One of the more challenging issues for a disciplinary panel is determining the appropriate sanction where the registrant continues to deny the allegations. An English court faced that issue head on in General Medical Council v Konathala [2025] EWHC 1550 (Admin).
The hearing panel made a finding that a physician had pushed a patient’s breasts out of her bra and squeezed them with both hands. This was done without explanation or consent and for no clinical purpose. The panel concluded that the physician was motivated by sexual gratification. The physician denied the incident entirely. During the sanction hearing the physician continued to deny that the events had occurred but indicated that he had learned that such behaviour would have a significant impact on patients, the profession, and the public and should never occur. The physician had also taken some courses on professionalism.
The panel imposed a twelve-month suspension. In finding that revocation was not necessary, the panel noted that this was an isolated instance in a 42-year career, characterized by opportunism rather than predatory behaviour. The panel also observed that there had been no repeat instances in the four and a half years since the event. The panel accepted that the physician had the right to deny the allegations. While the physician had only demonstrated limited insight, the panel believed that there was a low risk of repetition.
The regulator appealed the sanction. In finding that the only suitable sanction was revocation, the Court made the following points:
- The conduct was very serious, breaching trust, causing significant harm, and undermining confidence in the profession.
- The degree of insight by the physician was of an extremely limited degree. It did not amount to the level of insight described in the regulator’s sanctioning guidelines as warranting a suspension rather than revocation. The Court placed significant weight on the sanctioning guidelines.
- Even if one describes the chance of repetition as low, the conduct was so serious that the risk of repeating the behaviour was significant.
The Court concluded:
Sufficiency of a sanction for the protection of the public involves consideration not only of the health, safety and well-being of patients and the public. It also involves consideration of the need to maintain public confidence in the medical profession, and to maintain proper professional standards and conduct for the medical profession. When judged properly and reasonably against each of these factors and overall, I am in no doubt that, on the Tribunal’s findings as to his misconduct and impairment of fitness to practise, the Respondent’s behaviour was fundamentally incompatible with remaining in practice as a doctor.
Rather than treating the physician’s refusal to admit the conduct as an unmentionable consideration, the Court treated it as an important factor in assessing the degree of insight by the physician and as having a significant bearing on the risk of repetition, warranting the most severe sanction, revocation.
