High Court judgment – Professional Standards Authority v General Medical Council and Dr Igwilo
The Professional Standards Authority v The General Medical Council and Dr Okwuolisa Igwilo  EWHC 524
The Medical Practitioners Tribunal made a determination in September 2015 that Dr Igwilo’s fitness to practise was not impaired. Those proceedings concerned allegations that Dr Igwilo had made false statements on a number of documents in the course of his applications for review and re-review of the refusal of his initial application for entry onto the Specialist Register of Forensic Psychiatrists. Dr Igwilo admitted the allegations made in respect of the application for re-review which included an acceptance that he had altered the date and name of the author to his own name on various documents.
The Tribunal concluded that Dr Igwilo’s fitness to practise was not currently impaired despite finding misconduct. His misconduct was categorised as an isolated dishonest act during a period of severe personal stress. Dr Igwilo provided the Tribunal with evidence of extensive reflection and remediation so as to satisfy them that there was no risk of future repetition. In those circumstances the Tribunal found that public confidence in the profession would not be undermined by a finding of no impairment.
The Professional Standards Authority (“PSA”) referred this determination to the High Court under section 29 of the National Health Service Reform and Health Care Professions Act 2002. The crux of their case being that the Medical Practitioners Tribunal had been unduly lenient in finding Dr Igwilo’s fitness to practise not impaired.
The Honourable Mrs Justice Lang DBE handed down judgement on 15 March 2016. The full judgement can be accessed here.
Lang J referred to the decision of Silber J in R (on the application of Cohen) v General Medical Council  EWHC 581 (Admin) in which he stated:
“ I must stress that the fact that the stage 2 is separate from stage 1 shows that it was not intended that every case of misconduct found at stage 1 must automatically mean that the practitioner’s fitness to practise is impaired.
 There must always be situations in which a Panel can properly conclude that the act of misconduct was an isolated error on the part of a medical practitioner and that the chance of it being repeated in future is so remote that his or her fitness to practice has not been impaired.”
Lang J found that although the Tribunal’s findings on misconduct were sparse, they were adequate. She recognised that a finding of impaired fitness to practise did not flow automatically from a finding of misconduct. However, in the specific facts of Dr Igwilo’s case, Lang J found that the Tribunal had been unduly lenient. Having outlined the number range of documents which had been falsified she characterised the conduct as “..an elaborate deception which must have taken some considerable time to plan and implement.” She noted that Dr Igwilo had maintained the falsehood before it was exposed and that he did not confess the full scale of the falsifications until disciplinary proceedings were brought against him. She also noted that his conduct had jeopardised the integrity of the Specialist Medical Lists.
Whilst noting that “cases of dishonesty vary in severity” she concluded that this case fell towards the more serious end of the scale of severity seen in the range of dishonesty cases.
Lang J quashed the decision on impairment substituting a decision that Dr Igwilo’s fitness to practise is impaired. The question of sanction is to be determined by a freshly constituted Panel of the Medical Practitioners Tribunal. Dr Igwilo could now face a sanction of conditions, suspension or erasure from the medical register.
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