Privy Council Appeal No. 19 of 2001

Dr. Shiv Prasad Dey	Appellant
	v.
The General Medical Council	Respondent

	FROM

	THE PROFESSION CONDUCT COMMITTEE OF
THE GENERAL MEDICAL COUNCIL
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	JUDGMENT OF THE LORDS OF THE JUDICIAL
	COMMITTEE OF THE PRIVY COUNCIL,
	Delivered the 6th November 2001
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	Present at the hearing:-
			Lord Millett
			Lord Mackay of Clashfern
			Sir Swinton Thomas
		  	[Delivered by Lord Millett]
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1. 	On 22nd February 2001 the Professional Conduct Committee of the General Medical Council found that the  appellant Dr Dey had been convicted of fourteen counts of furnishing false information and directed that his name be erased from the register pursuant to Section 36 of the Medical Act 1983.

2. 	Dr Dey is a married man of previously good character. He is aged 49.  He qualified with the degrees of Bachelor of Medicine and Bachelor of Surgery of the University of Delhi in 1975 and came to England in 1978 where he began working in paediatrics. In 1985 he became a Member of the Royal College of General Practitioners and in 1993 began working as a general practitioner in Oswaldthistle.  In 1995 he accepted an invitation to join the practice of Dr Bhat in Colne.  Dr Bhat retired in 1997 and Dr Dey became the sole principal at the practice.
3. 	When starting in a new practice a general practitioner is given a period of time in which to carry out patient registration health screening tests.  These tests serve two purposes.  They provide an opportunity for a new practitioner to introduce himself to patients and at the same time permit a review of techniques that may be used in preventative medicine.  When he took over Dr Bhat's practice the local health authority gave Dr Dey 12 months to complete the tests.

4. 	Between 1st April 1997 and 31st March 1998 Dr Dey submitted to the local health authority 1085 requests for payment for health screening tests. He was paid £7.10 in respect of each claim.

5. 	Subsequently the police undertook an investigation into these claims and Dr Dey was charged with 41 counts of false accounting contrary to section 17(1)(b) of the Theft Act 1968 and two counts of obtaining money by deception contrary to section 15(a) of the Act. 

6. 	0n 4th October 2000 at Burnley Crown Court before His Honour Judge Bennett Dr Dey pleaded guilty to 14 counts of furnishing false information.  He was sentenced to a fine of £100 on each count making £1,400 in all and was ordered to pay £5,000 in costs.

7. 	The plea was tendered on the third day of the trial and prior to the calling of any evidence.  Dr Dey had previously maintained his innocence and had funded his own defence.  By the time he pleaded guilty he had incurred £40,000 of legal costs in respect of his defence in addition to the costs he was ordered to pay.

8. 	When passing sentence the trial judge observed that the sentence related only to the 14 counts to which Dr Dey had pleaded guilty and that these should not be regarded as “the tip of the iceberg”.  The total value of the claims which formed the subject-matter of the conviction was (14 x £7.10) = £99.40.

9. 	In announcing the Committee's decision, the Chairman stated:-
“Dr. Dey: You were convicted of 14 counts of furnishing false information.  The Committee have heard how you falsified patient medical records to suggest that you had carried out health screening examinations on patients when in fact you had not done so.  You then submitted claims to the East Lancashire Heath Authority in respect of those supposed examinations.

The Committee take an extremely grave view of your behaviour.  You have defrauded the National Health Service for your own financial gain.  When the matter was under investigation, you attempted to pass at least some of the blame onto others by drawing attention to the alleged shortcomings of your staff.  In addition by deliberately making false entries in patients’ medical records you placed patients at risk.  It is vital that patients’ medical records contain accurate and relevant clinical findings as other doctors may refer to them and reach decisions on what is recorded.  Such irresponsible behaviour cannot be tolerated in a registered medical practitioner. 

The Committee, taking account of all the circumstances of the case, have concluded that there is no option other than to direct the Registrar to erase your name from the Register.”

10. 	Dr Dey appeals against the determination that his name should be erased from the register.  He complains:
(i)	that the Committee failed to have proper regard to the purpose of the disciplinary process, namely to protect the public and/or to maintain the high standards and reputation of the profession;
(ii)	that the Committee imposed or appeared to impose a penalty in respect of matters for which he had already been sentenced in the Crown Court; and
(iii)	that the penalty and its consequences were excessive.

11. 	Their Lordships can take the first two contentions together, since essentially they cover the same ground.  The object of disciplinary proceedings against a medical practitioner who has been convicted of a criminal offence is twofold.  It is to protect members of the public who may come to him as patients and to maintain the high standards and reputation of the profession.  It is not to punish him a second time for the same offence. Nevertheless the same conduct which constitutes the offence for which he has been convicted may also demonstrate that the need to maintain the standards and reputation of the profession or to protect the public or both requires the erasure of his name from the Register.  There is no clear line of demarcation: the difference lies not in the facts themselves but in the perspective from which they are viewed.   

12. 	In their Lordships’ view it is clear from the terms of the Committee’s determination that it had due regard to the proper purposes of the proceedings.  It took account of the nature of the offences and the potential risk to patients which was involved. 

13. 	So far as the nature of the offences is concerned, Dr Dey had not merely acted dishonestly in obtaining money by fraud. He had done so in the course of his professional practice by submitting false claims to the local Health Authority.  Health Authorities must be able to place complete reliance on the integrity of practitioners; and the Committee is entitled to regard conduct which undermines that confidence as calculated to reflect on the standards and reputation of the profession as a whole. 

14. 	But Dr Dey’s conduct did not stop at there.  He not only submitted fraudulent claims for payment, but sought to substantiate the claims by deliberately falsifying patients’ records so that they showed records of medical examinations which had not in fact taken place.  The Committee  understandably took an extremely serious view of Dr Dey’s conduct in this regard, which obviously places patients at risk. Other practitioners must be able to rely on the accuracy of patients’ records and the integrity of the practitioner who made them. 

15. 	Their Lordships are satisfied that there is no basis for the contention that the Committee exceeded the proper bounds of its remit and was seeking to punish Dr Dey a second time for the offences for which he had already been sentenced.

16. 	Their Lordships have considered the able submissions made by counsel on Dr Dey’s behalf and the material which he placed before them by way of mitigation.  This includes a petition signed by some 300 patients and 20 or so letters in Dr Dey’s support. They testify to his excellence as a doctor and the care with which he has provided a vital service to local residents.  Their Lordships have taken  this material into consideration, while bearing in mind that Dr Dey’s clinical performance is not in issue, and that with the exception of the written material all the matters of mitigation were placed before the Committee. 

17. 	Their Lordships are satisfied that the sentence of erasure was not excessive.  The Committee was entitled to conclude that such irresponsible behaviour cannot be tolerated in a registered medical practitioner and that the need to maintain high standards and to protect the public, taken together, required the erasure of Dr Dey’s name from the Register.  

18. 	Their Lordships will humbly advise Her Majesty that the appeal ought to be dismissed.  Dr Dey must pay the Council’s costs before the Board.