AC-2025-CDF-000062 - [2025] EWHC 2619 (Admin)

Firstly, the appellant submits that the Guidance neither states nor implies that offences of violence should lead to erasure. He accepts that erasure may be imposed where this is the only means of protecting the public (Guidance, para 107) but submits that nothing emerges from the Guidance to suggest that, in cases involving violence, public protection will invariably outweigh the extremely serious consequences of erasure which may mean that a person never works as a doctor again.

In support of this submission, the appellant points out that an offence of violence is one of a number of factors listed at para 109 of the Guidance that “may indicate” (emphasis added) that erasure is appropriate, leaving a wide discretion to the MPT to impose a lesser sanction. He emphasises para 119 of the Guidance which states that, as a general principle, a doctor who has been convicted of a serious criminal offence should not be permitted to resume unrestricted practice until they have completed their sentence. He submits that this statement of general principle would not make sense if erasure were the invariable sanction in cases of serious criminal convictions. He directs the court’s attention to passages in the Guidance which state that certain conduct is likely to result in erasure, namely dishonesty (Guidance, para 128); predatory behaviour (Guidance, para 148); and sexual misconduct (Guidance para 150). He submits that there is no such steer to tribunals in relation to violence and that the absence of any such steer should have driven the MPT to be more cautious before imposing erasure.

In my judgment, the Guidance is a practical document intended to be used by tribunals for the purpose of ensuring proportionate and consistent decision-making in the sphere of regulatory sanctions. It does not need to be exhaustive and cannot capture all scenarios that the MPT must adjudicate upon. The Guidance expressly indicates that offences of violence may lead to erasure which is in my judgment a sufficient steer for the purposes of the present case.

I reject the proposition that, upon a fair reading, the Guidance establishes a hierarchy of offences, with violence falling lower in the hierarchy than dishonesty, predatory behaviour and sexual misconduct. The Guidance facilitates a fact-sensitive approach to the imposition of sanctions. It was the duty of the MPT to consider the facts of the case and to conclude for itself whether erasure was appropriate in the appellant’s case. That is what the MPT did.