Stefan v. General Medical Council

The appellant was a medical practitioner whose registration was suspended on several occasions following decisions of the Health Committee of the General Medical Council (“Committee”) that her fitness to practice was impaired by reason of her mental condition. In 1998, when the option of imposing an indefinite suspension was available to the Committee under section 37 of the Medical Act 1983 (the 1983 Act), by virtue of section 4 of the Medical (Professional Performance) Act 1995 (the 1995 Act), it directed her registration to be suspended indefinitely. The appellant challenged the Committee’s failure to give adequate reasons for its decision.

[Adapted from INTERIGHTS summary, with permission]

The Court held that the Committee was obligated to provide reasons for its decision to suspend the applicant's registration. The Court reasoned that, although there was no express or implied statutory duty to state reasons for its decisions within either the 1983 Act, or the General Medical Council Health Committee (Procedure) Rules Order of Council 1987 - 1997, neither the 1983 Act nor the rules excluded an obligation to give reasons where the common law would require them. The common law established that there is no general duty universally imposed on all decision-makers to give reasons, but it was well-established that there were exceptions where the giving of reasons will be required as a matter of fairness and openness. The Court stated that reasons are useful to enable an appeal to be prosecuted, and the presence of the right in this case was at least one indication from the statutory provisions pointing to the existence of the Committee's obligation to provide reasons for its decision. It was apparent that the procedures which the Committee followed and the functions which it performed were akin to those of a court where the giving of reasons would be expected. In the circumstances of this case, there was a duty at common law on the Committee to state the reasons for its decision.

The Court further held that, in all cases heard by the Committee, there will be a common law obligation for it to give at least some brief statement of the reasons forming the basis of the decision. The extent and substance of the reasons must depend on the circumstances, but they must be sufficient to tell the parties in broad terms why the decision was reached.

[Adapted from INTERIGHTS summary, with permission]

"Their Lordships were referred to the reference to the right to work embodied in Article 23 of the Universal Declaration of Human Rights 1948, a Declaration which is itself referred to in the preamble to the European Convention on Human Rights, and in Article 6(1) of the International Covenant on Economic, Social and Cultural Rights, 1966. But without necessarily founding upon those expressions, it can readily be accepted that the suspension causes Dr. Stefan considerable hardship, not only in financial terms through her inability to work as a registered practitioner, but also in respect of her own natural desire to spend the remaining years of her professional career in some fulfilling and satisfying capacity in the medical service. What she sought was to be allowed to do work as a clinical assistant in ophthalmology at a relatively humble level. The importance of the issue may not closely equate with the importance of personal liberty, but the matter is of very real significance in her own eyes and deserves to be respected. In Reg v. City of London Corporation, Ex parte Matson (1995) 94 L.G.R. 443, 457 the effect on the reputation of the complainer of a rejection from office without the disclosure of reasons was one factor in requiring an explanation to be given. It is not obvious why it was considered that Dr. Stefan's fitness for the work which she sought to do was not only impaired but seriously impaired." Para. 26.

"In addition, however, to that narrow approach their Lordships are also persuaded that in all cases heard by the Health Committee there will be a common law obligation to give at least some brief statement of the reasons which form the basis for their decision. Plainly the Health Committee are bound to carry out their functions with due regard to fairness. The first two of the grounds already mentioned will apply to any case coming before the Committee: the provision of a right of appeal and the judicial character of the body point to an obligation to give reasons. Furthermore in every case the subject matter will be the future right of the doctor to work as a registered practitioner, and while there may be differences between individual cases as to the significance of that from the point of view of the particular practitioner, the general consideration will remain that the Committee are adjudicating upon the right of a person to work as a registered practitioner. There is nothing in the Act nor the Rules requiring reasons not to be given and no grounds of policy or public interest justifying such restraint. In the light of the character of the Committee and the framework in which they operate, it seems to their Lordships that there is an obligation on the Committee to give at least a short statement of the reasons for their decisions." Para. 31.