MPTS Hearings and Attendance by Doctors

Do doctors have to attend their MPTS hearings, and what are the consequences for doctors who chose not to do so?

MPTS hearings

The Medical Practitioners Tribunal Service (MPTS) run hearings for doctors whose fitness to practise is called into question by the General Medical Council (GMC). The MPTS operates separately and independently of the investigatory role of the GMC.

In practice, this means that the GMC will refer cases to the MPTS following the conclusion of its investigation and in cases where a doctor’s fitness to practise may be impaired to a degree warranting action on their registration.

Do doctors have to attend their MPTS hearings?

The GMC and/or the MPTS cannot compel a doctor to attend or participate in a hearing. However, doctors should note that the GMC “expects” doctors to “attend any hearings held by the GMC or MPTS” and it is often in the interest of doctors to do so for a multitude of reason. Principle amongst these are the opportunity to respond to allegations and to present, and challenge, evidence.

A doctor’s absence or unwillingness to engage will ultimately be to their detriment.

Can a hearing proceed in my absence?

GMC Rule 31 states that ‘where the practitioner is neither present nor represented at a hearing, the Committee or Tribunal may nevertheless proceed to consider and determine the allegation if they are satisfied that all reasonable efforts have been made to serve the practitioner with notice of the hearing in accordance with these Rules’.

The Court of Appeal previously considered the approach to be adopted by a professional regulator (i.e. GMC) when a registrant (i.e. doctor) does not participate in a disciplinary hearing ‘convened to examine their behaviour’. The Court clarified that the onus is on the doctor to take steps to attend the hearing and arrange representation if they wish to do so, and that ‘although attendance by the practitioner is of prime importance, it cannot be determinative’ due to the adverse impact on the effective and efficient running of hearings.

In essence, therefore, a hearing can proceed in the absence of a doctor where the MPTS is satisfied that all reasonable efforts have been made to serve the doctor with notice of the hearing.

Costly Appeals

Doctors who chose not to attend their hearing or to engage are more likely to face harsher sanctions, including erasure. Whilst, in most cases, there will be a right of appeal for doctors, the courts have taken a dim view of doctors who did not attend their hearing or engaged in the process.

GMC appeals are not hearings afresh, but reviews of decisions. This means that the High Court will examine the MPTS decision to ensure it was fair and correct processes were followed. The examination will consider, as part of the overall case, engagement (or otherwise). In general terms, doctors who did not engagement or attend will be worse off. The High Court has commented:

“I fear that in many cases, registered professionals are not made fully aware of the dangers of not attending. In a regulatory jurisdiction, where issues of insight and remediation are very important, and where the conduct complained of is clearly very serious, non-attendance of the hearing can come close to professional suicide.” – Kimmance v GMC

“In a case of obvious dishonesty, not attending the hearing amounts virtually to courting removal. We are getting a disturbingly high number of cases in which appeals are brought against removals from the statutory registers, imposed at hearings the appellant failed to attend. Given the high number of unrepresented parties in disciplinary proceedings of this kind (of which this case is not one), I think it would be a good idea for the disciplinary bodies to forewarn the defendant not just that a hearing may proceed in his or her absence, but also that the consequences of non-attendance are likely to be severely prejudicial.” – Burrows v GPhC

Approach with Caution

This being said, doctors must approach engagement and attendance with great care. The entire process is complex, drawn out and legalistic. Doctors must seek legal advice at the earliest possible opportunity.

It is important for doctors to understand that obtaining the type of information and evidence that will support a case, relating to relevant contextual factors, is likely to be a long and potentially complex process and early legal advice is important.

Kings View Barristers

With over 30 years combined experience, Kings View Chambers have established itself as one of the best when it comes to fitness to practise defence. We fully understand that fitness to practise defence is not merely about processes and procedures. We also understand that we are working with people who are anxious and worried about what investigations might mean for them, their professions and the reputations.

We are proud to be rated ‘excellent’ by our clients. Our commitment to client care is genuine in both seeking the very best outcomes for our clients, but also ensuring we do what we can to support them through the process.

Contact us today for a no obligation and free telephone consultation about your case in the knowledge that you are speaking to one of the best in the business.

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Our GMC & MPTS Case Success

In upholding the appeal, Alan Bates, sitting as a Deputy Judge of the High Court, said:

Failure to assess witness credibility and reliability The panel did not sufficiently evaluate the general credibility and reliability of key witnesses, whose evidence was essential to the charges. It failed to consider factors such as contradictions between witnesses' accounts and whether their testimonies should be approached with caution. This omission undermined the panel's ability to justify its conclusions.
Lack of explanation for preferred evidence The panel failed to provide adequate reasons for preferring the complainants' evidence over the appellant nurse's and the paramedic's. Simply stating a preference for certain witnesses' accounts without detailed justification left the appellant without a clear understanding of why her evidence was rejected.
Errors in evidence evaluation The panel assessed each charge in isolation without considering broader patterns or contextual evidence. It failed to recognize that inaccuracies in one allegation (contradicted by CCTV) could cast doubt on the reliability of witnesses' accounts in other allegations, leading to flawed conclusions.
Improper handling of contextual evidence The panel neglected to evaluate the behaviour of the complainant nurses during the investigation, which was relevant to determining their credibility. Additionally, it overlooked the appellant nurse's claims that the allegations were fabricated to remove her from her managerial position.
Insufficient reasoning for findings The panel provided inadequate reasoning for its findings of misconduct. It did not fully explain how the evidence supported its conclusions, including why the NMC had met the burden of proof for each disputed allegation. This failure left the appellant with unsubstantiated conclusions, undermining the credibility of the process.

Lessons

This case highlights several critical considerations for fitness to practise tribunals. One key lesson is the importance of thoroughly evaluating the credibility and reliability of witnesses, particularly when their testimony is central to the charges. Without such assessments, the accuracy and fairness of the tribunal’s findings can be compromised. Witness accounts must be examined not only in isolation but also in a broader context, taking into account patterns and inconsistencies to achieve a holistic evaluation.

Additionally, tribunals must provide clear and rational reasoning for their decisions. Merely preferring one witness’s account over another without detailed explanations can lead to procedural unfairness. Ensuring transparency in decision-making fosters trust in the process and supports robust outcomes. Tribunals must also maintain procedural fairness by upholding the burden of proof on the prosecuting body. Accused parties should never feel pressured to disprove allegations, as fairness is crucial to preserving the system’s integrity.

Finally, the impact of procedural delays cannot be underestimated. Prolonged proceedings can cause undue harm to the accused, affecting their career and reputation. Timely resolutions are essential to upholding justice while minimizing unnecessary stress on all parties involved. By focusing on these principles, fitness-to-practise tribunals can enhance the fairness and effectiveness of their proceedings.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.