Doctors and Domestic Violence

Doctors and Domestic Violence in GMC Cases

Doctors-Domestic-Violence-and-the-GMCThe GMC annually receives complaints from spouses or ex-spouses, or their friends and relatives, that a doctor has been violent at home or elsewhere toward their ex-partner or children. Each year a number of doctors will be convicted of the criminal offence of assault or harassment in a domestic violence context. However, a number of false complaints are also made to the GMC each year, out of spite or as a tool to obtain custody of children. In either situation, the GMC will investigate. Some cases are closed on paper and some progress.

The GMC will refer certain complaints it receives from complainants to the police, or wait until the police have investigated an alleged crime. Where there is no conviction or charge (or there has been an acquittal), the GMC might still take action against a doctor on the evidence that it has been obtained by the police or which can be obtained by the GMC. If domestic violence complainants are willing to testify then the GMC may proceed to a hearing.

A doctor who is found to have committed domestic violence clearly brings the profession into disrepute and also undermines confidence in the profession. In such circumstances a doctor might be given a formal GMC warning, which sits on their registration for a period of two years, or be given guidance at the closure (on paper) of the case. See more on this subject at: GMC Investigations.

Doctors might find that the allegations are referred to an interim orders tribunal (IOT), where the strength of the evidence will be examined and given appropriate weight, leading to a risk assessment as to whether or not a doctor should be suspended or given conditions of practise (restrictions)

Where a doctor is referred to a fitness to practise tribunal hearing, and while there is a possibility fo a warning being imposed, where domestic violence has been found proved, the greater likelihood is that a period of suspension will be imposed. In some instances, a doctor’s name might be erased from the register.

domestic violence convictions and the GMCA doctor who is facing criminal allegations should ensure that they have a lawyer attend with them at any police-led interview that they are invited to. What the doctor says and doesn’t say can have an effect on the proceedings that follow, whether they be criminal or GMC proceedings. Where a doctor denies the allegations, they may need to defend their case in a criminal court, civil court, or at the GMC. A lawyer who can represent the doctor at such hearings should ideally be instructed.

Legal aid may be available to some doctors in criminal cases but their earning capacity and assets will often take them above the eligibility threshold. Most doctors prefer to instruct a lawyer on a private basis any way. Doctor are not entitled to legal aid in GMC proceedings, save on appeal, and again subject to eligibility criteria being met. Obtaining legal aid for appeals is now very difficult indeed.

The Local Authority Designated Officer (LADO) will also be consulted by employers and the police, where a doctor is said to have committed domestic violence in front of or nearby children, or been violent towards children. Social workers will generally be instructed to speak to the children, and other individuals, including the complainant and the alleged perpetrator. LADOs will liaise will employers and employers will consider excluding a doctor who is facing such allegations. For more information about LADO procedures, look up the relevant local municipal authority (council) to find their procedures and policies. The GMC will usually liaise with the LADO and vice versa, to meet their respective statutory obligations.

A doctor who admits or is found to have committed domestic violence will usually have to take significant steps of remediation, in order to reassure the GMC or a tribunal, that they are fit to practise. Even where a doctor does not admit to the alleged domestic violence, it is recommended that they undertake steps of remediation. Such positive evidence can be advanced at IOT hearings, Rule 7 stage, and at fitness to practise hearings, and can have beneficial impacts. The importance of remediation, and the demonstration of insight is key to analysing whether a doctor has learned lessons, whether there is a risk of repetition, and can be reassuring to the public that the doctor means what they say

It should be noted that harassment, controlling behaviour, and abuse does not necessarily have to lead to physical violence for the authorities to take action against a doctor. Further, even where the police decide not to proceed with a prosecution, the GMC can still take up the same concerns and bring misconduct proceedings. There are a number of cases where the GMC had brought proceedings of assault and non-consensual sex, among other things, which could also be classified as criminal conduct in the criminal justice jurisdiction.

A number of doctors have been convicted of controlling behaviour, and been imprisoned. A custodial sentence will likely indicate that the doctor’s behaviour was towards the top end of seriousness.

A doctor should be careful what they say about domestic violence allegations, when speaking to the police or GMC, as admissions and denials could be used against them in a number of legal jurisdictions (GMC, DBS, criminal, civil and family courts). In some instances, doctors will make admissions and express regret, and early admissions can indicate that a doctor is developing insight into their conduct.

The case law reminds us that a decision by a MPT tribunal for conduct that falls within the category of domestic violence, can lead to erasure from the GMC Medical Register. In Ibrahim v. General Medical Council [2022] EWHC 2936 (Admin) the appeal court held that erasure was an appropriate sanction (para 37):

Conclusion: 37:”I have addressed issues on this appeal by way of a rehearing. I have exercised an objective judgment on all the materials. I have undertaken an exercise in evaluating, for myself, issues of public protection and issues relating to the reputation of the medical profession. But in doing all of this, I have found the Tribunal’s detailed and careful analysis and reasoning of great assistance. I adopt it because it is cogent and convincing and I agree with it. I find the sanction which was imposed in this case fully objectively justified, for the reasons given by the Tribunal. In my judgment, the sanction was not “wrong”; erasure was not “excessive” or “disproportionate”; suspension would not have met the public interest concerns properly identified, and erasure was objectively appropriate and necessary in the public interest. Erasure was necessary to promote and maintain proper conduct standards, and to promote and maintain public confidence in the medical profession, and to achieve both of those aspects of the statutory overarching objective. Having reached those views, on the particular facts and features of this individual case, I dismiss the appeal.” per Fordham J.

The history was set out by the judge (para 3) with the overarching objective explained subsequently (para 4):

“3. The context for the issues which the Tribunal was addressing concerned the domestic setting within a family home, involving a married couple: the Appellant and his ex-wife (“Ms A”), living with their young son (“Child B”). What had happened was this. On 17 April 2019 Ms A reported to the police an incident of domestic violence. The Appellant was charged with assaulting Ms A by beating. He denied the charge and pleaded not guilty. He was convicted by the magistrates on 19 September 2019. He was sentenced on 4 November 2019 to a community order with a fine. The conditions of the community order included the “building better relationships” (BBR) programme and a “rehabilitation activity requirement” (RAR). The Appellant complied with those requirements as called on to do. He completed the RAR with its 6 one-hour managing emotions sessions, and 6 one-hour counselling sessions. He completed one module out of the four modules of the BBR programme, being excused from the rest after the intervention of the Covid-19 pandemic. The community sentence and conditions were confirmed as expired on 22 January 2021. The GMC then took the case up, pursuant to its regulatory procedures, the Appellant having made a self-referral to the GMC on 10 May 2019. Ms A provided evidence to the GMC, to a large extent covering the same ground as “victim impact assessment” evidence which had been before the magistrates’ court. In due course, as I have mentioned, Ms A gave oral evidence at the hearing before the Tribunal; as did the Appellant.”

“The Overarching Objective 4. Section 1(1A) of the 1983 Act states that the “overarching objective” of the GMC in exercising its functions is the “protection of the public”. Section 1(1B) provides that the pursuit of the overarching objective involves the pursuit of the following objectives: (a) “to protect, promote and maintain the health, safety and well-being of the public”, (b) “to promote and maintain public confidence in the medical profession”, and (c) “to promote and maintain proper professional standards and conduct for members of that profession” Per Fordham J.

(November 2022)

With doctors facing such risks in domestic violence cases, a doctor should take steps to present appropriate and relevant evidence to the GMC. We can advise on the steps to take in a given case, and in particular how to provide reassuring evidence to deal with policy concerns arising under the umbrella of the  overarching objective. The GMC’s overarching objective will be a key consideration to decision-makers, who must apply it pursuant to the sanctions guidance. A doctor who is facing domestic violence allegations should give considerable thought to how they will present evidence relating to facts and their credibility, evidence relevant to misconduct, and evidence relevant to impairment and sanction.

If you are a doctor facing allegations of domestic violence, call Doctors Defence Service on 0800 10 88 739 in strict confidence. Or use our online Contact Form.

Written by

Doctors Defence Service (DDS) assists medical doctors who are registered with the General Medical Council (GMC) in the United Kingdom (UK) and also those doctors from abroad who wish to register and practise as doctors in the UK. Doctors Defence Service also assists doctors in relation to all other legal issues arising from daily practice and operating businesses in the clinical arena. DDS represents doctors in FTP and IOP GMC proceedings, at inquests, in general civil cases, in commercial and contract law, in revalidation matters, and employment law. Doctors Defence Service can be contacted on 0800 10 88 739. We have main offices in London, Manchester, and Telford. We cover most other UK regions too.