustained over a period of time, and was therefore regarded by the original Panel as repeated dishonesty. Reasons given by the previous Panel for the decision to direct erasure 33. The 2009 Panel erased your name from the Medical Register due to the severity and persistency of your dishonesty, and due to your lack of insight and tendency to blame others. Whether you have any insight into the matters that led to erasure 34. At this hearing, you were eager to accept responsibility for your previous wrongdoings, and your expressions of regret appeared genuine. You showed remediation and insight by acknowledging fault, and by saying that you were sorry. 6

7 The Tribunal was satisfied that you had learned lessons from your experience. Though you referred to the adverse impact your actions had on yourself and your family in terms of loss of reputation and income, you also made reference to the risk of harm to patients, and the damage to the reputation of the profession. You accepted that you had put patients at risk of harm by taking a job that you were not qualified to perform you would not, in your own words, allow your own child to be treated by such a doctor. The Tribunal were of the view that, given the high level of insight you demonstrated, the risk of repetition is low. What you have done since your name was erased from the Medical Register 35. Since your name was erased from the Medical Register, you have continued to enhance your medical knowledge as an international student undertaking a five year period of training in Romania, demonstrating dedication to the medical profession. This training is self-funded and has taken you away from your wife and young child. You have also passed Part 1 and Part 2 of the membership examination of the Royal College of Physicians (RCP) of Ireland, and are awaiting results of Part The Tribunal noted that it is now over ten years since your misconduct and nearly seven years since your name was erased from the Medical Register. It has been provided with no evidence of repetition of your misconduct. Steps you have taken to keep your medical knowledge and skills up to date and the steps you have taken to rehabilitate yourself 37. The Tribunal noted that you have recently passed Part 1 and Part 2 of the membership examination of the RCP of Ireland, and would not be able to do so if your knowledge and skills were not up-to-date. It further took into account that you are in your final year of a medical oncology course in Romania. You have also taken various other steps to demonstrate your remediation, such as the ethics course you undertook at Imperial College London in October The Tribunal took into account the various positive professional testimonials and character references that you provided, all dated since 2009, and most of which refer to having been told of your erasure in The Tribunal was of the view that neither public confidence in the profession, nor the high standards of conduct expected of practitioners in the UK would be compromised by the restoration of your name to the Medical Register at this point. The 2009 Panel sent a clear message that your misconduct was so serious that it was fundamentally incompatible with continued registration. The Tribunal was satisfied that you have now demonstrated insight and provided convincing evidence of remediation. It is of the view that, as a significantly more mature doctor, who has experienced the serious consequences of your actions and demonstrated insight into them, you do not pose a risk of repeating your previous failings. 7

8 39. In all the circumstances, the Tribunal considered that the statutory overarching objective would not be compromised through the restoration of your name to the Medical Register. It was of the view that you are fit to practise and that you are a fit and proper person to be restored. Such a course would be an appropriate and proportionate response. It was also reassured that, as for all doctors restored to the Medical Register after a prolonged period out of UK practice, you would only be able to return to practice in an Approved Practice Setting until your first revalidation after restoration. 40. Accordingly, the Tribunal determined to grant your application and directs that your name be restored to the Register. The Tribunal directs the Registrar to restore your licence to practise. 41. That concludes this case. Confirmed Date 15 November 2016 Dr Nigel Westwood, Chair 8