Controlling and Coercive Behaviour: Widening the Net
The Panel of the General Medical Council were correct to sanction erasure for conduct showing a “blatant disregard for patient safety”
In this case, Dr Cornish, a Consultant Anaesthetist at Yeovil District Hospital had been struck off the register. The Panel found that his fitness to practise was impaired on the grounds of (1) a conviction for theft of drugs from his employer (2) misconduct (for taking drugs from the hospital and administering them on Trust premises and at home) and (3) his adverse physical or mental health (Opioid Dependence Syndrome; he had abused medicinal drugs such as Fentanyl and Morphine, obtained in the course of his employment, for many years).
It was decided that the allegation of impairment by reason of health would be considered together with the conviction at the General Medical Council (GMC) hearing.
Dr Cornish did not contest the finding that his fitness to practise was impaired, but he appealed against the Panel’s determination that he had self-administered drugs within the hospital building, arguing that he had only done this in the hospital car-park. He also appealed the sanction of erasure.
His appeal was dismissed. Justice Lang ruled that the Panel were entitled to find that Dr Cornish had self-administered within the hospital buildings. He was not a credible witness given his consistent lies about his drug history. The Panel set out an “impressive summary” of the evidence prior to outlining its conclusions, and its reasons were full and clearly stated.
Dr Cornish argued that the Panel was wrong to reject his submission that the drugs paraphernalia found in his locker was used as a holding place for used drugs detritus brought from his car or home, arguing that the Panel treated this as circumstantial evidence supporting the GMC’s submission that he had injected in the hospital buildings. This submission was rejected. With the benefit of advice from the Legal Assessor, the Panel had correctly directed itself on the use of circumstantial evidence and on the burden and standard of proof.
As for sanction, Dr Cornish argued that the Panel failed to view his misconduct in the proper context by failing to give appropriate weight to the evidence that his misconduct was linked to his ill-health. He also argued that the Panel failed to take into account his attempts to remediate his opioid dependence. Justice Lang stated that Dr Cornish’s grounds of appeal on this point failed to acknowledge the seriousness of his misconduct, and that the Panel was justified in finding that Dr Cornish did not have sufficient insight. Dr Cornish had showed a “blatant disregard for patient safety”, and it was more by good luck than good management that no patients were harmed. The Panel was also justified in concluding that it was not convinced that Dr Cornish would not repeat the behaviour if given the opportunity.
Clearly, the credibility of the registrant in conjunction with the severity of their misconduct are factors that play an important role in supporting a regulator’s findings and decision on sanction.
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