Surbiton doctor struck off by General Medical Council

Disgraced doctor erased from medical register for theft conviction cover-up
A doctor who covered up a theft conviction to land a top job at East Surrey Hospital has been struck off the medical register.

Raymond Onwuelo, 40, of Raleigh Drive, Surbiton, spent two years in his post as clinical fellow in anaesthetics before the discovery that he was fined £300 in 2000 for shoplifting.

He denied intentionally misleading Surrey and Sussex Healthcare Trust but despite his protests his career as a medical practitioner is effectively over after being found guilty of serious professional misconduct by the General Medical Council on November 3.

Onwuelo failed to disclose on an application form that he had a theft conviction from Wolverhampton Crown Court and he went on to be appointed to the post in February 2001.

When he was arrested in 2003 and later cleared over a domestic case of unlawful imprisonment and actual bodily harm, the Trust was contacted by police and carried out a search through the Criminal Records Bureau, discovering the previous conviction.

Onwuelo believed he had admitted his conviction on the Employment Status Form and maintains the stressful nature of his job and personal life at the time contributed to his confusion.

However a Fitness to Practice panel ruled his conduct "amounted to a serious departure from the standards of a registered medical practitioner" and has erased him from the register.

11:40am Sunday 13th November 2005

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http://www.thisislocallondon.co.uk/misc/print.php?artid=650729

List of Registered Medical Practitioners

Results of search on 11 JAN 2007 at 18:03:33. The details shown are valid at the date and time of the search only.

Details

GMC Reference Number 4756831
Given Names Raymond Emeka
Surname Onwuelo
Sex Male
Primary Medical Qualification MB BS 1989 Benin (Conferred)

Full Registration Date 06 OCT 2000
Specialist Register This doctor is not in the Specialist Register
GP Register This doctor is not in the GP Register

Current Registration Details

Registration Status Registered
Information for Employers Substantive, honorary and fixed term consultants working in the NHS are required to be on the specialist register, however there are exemptions. Please refer to the National Health Service (Appointment of Consultants) Regulations 1996, as amended by the National Health Service (Appointment of Consultants) Amendment Regulations 2004.

Doctors working in general practice in the UK health service are required to be on the General Practitioner Register. Please refer to the General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003 and the NHS (Performers Lists) Regulations 2004.

History

History Since 20 OCT 2005

From To Status
10 JAN 2007 Registered
02 DEC 2006 10 JAN 2007 Suspended
02 DEC 2005 01 DEC 2006 Suspended
04 NOV 2005 02 DEC 2005 Suspended
20 OCT 2005 04 NOV 2005 Registered

GMC Hearings

Date Panel
08 JAN 2007 Fitness to Practise Panel
15 NOV 2006 Fitness to Practise Panel
04 NOV 2005 Fitness to Practise Panel

Dr Emmanuel Sunday IDOKO 6025481 SHO psychiatrist

Rochdale Observer

News 12 January 2007

Published: 20th December 2006

Doctor who had affair is allowed to practise again

A BIRCH Hill psychiatrist suspended for a year for having an affair with a patient has been allowed to practise again.

Dr Emmanual Idoko conducted an improper relationship with a patient during May and June 2004.

A General Medical Council fitness to practice panel, sitting in December 2005, found he had made improper phone calls, kissed her and carried out a sexual act with her. He was suspended until Friday 19 January 2007.

But a GMC review panel, sitting in Manchester on Friday, found he had addressed the reasons for his misconduct and patients would not be at risk by him resuming practice.

The panel heard how Dr Idoko had been required to keep his medical knowledge up to date and attend weekly psychotherapy treatment during his suspensions.

He also undertook on-line medical courses and underwent mentoring from another doctor.

Dr Idoko, who had been working evenings at a call centre, told the panel he was very sorry to have damaged the medical profession and the situation had been out of character.

He said he wanted to get to the root of the problem, deal with it and put it behind him and undergoing psychotherapy had helped.

He said the previous panel had not told him specifically how to meet any criteria and he felt he had done all he could under the circumstances.

He said: “I will carry the incident on my conscience and it is an indelible smudge on my life.

“I will have to work hard to build up the respect of my patients, members of the public and staff, but I’ve learnt a valuable lesson and will be the best doctor I can ever be.”

But Chris Hamlett, GMC advocate, argued against re-instatement and said that Dr Idoko had fallen short of the requirements and, while he had taken ‘great steps’ in the right direction, he had not gone far enough.

He said: “While Dr Idoko has made great efforts in dealing with the requirements, the courses he has undertaken have not sufficiently addressed the root causes of the problems.”

The panel, chaired by Professor Dennis McDevitt, found Dr Idoko had shown insight into his failings and his fitness to practice was not impaired.

http://www.rochdaleobserver.co.uk/news/s/221/221307_doctor_who_had_affai...

List of Registered Medical Practitioners

Results of search on 12 JAN 2007 at 19:51:54. The details shown are valid at the date and time of the search only.

Details

GMC Reference Number 6025481
Given Names Emmanuel Sunday
Surname Idoko
Sex Male
Primary Medical Qualification MB BS 1996 Nigeria (Conferred)

Full Registration Date 18 FEB 2004
Specialist Register This doctor is not in the Specialist Register
GP Register This doctor is not in the GP Register

Current Registration Details

Registration Status Suspended
Information for Employers This person has been suspended from the Medical Register and may not practise as a doctor.

A hearing date has been set for this doctor.

History

History Since 20 OCT 2005

From To Status
20 JAN 2006 19 JAN 2007 Suspended
20 OCT 2005 20 JAN 2006 Registered

GMC Hearings

Date Panel
15 DEC 2006 Fitness to Practise Panel
22 DEC 2005 Fitness to Practise Panel

https://webcache.gmc-uk.org/ods/home.do

Fitness to PractiSe Panel

19 – 22 December 2005

7th Floor, St James’s Buildings, 79 Oxford Street, Manchester, M1 6FQ

Name of Respondent Doctor: Dr Emmanuel Sunday IDOKO

Registered Qualifications: MB BS 1996 Nigeria

Registered Address: Manchester

Registration Number: 6025481

Type of Case New Case (Misconduct)

Panel Members Dr N Hester, Chairman (Medical)

Mrs S Chaudhry (Lay)

Dr M Johnson (Medical)

Dr A Montgomery (Lay)

Mr A Simanowitz (Lay)

Legal Assessor: Mr D Smith

Secretary to the Panel: Miss J Kramer

Representation:

GMC: Mr Michael Taylor, Counsel, instructed by Mills and Reeve Solicitors.

Doctor: Mr Nicholas Braslavsky, Counsel.

allegation

That being registered under the Medical Act 1983

1. At all material times you were employed as a Senior House Officer (“SHO”) in Psychiatry by Pennine Care NHS Trust at Birch Hill Hospital (“the Hospital”) Rochdale; Admitted and Found Proved

2. On or around 12 March 2004 Mrs X was admitted for treatment as an inpatient to the hospital under the care of her Consultant Psychiatrist Dr A;

Admitted and Found Proved

3. Upon her admission Mrs X was noted as suffering from low mood and depression; Admitted and Found Proved

4. Mrs X had a history of;

a. low mood, Admitted and Found Proved

b. self harming, and Admitted and Found Proved

c. excessive alcohol use; Admitted and Found Proved

5. Upon admission to the hospital Mrs X reported that her father had sexually abused her in the past; Admitted and Found Proved

6. You became involved in treating Mrs X as the SHO to Dr A;

Admitted and Found Proved

7. During your treatment of Mrs X you had full access to her medical notes and records and given her recorded history you knew or ought to have known that Mrs X was an emotionally vulnerable patient; Admitted and Found Proved

8. On or around 24 June 2004 Mrs X was discharged as an inpatient at the hospital;Admitted and Found Proved

9. During May and June of 2004 youconductedan improper relationship with Mrs X; Admitted and Found Proved

10. During May and June 2004 you;

a. exchanged mobile telephone numbers with Mrs X,

Admitted and Found Proved

b. made improper telephone calls to Mrs X,

Admitted and Found Proved

c. kissed Mrs X, Admitted and Found Proved

d. engaged in oral sex with Mrs X, Admitted and Found Proved

e. had sexual intercourse with Mrs X; Found Not Proved

11. Your conduct as above was;

a. inappropriate,

Found Provedin relation to Allegations 9, 10a, b, c and d

b. unprofessional,

Found Provedin relation to Allegations 9, 10a, b, c and d

c. an abuse of your position of trust as a doctor,

Found Proved in relation to Allegations 9, 10b, c and d

d. not in the best interest of the patient Mrs X,

Found Provedin relation to Allegations 9, 10a, b, c and d

e. liable to bring the profession into disrepute,

Found Proved in relation to Allegations 9, 10b, c and d

And that by reason of the matters set out above your fitness to practise is impaired because of your misconduct.

Determination on impaired fitness to practise

Dr Idoko

At the start of these proceedings you admitted a number of the factual allegations namely 1, 2, 3, 4a, b and c, 5, 6, 7, 8, 9, 10a, b, c and d. The Panel has recorded that these allegations are admitted and found proved. The Panel has also found allegations 11a, b, c, d and e proved.

The Panel has considered all the information presented to it including the submissions by Mr Taylor for the GMC, and by Mr Braslavsky on your behalf. It has also noted and accepted the advice of the Legal Assessor.

You have admitted that at all material times you were employed as a Senior House Officer in Psychiatry by Pennine Care NHS Trust at Birch Hill Hospital, Rochdale. On 12 March 2004 Mrs X was admitted for treatment as an inpatient to the hospital under the care of her Consultant Psychiatrist, Dr A. Upon her admission Mrs X was noted as suffering from low mood and depression. She had a history of low mood, self harming and excessive alcohol use. She reported upon admission to the hospital that her father had sexually abused her in the past. Mrs X remained as an inpatient until her discharge on or around 24 June 2004. When you became involved in treating Mrs X as the SHO to Dr A you had full access to her medical notes and records and you have admitted that, given Mrs X’s recorded history, you knew or ought to have known that she was an emotionally vulnerable patient.

You have admitted that during May and June 2004 you conducted an improper relationship with Mrs X. This involved exchanging mobile telephone numbers with Mrs X, making improper telephone calls to her, kissing her and engaging in oral sex with her. The Panel did not find proved that you had sexual intercourse with Mrs X. It noted, however, that during the course of your evidence you admitted to having attempted sexual intercourse with her, but found yourself physically unable to penetrate.

The Panel has found proved that your conduct in engaging in such a relationship with Mrs X was inappropriate, unprofessional, an abuse of your position of trust as a doctor, not in the best interests of Mrs X and liable to bring the profession into disrepute.

The Panel has found that you have breached the principles contained within the General Medical Council’s guidance ‘Good Medical Practice’ (May 2001 edition, applicable at the time), which states that doctors must avoid abusing their position as a doctor. In particular you have breached the following principle, under the heading ‘Relationships with Patients’:

“You must not allow your personal relationships to undermine the trust which patients place in you. In particular, you must not use your professional position to establish or pursue a sexual or improper emotional relationship with a patient.”

The Panel is concerned about the serious nature of the proven allegations given that your patient, Mrs X, was emotionally vulnerable and that at the time of the sexual activity you were one of Mrs X’s attendant psychiatrists. Doctors occupy a position of privilege and trust in society and are expected to act with integrity and to uphold proper standards of conduct. The public have a right to expect that a doctor will not behave in an inappropriate and unprofessional manner. The Panel is in no doubt that your behaviour fell seriously below the standards expected of a registered medical practitioner.

The Panel’s attention was drawn to Dame Janet Smith’s fifth Shipman Inquiry report in which it is stated that impairment of fitness to practise is not defined in the legislation.

The Panel has adopted as a working definition of conduct amounting to impaired fitness to practise:

“Conduct which when viewed objectively falls so far short of the standard reasonably expected of a qualified medical practitioner as to call into question his/her ability to practise.”

In the light of the circumstances detailed previously the Panel is left in no doubt that your fitness to practise is impaired pursuant to Section 35C (2) (c) of The Medical Act 1983 as amended, by reason of the misconduct.

The Panel will now invite further submissions from both Counsel as to the appropriate sanction, if any, to be imposed on your registration. Submissions on sanction should include reference to the Indicative Sanctions Guidance, using the criteria as set out in the guidance to draw attention to the issues which appear relevant to this case.

The Panel will now take submissions under Rule 17(2)(l) regarding the appropriate sanction to impose in this case.

Determination on sanction

Dr Idoko:

The Panel has previously determined, and announced, that your fitness to practise is impaired by reason of your misconduct in pursuing an improper relationship of a sexual nature with Mrs X.

The Panel noted some conflict of evidence between yourself and Mrs X and, because the burden of proof lies with the GMC and the high standard of proof required was not met, it has resolved this in your favour. The Panel has heard, however, that you take full responsibility for these events and accept that, as her doctor, you should not have allowed the situation to develop in the way that it did.

The Panel has considered what action, if any, should be taken against your registration.

It has considered all the oral and written evidence in this case together with the submissions made by both Counsel as to the appropriate sanction, and has noted and accepted the advice of the Legal Assessor. It has also taken into consideration the Indicative Sanctions Guidance.

Although evidence in mitigation was presented before a decision on the facts had been made (in order to accommodate the medical witnesses), the Panel was careful to consider this evidence only as far as it addressed the issue of mitigation. In this respect it heard from Dr B, consultant psychiatrist, and psychotherapist, who stated that situations such as the one in which you found yourself with Mrs X are not uncommon, particularly when junior doctors of limited experience are treating psychiatric patients with ‘huge unmet needs for love and affection’.

She explained that such patients often use other people to address their own emotional needs. She was strongly of the opinion that, although you were unable to deal with this situation, you would not repeat your inappropriate behaviour as you have taken steps to ensure that it does not happen again. She believes that the lessons you have learnt from this experience are likely to preclude any repetition of this behaviour.

The Panel has heard impressive evidence from Dr C, consultant psychiatrist and college tutor at North Manchester General Hospital whom you knew as a member of staff and to whom you turned as a mentor. He stated you had displayed appropriate remorse and made a very sustained and genuine effort to address your failure. In his testimonial dated 5 May 2005, he stated:

“During our discussions Dr Idoko has been frank about all aspects of his behaviour and conduct. He has also expressed his deep regret for his failure to uphold the professional code expected of him.”

He was of the opinion that, at the time, you did not have the requisite clinical acumen to deal with a highly complex situation.

It has been submitted on your behalf that the sexual activity which took place between yourself and Mrs X and the circumstances leading up to it were wholly out of character for you and it was not disputed by Mrs X that it did not take place without her consent. Nevertheless, the Panel has borne in mind that a sexual relationship with a patient, particularly a vulnerable patient, is viewed extremely seriously. Such action, in addition to the harm that it can cause the patient, can damage the reputation of the medical profession and the trust which patients and members of their families are entitled to place in it.

The Panel has considered the three competing interests in this case, namely public confidence in the medical profession; public confidence in retaining the services of a capable doctor; and your own interests. Further, it has borne in mind that it is the duty of the GMC to declare, and of this Panel to uphold, proper standards of conduct and behaviour.

The Panel was referred to the High Court Judgement case of Dr Giele (Case No: CO/2495/2005) in which Dr Giele had appealed against a GMC direction of erasure following a finding of serious professional misconduct for conducting a sexual relationship with a vulnerable patient. In his judgement, Mr Justice Collins stated:

“The misconduct will inevitably be regarded as more serious if the patient is vulnerable and this is why a psychiatrist will always be at greater risk of the most severe sanction since he will almost always know that his patient was particularly vulnerable...”

He goes on to say

“…The GMC has always regarded improper sexual relationships with patients as misconduct which is very serious indeed. They will often constitute an abuse of trust and will be particularly reprehensible if the patient is vulnerable and known to be so by the doctor. In the past, erasure was virtually automatic and was almost always upheld by the Privy Council on appeal.”

Mr Justice Collins further stated, however:

“… I have also emphasised that erasure is not to be regarded as inevitable. Nor did I say that erasure would be the appropriate sanction in any but an exceptional case. The Panel would think in terms of erasure but would only erase if that was in the circumstances of the particular case ‘the only means of protecting patients and/or maintaining public confidence in the medical profession.’”

The Panel’s attention has also been drawn to the GMC’s Indicative Sanctions Guidance (May 2004) and has considered carefully the principles set out in the case of Bolton v The Law Society and adopted in the case of Dr Gupta:

“The reputation of the profession is more important than the fortunes of an individual member. Membership of a profession brings many benefits, but that is part of the price.”

Against this the Panel has set part of the dicta in the case of Bijl v GMC (Privy Council appeal number 78 of 2000) in which it was stated that it was not necessary to erase:

“an otherwise competent and useful doctor who presents no danger to the public in order to satisfy demand for blame and punishment.”

The Panel has taken into account the principle of proportionality and weighed your own interests against its duty to protect the wider public interest. Your behaviour undermines public confidence in the medical profession and damages its reputation. The public expects appropriate standards of behaviour from a doctor and is entitled to expect that a registered practitioner will conduct himself in an appropriate professional manner. The findings made against you represent a serious breach of the principles that are central to Good Medical Practice.

The Panel considered, in turn, each of the sanctions available. In light of the misconduct that has been found proved, it concluded that to take no action on your registration would be wholly insufficient.

The Panel next considered the imposition of conditions. It determined that it would not be in the public interest to place conditions on your registration as there are no conditions which could properly address your misconduct. Nor would they fully reflect the seriousness of this case.

The Panel considered that this was an incident of such gravity that it is necessary to impose a severe sanction for your inappropriate and unprofessional actions and the abuse of your professional position. It therefore went on to consider whether a period of suspension would be sufficient.

This was a course of conduct of limited duration, and you have shown considerable remorse for your actions, particularly as regards your willingness to confront your failings by reporting the facts frankly to your mentor, Dr C and several colleagues. You have also readily accepted psychotherapeutic treatment aimed at recognising your shortcomings and sufficiently strengthening your ability so as to ensure no repetition of such an episode.

The Panel is encouraged by your efforts and considers that, in addition to the admissions you have readily made and the evidence you have given, they demonstrate genuine insight into the conduct which led to your appearance here.

It has borne in mind numerous testimonials, several from senior colleagues that attest to your general good character and clinical competence. It was particularly impressed by the willingness expressed by Dr C to have you working with him again. In this context he envisaged a plan of prolonged supervision, with regular reports from your supervising consultant and your psychotherapist, by which your safe return to practice could be piloted.

Further, the Panel notes that you have not worked clinically, nor sought such work, since shortly after the relationship with Mrs X took place. You have thereby voluntarily augmented the restrictions placed upon you by the suspension imposed by your previous employers.

In the particular circumstances of this case, the Panel does not consider that erasure is the only means of protecting patients and maintaining public confidence in the medical profession and is of the view that the maximum period of suspension will achieve that objective.

Having thus determined, the Panel is satisfied that it is both appropriate and proportionate to direct the Registrar to suspend your registration for a period of 12 months.

The effect of the foregoing direction is that, unless you exercise your right of appeal, your registration will be suspended for a period of 12 months beginning 28 days from today.

The Panel will resume consideration of this case at a review hearing to be held before the end of the period of 12 months. It will then consider whether it is necessary to take further action in relation to your registration. You will be informed of the date of that hearing, which you will be expected to attend.

In deciding what information should be provided at the next hearing, the Panel has noted the following excerpt from paragraph 32 of the Indicative Sanctions Guidance:

“It is important that no doctor should be allowed to resume unrestricted practice following a period of … suspension unless the Panel can be certain that he or she is safe to do so. … The Panel will also need to satisfy itself that the doctor has … maintained his or her skills and knowledge and that patients will not be placed at risk by resumption of practice or by the imposition of conditional registration.”

The Panel therefore considers it appropriate to specify the nature of the documentation which it would find helpful at the next hearing, as follows:

· written evidence of the measures you have taken to maintain your medical knowledge and skills;

· evidence of any medical educational activities which you have undertaken in order to keep your knowledge and skills up to date;

· evidence that you have continued with your psychotherapy treatment during your period of suspension and a report from Dr D or your treating psychotherapist as to your progress;

· evidence that you have continued to receive mentoring from Dr C or another mentor of appropriate standing.

Shortly before the review hearing, you will be asked to furnish the Council with names of professional colleagues and other persons of standing to whom the Council may apply for information as to their knowledge of your conduct throughout the interval since this hearing of your case.

Having concluded that your name should be suspended from the Register, the Panel will now go on to determine whether it considers it necessary under section 38(1) of the Medical Act for the protection of members of the public or in your own interests, to order that your registration be suspended forthwith. Before deciding whether it is necessary to do so, the Panel will now invite submissions from Mr Taylor and Mr Braslavsky on this matter.

Determination on immediate sanction

Dr Idoko:

Having determined that your name should be suspended from the register, the Panel has now considered in accordance with Section 38 of the Medical Act 1983 as amended, whether your registration should be suspended immediately.

The Panel has considered the submissions of Mr Taylor, GMC Counsel and Mr Braslavsky on your behalf and the advice of the Legal Assessor.

The Panel has noted that Mr Taylor, on behalf of the GMC has not asked for immediate suspension in this case and it has borne in mind that you have not worked clinically, nor sought such work, since shortly after the relationship with Mrs X took place. The Panel notes that no interim order has been placed upon your registration and has therefore determined not to suspend your registration immediately.

The effect of the foregoing order and the direction for suspension previously announced is that, unless you exercise your right of appeal your registration will be suspended 28 days from the date when this notice is deemed to have been served on you.

Confirmed

December 2005 Chairman

Dr Michael Alwyn Johnson MB ChB DPH MRCGP DRCOG Medical

Specialist Prescriber Adult Community Drug Team Kirklees. Medical Advisor South Kirklees PCT's. Complaints adviser Healthcare Commission. Advisor, NCAS. Fell & Rock Climbing Club.

http://www.gmc-uk.org/about/register/panellists.asp#J

List of Registered Medical Practitioners

Results of search on 12 JAN 2007 at 20:08:07. The details shown are valid at the date and time of the search only.

Details

GMC Reference Number 0352329
Given Names Nigel William Scobie
Surname Hester
Sex Male
Primary Medical Qualification MB ChB 1964 Leeds (Conferred)

Provisional Registration Date 10 JUL 1964
Full Registration Date 18 AUG 1965
Specialist Register This doctor is not in the Specialist Register
GP Register This doctor is not in the GP Register

Current Registration Details

Registration Status Registered
Information for Employers Substantive, honorary and fixed term consultants working in the NHS are required to be on the specialist register, however there are exemptions. Please refer to the National Health Service (Appointment of Consultants) Regulations 1996, as amended by the National Health Service (Appointment of Consultants) Amendment Regulations 2004.

Doctors working in general practice in the UK health service are required to be on the General Practitioner Register. Please refer to the General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003 and the NHS (Performers Lists) Regulations 2004.

History

History Since 20 OCT 2005

From To Status
20 OCT 2005 Registered

https://webcache.gmc-uk.org/ods/home.do

Fitness to PractiSe Panel

15 December 2006

7th Floor, St James's Buildings, 79 Oxford Street, Manchester, M1 6FQ

Name of Respondent Doctor: Dr Emmanuel Sunday IDOKO

Registered Qualifications: MB BS 1996 Nigeria

Registered Address: Manchester

Registration Number: 6025481

Type of Case: Review case of impairment by reason of misconduct

Panel Members: Prof McDevitt, Chairman (Medical)

Mr Fyfe (Medical)

Ms Steel (Lay)

Legal Assessor: Mrs Sarah Breach

Secretary to the Panel: Mrs Sam Montgomery

Representation:

GMC: Mr Chris Hamlet, Counsel, of GMC Legal represented the Council.

Doctor: Dr Idoko was present and was not represented.

Determination on impaired fitness to practise

Dr Idoko:

Your case was first considered by a Fitness to Practise Panel in December 2005. At that hearing you admitted and the Panel found proved that, whilst employed as a Senior House Officer (SHO) in Psychiatry, you conducted an improper sexual relationship with Mrs X, an emotionally vulnerable patient. You admitted that you had exchanged mobile telephone numbers with Mrs X, made improper telephone calls to her, kissed and engaged in oral sex with Mrs X. The Panel found your conduct in relation to Mrs X to be inappropriate, unprofessional, an abuse of your position of trust as a doctor and not in the best interests of the patient. The Panel also found your conduct liable to bring the profession into disrepute.

The Panel concluded that your fitness to practise was impaired by reason of your misconduct and determined that a period of suspension would be the appropriate and proportionate sanction and went on to suspend your registration for a period of 12 months.

The Panel has today reviewed your case. It has considered, under Rule 22 (f), whether your fitness to practise is impaired. It has taken into account all the evidence placed before it, the submissions made by Mr Hamlet, on behalf of the GMC and those you have made.

The Panel notes that in Mr Hamlet's submissions he acknowledges that you have taken ‘huge steps' forward in your rehabilitation and have made great efforts to keep your medical knowledge up to date. However, he submitted that the courses you have undertaken have not sufficiently addressed the root cause of your behaviour, which brought you before the GMC. In your evidence you informed the Panel that you did seek guidance about what measures you should take to rehabilitate yourself, from both the GMC and BMA. Neither was able to offer you the guidance requested. You have submitted that you have done all that you can to satisfy the previous Panel's requirements, in complying with all the advice you have received from your medical and educational advisers.

The Panel has considered the determination from the previous hearing and notes the evidence accepted by that Panel that, at that time, as a junior doctor, you did not have the clinical acumen to deal with a highly complex situation. Despite that, it notes that you took full responsibility for the events that took place and you accepted that, as Mrs X's doctor, you should not have allowed the situation to develop in the way that it did. You have told this Panel, on oath, that you regret your behaviour, that you are concerned about the effect it may have had on Mrs X and that you regret that you have tarnished the reputation of the medical profession. The Panel is satisfied that you have fully appreciated the gravity of these matters that led to the suspension of your registration.

At the previous hearing the Panel requested that, during the period of suspension, you should take steps to satisfy any review Panel that you had maintained your medical skills and knowledge. The Panel went on to suggest that it would be helpful to receive the following:

1. Written evidence of the measures you have taken to maintain your medical knowledge and skills.

• Evidence of any medical educational activities which you have undertaken in order to keep your knowledge and skills up to date.

• Evidence that you have continued with your psychotherapy treatment during your period of suspension and a report from Dr D or your treating psychotherapist as to your progress.

• Evidence that you have continued to receive mentoring from Dr C or another mentor of appropriate standing.

The Panel has been assisted by your evidence today and by the information put before it. You have provided the Panel with evidence of the steps you have taken to maintain your medical knowledge since your registration was suspended. The information includes details of the considerable educational activities you have undertaken since December 2005.

The Panel notes that, following the incident with Mrs X, you self- referred yourself to a psychotherapist. The Panel has had regard to the letter from Ms Y, Principal Adult Psychotherapist, dated 18 October 2006. In her letter to you she confirms that you attended the Gaskell House Psychotherapy Centre for a six month period of individual weekly sessions of psychotherapy, from January to June 2006, completing the treatment programme.

You have told the Panel that you have benefited greatly from your psychotherapy sessions. They helped you to gain deeper insight into the doctor-patient relationship, how to identify, acknowledge and meet the needs of patients in an appropriate manner and, above all, seek help as soon as things go wrong.

At the previous hearing you were asked to provide the Council with the names of professional colleagues and other persons of standing who could provide information to the GMC with regard to their knowledge of your conduct throughout the period of suspension. Dr A, Dr C, Dr B and Dr E have provided this information.

Dr A, Associate Postgraduate Dean wrote to the GMC on 18 October 2006. He confirmed that you had been in contact with him in January 2006, seeking advice as to what measures you could take to keep your knowledge up to date. Dr A suggested that you liaise with Dr C and Dr B at the Pennine Care Trust, to agree specific objectives for your personal development plan. He also attempted to arrange a clinical attachment for you. You met with Dr A at the Deanery, on 12 July 2006, when you were informed that Dr B had arranged a clinical attachment for you. Unfortunately this was blocked by the Pennine Care Trust Human Resources Department, as the matters leading to your suspension occurred while you were employed by the Trust. Further attempts to secure a clinical attachment have failed. Dr A also states that, in his opinion, you appeared to him to be remorseful for your actions and that you had complied with and benefited from your psychotherapy.

You have provided the Panel with evidence of your Performance Improvement Plan (PIP), which was compiled with your educational supervisor, Dr C and the Associate Postgraduate Dean, Dr A. This set out specific objectives relating to maintaining your medical knowledge relevant to all doctors and trainees in Psychiatry and also your own specific training needs. The Panel notes that you achieved these objectives.

In his letter dated 19 October 2006, Dr C, Consultant Psychiatrist and College Tutor (your mentor), stated that you had attended regular appointments with him and he believes that you have continued your efforts to rehabilitate yourself. You have studied on a regular basis, regularly attended the grand rounds at North Manchester General Hospital and clinical conferences at Tameside and completed the psychotherapy sessions. His opinion is that you have handled yourself with dignity in the face of rejection and you remain steadfast in your aim to become a trustworthy member of the medical profession. He further stated that you had become more insightful about your own limitations and had developed greater confidence in seeking help when required.

The Panel has also considered the letter from Dr E, Consultant Psychiatrist, dated 30 October 2006, who has met with you on a number of occasions. He also states that you have been genuinely remorseful of your actions and that, in his view, y ou have learnt a lesson in the importance of maintaining appropriate conduct in doctor/ patient relationships.

The Panel notes the supporting references which state that you have dealt with the issues which led to your misconduct. You have also demonstrated contrition and a continuing personal commitment to returning to work by keeping your knowledge and skills up to date.

The Panel has had regard to the Indicative Sanctions Guidance. Paragraph 32 states that:

“ It is important that no doctor should be allowed to resume unrestricted practice following a period of …suspension unless the Panel can be certain that he or she is safe to do so. …The Panel will also need to satisfy itself that the doctor has fully appreciated the gravity of the offence, has not re-offended, and has maintained his or her skills and knowledge and that patients will not be placed at risk by resumption of practice or by the imposition of conditional registration.”

The Panel is satisfied that you have shown insight into your failings. You have told the Panel that you are concerned about the effect the improper relationship would have had on Mrs X's health and well being. You have also told the Panel that the effect on you has been unquantifiable. You have lived daily with an overwhelming feeling of regret, shame and embarrassment at the disgrace you have brought upon the profession. You believe that you have learnt an invaluable lesson.

The Panel has determined that you have complied with all the recommendations of the previous Panel and that you have addressed the reasons for the misconduct through your psychotherapy sessions. Consequently the Panel considers that patients will not be placed at risk by your resumption of practice.

Having considered all the evidence the Panel has determined that your fitness to practise is not impaired. Accordingly, the current suspension will lapse on 19 January 2007.

The Panel would advise you that it would be in your best interests to continue to receive mentorship from a person of standing in the medical profession to guide you in your re-entry into clinical practice.

That concludes the case.

Confirmed

15 December 2006 Chairman

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Professor Denis Gordon McDevitt MD FRCP FFPM DSc FRSE Medical

Emeritus Professor of Clinical Pharmacology. Former Head of Clinical Pharmacology & Dean of Medicine, Dentistry & Nursing, The University of Dundee; & Consultant Physician, Tayside University Hospital NHS Trust. Ex appointed Member & Treasurer of GMC. Member of Council of Royal College of Physicians of Edinburgh & Faculty Board of Faculty of Pharmaceutical Physicians. Fellow of: The Royal Colleges of Physicians of London, Edinburgh and Ireland; The Faculty of Pharmaceutical Medicine; The Academy of Medical Sciences and The Royal Society of Edinburgh.

http://www.gmc-uk.org/about/register/panellists.asp#M

Mr Neil C M Fyfe MBBChir MChir FRCS FRCP Medical

Consultant, Rehabilitation Medicine (Newcastle upon Tyne Hospitals/ NHS Trust). Fellow: Royal College of Physicians of London (Secretary of Joint Specialist Committee for Rehabilitation Medicine), Fellow: Royal College of Surgeons of England. Member: Appeals Panel- Specialist Training Authority. Member: Medical Defence Union. Trustee & Treasurer, British Society of Rehab Med. Panel member, The Appeals Service. Member: Sidney Sussex College, Cambridge.

http://www.gmc-uk.org/about/register/panellists.asp#F