Minutes of Investigation Committee (Oral) hearing Date of hearing: 18 December 2014 Name of doctor: Mr Muhammad Shakil Akhtar Reference Number: 6043910 Registered qualifications: MB BS 1999 University of Punjab (Pakistan) Committee Members: Dr Tim Ward – Chair (Medical) Mr Pradeep Agrawal – Lay Mr John Anderson – Lay Mr Richard Khoo - Lay Ms Mandie Lavin – Lay Legal Assessor: Mr Nigel Parry Secretary to the Committee: Mrs Clare Moley Type of Case: Conviction Representation: GMC: The General Medical Council was represented by Mr Robert Sastry, of Counsel, instructed by GMC Legal. Doctor: Dr Akhtar was present but not represented. Determination Dr Akhtar, At today’s hearing, the Investigation Committee carefully considered all the material before it including the submissions made by you, and those made on behalf of the GMC by Mr Sastry. It has accepted the advice of the Legal Assessor. The Committee is aware that it must have in mind the GMC’s duty to act in the public interest, which includes the protection of patients, the maintenance of public confidence in the profession and declaring and upholding proper standards of conduct and behaviour. In deciding whether to issue a warning the Committee must 1 apply the principle of proportionality, and balance the interests of the public with those of the practitioner. On 02 December 2013, you wrote to the GMC to inform them that you were charged with common assault on 01 December 2013. On 09 December 2013, the GMC wrote to you to inform you that the allegation would be considered in accordance with fitness to practise procedures. The GMC obtained a copy of the police documentation which detailed the incident. You had attended your ex-wife’s home in order to collect your children as had been pre-arranged. An altercation occurred during which you pulled your ex-wife’s hair, but denied any further misconduct as she alleged. Court proceedings were delayed until June 2014. On 16 May 2014 the Crown Prosecution Service wrote to your solicitors indicating that your basis of plea was acceptable. You then pleaded guilty and were convicted of the charge of ‘assault by beating’. The Court also ordered you to pay a fine, costs, victim surcharge and issued a restraining order. On 29 August 2014, the GMC wrote to you in accordance with Rules 7 and 11 of the General Medical Council (Fitness to Practise) Rules 2004, and advised you that the Case Examiners had considered the allegations and the supporting information, and decided that this was a case which they may decide to conclude with a warning. On 15 September 2014, the GMC received a letter from you stating that, if the Case Examiners were minded to issue you with a warning, you wished to exercise your right under Rule 11 (3) of the Rules to an oral hearing before the Investigation Committee. At this hearing, Mr Sastry submitted that it is proportionate to issue you with a warning and that your actions serve to undermine the public trust in the profession. He stated that although you have demonstrated remorse, it remains a serious incident. He submitted that you have demonstrated little insight and it is of concern that you consider that pulling a person’s hair on the street would not have resulted in the same response, and would not be considered a crime by most people. He submitted further that, given that proceedings with your children are ongoing, there remains potential for repetition. It is of concern that limited steps have been taken to reduce the likelihood of repetition. A warning would therefore act as a deterrent and is an appropriate response. You submitted that you accept the conviction and have demonstrated remorse, including sending a number of written apologies to your ex-wife via her solicitors. You consider that the circumstances surrounding the assault serve as mitigation and that the actions of the victim should be taken into account. You submitted that the background of your situation, in that you and your wife had recently been through an acrimonious divorce, has been disregarded by the GMC and interpreted as a lack of insight on your part. You do not accept that you have demonstrated little insight and submitted that you have told the truth throughout the process. 2 You submitted that you have only received the level of punishment that you have because it was a domestic incident. You feel that you have already suffered unduly due to your temporary suspension by the Deanery for two and half months and the conviction itself. You do not accept that your actions impact on the public confidence in the profession. You submitted that if every doctor convicted of a minor offence were given a warning, you would accept it. Upon questioning you agreed that a conviction for assault would be deemed as serious in the eyes of the public, but submitted that they would be unaware of the background leading up to the incident in your case. You submitted that repetition would not occur, that you have taken rehabilitative steps, and that this was an isolated incident. The Committee has considered all the information before it, including the testimonials presented. The Committee has noted your previous good history, the fact that this is an isolated incident to date, that you have taken some rehabilitative steps including engaging with Occupational Health, and considers that you have demonstrated a degree of remorse. It notes that you informed the GMC promptly of the incident and were cooperative with the investigation. The Committee has had regard to the judgement referred to by the Legal Assessor of Royal College of Veterinary Surgeons v Samuel [2014] UKPC 13. It has carefully considered the circumstances of this case and has decided to give limited weight to it. The case is dissimilar from the case before the Committee today, in that your conviction is directly relevant to your work as a General Practitioner. The Committee considers that your actions fall seriously below the standards expected of a doctor, and that they represent a significant breach of GMC guidelines as set out in Good Medical Practice. It considers that a conviction for common assault is a serious matter which warrants a formal response from the regulator. It is concerned that you do not appear to understand the gravity of your conviction for assault in the context of your work as a medical practitioner, and considers that you have demonstrated limited insight. It considers that there has been a lack of assurance that the incident will not be repeated, particularly given your ongoing situation and plans for the future. It is of concern that your submissions today are inconsistent with your previous statements to the GMC. It does not accept your submission that the circumstances of the conviction do not relate to your everyday practice. It considers that the public may be concerned about a doctor with a conviction for assault potentially dealing with sensitive matters including patients who may be victims of domestic abuse. The Committee has had regard to the Guidance on Warnings, in particular paragraph 33 ‘the level of insight into the failings’ and 20 (d) ‘there is a need to record formally the particular concerns (because additional action may be required in the event of any repetition)’. It is in the public interest for a warning to be given in these circumstances. 3 The Committee considers that a warning is appropriate and proportionate in order to protect the public, uphold the confidence in the profession, uphold proper standards of conduct and behaviour, and act as a deterrent to repetition. It therefore directs that the following warning be attached to your registration: On 6 June 2014 you were convicted of assault by beating contrary to s39 of the Criminal Justice Act 1988. This conduct does not meet with the standards required of a doctor. It risks bringing the profession into disrepute and it must not be repeated. The required standards are set out in Good Medical Practice and associated guidance. In this case, paragraph 65 of Good Medical Practice is particularly relevant: ‘You must make sure that your conduct at all times justifies your patients’ trust in you and the public’s trust in the profession.’ Whilst this failing in itself is not so serious as to require any restriction on your registration, it is necessary in response to issue this formal warning. This warning will be published on the List of Registered Medical Practitioners (LRMP) for a period of five years and will be disclosed to any person enquiring about your fitness to practise history. After five years, the warning will cease to be published on LRMP however it will be kept on record and disclosed to employers on request. You will be notified of this decision, in writing, in the next two working days. That concludes the determination of the Investigation Committee in this case. 4
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