PUBLIC RECORD · give further evidence to the Tribunal by means of a video link given his availability and clinical commitments. Mr Jenkins did not object to this application and

Record of Determinations – Medical Practitioners Tribunal

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PUBLIC RECORD Dates: 02/09/2019 - 13/09/2019 08/10/2019 03/03/2020 – 06/03/2020

Medical Practitioner’s name:

Dr Abdul BASIT

GMC reference number: 7081034

Primary medical qualification: MBBS 2009 National University of Science and Technology - Army Medical College

Type of case New - Misconduct

Outcome on impairment Impairment

Summary of outcome

Suspension, 4 months

Tribunal:

Legally Qualified Chair Mrs Jayne Wheat Lay Tribunal Member: Mr Michael Crewe Medical Tribunal Member: Dr Nisreen Booya Tribunal Clerk: Dr Joshua Kirby 02/09/2019 -

13/09/2019 Mr David Salad 08/10/2020 Miss Fiona Johnston 03/03/2020 – 06/03/2020

Attendance and Representation:

Medical Practitioner: Present and represented Medical Practitioner’s Representative: Mr Alan Jenkins, Counsel, instructed

directly GMC Representative: Ms Elizabeth Dudley-Jones, Counsel


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Attendance of Press / Public In accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004 the hearing was held in public Overarching Objective Throughout the decision-making process the Tribunal has borne in mind the statutory overarching objective as set out in s1 Medical Act 1983 (the 1983 Act) to protect, promote and maintain the health, safety and well-being of the public, to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional standards and conduct for members of that profession. Determination on Facts - 08/10/2019 1. The Tribunal determined in accordance with Rule 41 of the General Medical Council (‘GMC’) (Fitness to Practise) Rules 2004 (‘the Rules’), that as matters which form the subject of the Allegation refer XXX that this determination will be announced in private. However, as matters under consideration relate to Dr Basit’s alleged misconduct, a redacted version of this determination will be published after the hearing. Background 2. Dr Basit qualified in 2009 in Pakistan. He passed the Professional and Linguistic Assessments Board (‘PLAB’) exam and obtained full GMC registration with a licence to practise on 12 December 2013. Dr Basit arrived in the UK in July 2014, and worked as a Resident Medical Officer in private sector hospitals for six months. He then worked as a Clinical Fellow in Stroke Medicine at Salford Royal NHS Foundation Trust between February and September 2015 when he moved to the Emergency Medicine Department at West Cumberland Hospital, Whitehaven, part of North Cumbria University Hospital Trust (‘the Trust’). 3. At the time of the events Dr Basit was working as a Trust Grade Doctor in a 12-month fixed-term post in the Dermatology Department at Cumberland Infirmary, Carlisle, also part of the Trust. Dr Basit then secured a surgical rotation mirroring the Core Surgical Training with Newcastle Upon Tyne NHS Hospital Trust in June 2016 which started in August of the same year. 4. The allegation that has led to Dr Basit’s hearing relates to acts of physical violence which allegedly took place in a domestic setting. The allegation can be summarised as follows. It is alleged that on or about 15 May 2016, in Brighton, Dr Basit hit Dr A, XXX,


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in the face and on the ear, and that he also hit Dr B, XXX, in the face. It is further alleged that on one or more occasions between February 2016 and July 2016 Dr Basit pushed and/or shoved Dr A and/or squeezed her neck with his hand. 5. The initial concerns were raised with the GMC on 8 October 2017 by Dr A. The Outcome of Applications Made during the Facts Stage 6. On day four of this hearing, Thursday 5 September 2019, the GMC closed its case. Ms Dudley-Jones then informed the Tribunal that a piece of ‘significant evidence’ had just been disclosed to her by Dr Basit’s representative, Mr Alan Jenkins, (described by him as ‘unused material’) which she needed time to consider. The Tribunal heard that the evidence consisted of two audio recordings made at the time of the incident in Brighton on or about 15 May 2016. While Dr Basit had arranged a transcript/translation to be made of the recordings, the GMC indicated that it would need to speak to both Dr A and Dr B and potentially seek an independent transcript/translation which may take up to several weeks. The GMC consequently applied for an adjournment under Rule 29(2) of the Rules until the morning of Friday 6 September 2019 for the relevant enquiries to be made. There was no objection from Mr Jenkins. The Tribunal granted the adjournment because it considered that it was in the interests of justice to do so. 7. On day five of this hearing, Friday 6 September 2019, Ms Dudley-Jones applied for a further adjournment under Rule 29(2) until Monday 9 September 2019. The adjournment was for further witness statements to be taken from both Dr A and Dr B in relation to the audio recordings of the Brighton incident and for an independent translation/transcript which she confirmed would take 24 hours. There was no objection from Mr Jenkins and the Tribunal was satisfied that it was in the interests of justice to grant the application. 8. On day six of this hearing, Monday 9 September 2019, Ms Dudley-Jones applied to re-open the GMC’s case, to admit further evidence under Rule 34, and to re-call Dr A and Dr B to give further evidence. The proposed evidence consisted of the two audio recordings of the Brighton incident, supplemental witness statements from Dr A and Dr B, and a translation/transcript of the audio recordings obtained by the GMC. There was no objection to these applications by Mr Jenkins. The Tribunal considered that the evidence was relevant to its consideration of paragraphs one and two of the allegation. Given the circumstances in which the evidence had been presented to it, the Tribunal also determined that it would be fair to admit it. The Tribunal therefore determined to admit the audio recordings, further witness statements and the translation/transcript of the recordings into evidence. The Tribunal also determined to grant the GMC’s application to re-open its case and to re-call Dr A and Dr B to give further evidence.


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9. The Tribunal also granted the GMC’s application, made pursuant to Rule 34, that a document consisting of Dr A’s comments on the translations/transcripts of the two audio recordings be admitted into evidence. Mr Jenkins did not object to this application and the Tribunal considered that it was both relevant and fair to admit it. 10. The GMC subsequently made an application under Rule 34(13) for Dr B to give further evidence to the Tribunal by means of a video link given his availability and clinical commitments. Mr Jenkins did not object to this application and the Tribunal considered that it was in the interests of justice to grant it. 11. The Tribunal granted several applications made by Mr Jenkins on Dr Basit’s behalf pursuant to Rule 34 during the facts stage of the hearing. Mr Jenkins applied to admit the following documents into evidence:

• Dr A’s bank statements for March-April 2016; • Emails from Dr A to Dr B attaching those statements; • A Pakistan Police Clearance Certificate; • A further witness statement from Dr Basit dated 9 September 2019 and

an attached Police MG4F form dated 15 May 2016; • Dr Basit’s XXX Bank Statements for March-May 2016; • An extract from Dr Basit’s first interview with Northumbria Police on 1

November 2016; and • Dr Basit’s XXX Bank Statement for 12 March to 11 April 2016.

12. Ms Dudley-Jones did not object to these documents being admitted in principle, however she expressed concerns that the contents of Dr Basit’s bank statements had not been put to Dr A during her evidence to the Tribunal and submitted that no weight should be attached to them by the Tribunal. XXX, the Tribunal considered that the bank statements were relevant to its considerations and that it would be fair to admit the documents. However, it determined that what weight it would attach to these documents would be a matter for its own judgement in due course. Similarly, Ms Dudley-Jones urged caution with regard to the Pakistan Police Clearance Certificate, dated 7 September 2016, placed before the Tribunal which purported to show that Dr Basit had no criminal record at his ‘place and period of stay’. The certificate was valid for 180 days. She explained she had not had any opportunity to verify the authenticity of the document. Again, the Tribunal determined the document was relevant and it was fair to receive it, as there had been evidence given by Dr’s A and B that Dr Basit XXX. It determined to consider the document and apportion what weight it saw fit to it, in due course. The Allegation and the Doctor’s Response 13. The Allegation made against Dr Basit is as follows:

That being registered under the Medical Act 1983 (as amended):


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1. On or about 15 May 2016 in Brighton you hit Dr A:

a. In the face, To be determined

b. On the ear. To be determined

2. On or about 15 May 2016 you hit Dr B in the face. To be

determined

3. On one or more occasions between February 2016 and July 2016 you:

a. Pushed Dr A and/or To be determined

b. Shoved Dr A and /or To be determined

c. Squeezed Dr A’s neck with your hand. To be determined

And in relation to the above your fitness to practice is impaired because of your misconduct. To be determined

Factual Witness Evidence 14. The Tribunal received evidence on behalf of the GMC from the following witnesses:

• Dr A, in person; • Dr D, in person; and • Dr B, in person and subsequently by video link.

15. Dr Basit provided his own witness statements, dated 15 July 2019 and 9 September 2019, and gave oral evidence at the hearing. Documentary and other Evidence 16. The Tribunal received into evidence two partial audio recordings of the incident in Brighton on 15 May 2016 provided by Dr Basit. 17. The Tribunal had regard to the documentary evidence provided by the parties. This evidence included, but was not limited to:

• six statements made by Dr A to Northumbria Police, dated: o 12 October 2016; o 25 October 2016;


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o 6 November 2016; o 8 November 2016; o 15 November 2016; and o 16 May 2017;

• Dr A’s Research Experience Certificate, dated 29 January 2016; • Dr A’s XXX statement for March 2016; • Dr A’s XXX statement for 22 March to 21 April 2016; • Sussex Police’s call-log of Dr B’s 999 call on 15 May 2016; • Witness statement of PC E of Sussex Police, dated 15 May 2016; • A Sussex Police MG4F Form for Dr Basit, dated 15 May 2016; • Two translations/transcripts of the audio recordings of the incident in

Brighton on 15 May 2016 from Rosetta Translation, dated 3 May 2019 and 30 August 2019 respectively provided by Dr Basit;

• A translation/transcript of the audio recordings of the incident in Brighton on 15 May 2016 from Translation Empire, dated 9 September 2019 provided by the GMC;

• Dr Basit’s XXX Bank statements for February to June 2016; • Dr Basit’s XXX statement for 12 March to 11 April 2016; • A XXX from Dr A to Dr Basit dated 8 June 2016; • A Pakistan Police Clearance Certificate for Dr Basit dated 7 September

2016; • XXX • A Northumbria Police Incident details form and Police Record, both dated

24 October 2016; • An extract from Dr Basit’s Police Interview with Northumbria Police on

1 November 2016; • Dr Basit’s Police Interview with Northumbria Police on 17 November 2016; • XXX • XXX • XXX • Dr A’s email complaint to the GMC, dated 8 October 2017; and • Correspondence from Cumbria Police to the GMC, dated 12 February

2018, 16 February 2018, and 4 April 2018. The Tribunal’s Approach 18. In reaching its decision on facts, the Tribunal has borne in mind that the burden of proof rests on the GMC and it is for the GMC to prove the Allegation. Dr Basit does not need to prove anything. The standard of proof is that applicable to civil proceedings, namely the balance of probabilities, i.e. whether it is more likely than not that the events occurred. 19. The Tribunal accepted the direction of the Legally Qualified Chair, subsequently confirmed by the parties, that Dr Basit is otherwise a person of good character. While good character is not in itself a defence to the allegation, it is nonetheless relevant to


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the Tribunal’s consideration of Dr Basit’s alleged actions in two ways. First, Dr Basit’s good character is a positive feature which supports his credibility. Second, the fact that Dr Basit has not acted as alleged in the past may make it less likely that he acted as is alleged. It is a matter for the Tribunal’s own judgement to decide what weight to give to Dr Basit’s good character and the extent to which it assists on the facts of this particular case. The Tribunal’s Analysis of the Evidence and Findings 20. The Tribunal has considered each paragraph of the Allegation separately and has evaluated the evidence in order to make its findings on the facts. The Tribunal’s Assessment of the Credibility and Reliability of the Witnesses 21. The Tribunal accepted the submissions of both parties that the credibility and reliability of all the witnesses is the key issue in this case. Dr A 22. The Tribunal found Dr A to be a generally credible and reliable witness whose oral evidence was largely consistent with her various statements made to the Police and her GMC witness statements. In particular, the Tribunal found Dr A’s account of what happened in Brighton on or about 15 May 2016 to be compelling, especially her description of being struck in the face by Dr Basit. 23. In respect of the acts alleged at paragraph three of the allegation, the Tribunal noted that Dr A did not report any physical violence initially, XXX or her first interview with Northumbria Police in October 2016. It further noted that her statement made XXX is the first that describes the incident in Brighton in May 2016. She stated that this was ‘The first and worst incident of violence’. XXX. 24. XXX 25. XXX 26. XXX Dr B 27. The Tribunal found Dr B to be a credible witness overall. In respect of events in Brighton on or about 15 May 2016, the Tribunal considered that Dr B did attempt to minimise the level of his verbal aggression in the argument which preceded the incident but it noted that Dr B also fully volunteered that he had himself acted violently, in his description to the Tribunal of his attempts to restrain Dr Basit in self defence, which included the use of a ‘headbutt’. The Tribunal noted that Dr B’s


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account of events in Brighton was supported for the most part by Sussex Police’s Report into the incident. Dr B described Dr Basit as the aggressor and the Tribunal noted that Sussex Police’s Report into the incident only describes injuries to Dr B, and not Dr Basit. The Police also treated Dr B as the victim of an assault, which was commensurate with Dr B’s account of how events unfolded. 28. Dr B’s oral evidence regarding events in Brighton was consistent with his witness statement; while Dr B provided more detail in his evidence to the Tribunal he prefaced this by accepting that what he recorded in his statement was a summary of what had happened. The Tribunal found the details provided by Dr B to be persuasive. Dr B was adamant in his evidence that he had provided a statement to Sussex Police and that photographs of his flat had been taken. He was able to recall details of exactly what was photographed and where he was taken to make a statement, ie his cloakroom. Whilst PC E was reported to have said that he could not remember photographs being taken and that no statement was taken, the Tribunal accepted Dr B’s evidence on this point. Dr D 29. Dr D was a university lecturer for twenty-five years XXX. The Tribunal considered Dr D to be a credible, reliable, fair, measured and independent witness. Dr D’s evidence to the Tribunal was consistent with her witness statement and the affidavit she produced on Dr A’s behalf XXX. The Tribunal was satisfied from the evidence that Dr D and Dr A were not friends and that Dr D had maintained her independence as a witness in the time since the events in question took place. 30. XXX Dr Basit 31. Overall the Tribunal found Dr Basit to be a less credible and reliable witness than Dr A and Dr B. The Tribunal found Dr Basit’s explanation of XXX to be somewhat contradictory. The Tribunal did not accept this, preferring the evidence of Dr A. 32. XXX The Tribunal acknowledges that Dr Basit does not have to prove anything in this case. However, it found the explanations he did give in relation to XXX to be unlikely. XXX. Similarly, it found his explanation that she has made these allegations against him in order to ‘decimate him’ to be also unlikely. 33. In respect of the events that took place in Brighton on or about 15 May 2016, the Tribunal found Dr Basit’s evidence to be unsatisfactory. Dr Basit’s evidence was that he did not say anything to Sussex Police when he was cautioned by them. However, Dr Basit then told the Tribunal that he had an ‘off the record’ conversation with the arresting officer about himself being the victim of an assault by Dr B when


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being escorted to the Police station. Given the witness statement from the arresting officer detailing his arrest, caution and transport to Brighton custody the Tribunal found this unlikely. 34. In respect of the audio recordings of the incident in Brighton, the Tribunal considered the two explanations given of how Dr Basit came to record the incident that he gave to the Police and the Tribunal were markedly different. In his first interview with Northumbria Police, which took place on 1 November 2016, Dr Basit stated that he had been ‘playing’ with his mobile ‘phone, trying to contact his mother in Pakistan by WhatsApp and that his iPhone in effect recorded the incident that followed accidentally. However, in his witness statement and oral evidence to the Tribunal Dr Basit was consistent in saying that he had intended to record the incident from the outset to demonstrate to his mother the disrespect that Dr B had shown towards him. He explained, in answer to Tribunal questions, the mechanism on his phone for so doing. It was not disputed that the recordings do not capture all of what happened. However, the Tribunal noted that the only parts of the incident captured on Dr Basit’s recording are those parts which lead up to the alleged assaults, (not the alleged assaults themselves), and which have the potential to portray Dr B as disrespectful and angry towards Dr Basit. 35. The Tribunal also noted that in his first interview with Northumbria Police Dr Basit was asked if he had ever assaulted Dr A in the manner alleged at paragraph three of the allegation. Dr Basit responded that Dr A had never said that he had assaulted her. The Tribunal considered this response to have been evasive and was not the same as clearly answering ‘no’. 36. The Tribunal found some of the language used by Dr Basit throughout his evidence to be revealing and supportive of Dr A’s evidence about the nature of his personality XXX. The Tribunal’s Evaluation of the other Evidence The Bank Statements of Dr Basit 37. The Tribunal has been provided with a number of bank statements showing sums of money being transferred from Dr Basit’s account to Dr A’s account. The Tribunal accepted Ms Dudley-Jones’ submission that due to the stage in the proceedings at which those statements were admitted into evidence, Dr A did not have an opportunity to comment on the payments and provide an explanation as to what they related to. The Tribunal therefore determined to attach no weight to these documents when making its decisions. Dr A’s Research Certificate


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38. Dr Basit contends that Dr A’s Research Experience Certificate is fraudulent in that the first day of Dr A’s work as stated was actually a public holiday in Pakistan. The Tribunal considered that matters such as establishing public holidays in Pakistan were not capable of resolution by it and were of little relevance to its overall deliberations on the specifics of the allegations. Furthermore, it accepted the evidence of Dr A, in that she undertook the research in her own time and the certificate simply recorded the start and end dates of her association with the research. It therefore took the certificate at face value and attached no weight to it. XXX 39. XXX. XXX 40. XXX. The Audio Recordings and Transcripts/Translations of the Brighton Incident 41. The Tribunal has been provided with two partial recordings of the incident in Brighton on or about 15 May 2016. The recordings were made by Dr Basit on his iPhone 5C. As noted above, Dr Basit has provided two conflicting explanations as to how the incident in Brighton came to be recorded. He told the Tribunal that when he took his phone out at the end of the Brighton incident, it had already stopped recording at some earlier point. He said that originally there was one recording on his phone. When interviewed by the Police in late 2016, Dr Basit’s iPhone 5C was confiscated for around 14 months. Dr Basit’s evidence was that his phone had ‘died’ while confiscated by the Police and that his legal team in Pakistan had retrieved the data, by which time there were two recordings which did not comprise the entirety of events. The evidence of Dr A and Dr B was that the recordings had been ‘tampered with’ by Dr Basit. The Tribunal is unable to resolve the issue of whether tampering had occurred. The Tribunal accepted that the various transcripts and translations of the audio recordings provided to it broadly reflect what was said during part of the incident, notwithstanding slight differences in phrases and wording. 42. It was accepted by Dr Basit, Dr A and Dr B that the two recordings do not comprise the totality of events in Brighton on the evening in question and that they only capture the start of the incident, when Dr Basit entered the living room of Dr B’s flat and a verbal argument ensued between Dr Basit and Dr B followed by pushing and shoving between the two. The Tribunal was satisfied that the recordings clearly demonstrate a heated verbal argument taking place between the two men and that Dr A was very upset by what was occurring. It noted that Dr B did use the informal Urdu word ‘tum’ to refer to Dr Basit. The Tribunal considered that both men appeared to be angry from the tone of their exchanges. Given the Tribunal


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did not have a complete recording of the incident it concluded that the partial audio recordings could not be relied upon to resolve paragraphs 1 and 2 of the allegation. Testimonial Evidence 43. The Tribunal has read and evaluated the testimonials provided regarding Dr Basit’s character. It accepts them at face value, they are evidence of the way in which Dr Basit conducts himself professionally and when sharing hospital accommodation, and the high regard those writing the testimonials hold him in. XXX. XXX 44. XXX. The Pakistan Police Clearance Certificate 45. The Tribunal accepted this certificate at face value but noted that it was not of assistance in terms of resolving the specifics of the allegation. As previously noted for the purposes of this hearing Dr Basit has been treated as a person of good character. Paragraphs 1 and 2 46. Paragraphs 1 and 2 of the Allegation relate to an incident which occurred on or about 15 May 2016 in Brighton. 47. It was not disputed that Dr Basit, Dr A, and Dr B all had a Core Medical Training interview in London on Friday 13 May 2016. Dr B lived in Brighton, and Dr Basit and Dr A drove to Brighton to pick Dr B up and to take him to London with them. After the interviews in London, Dr Basit drove Dr A and Dr B back to Brighton where they stayed at Dr B’s flat in Brighton XXX. It was accepted that Dr Basit, Dr A and Dr B then spent the day together in Brighton on Saturday 14 May 2016, where they saw a film and ate out together at a restaurant. Both Dr Basit and Dr B accepted that their relationship was strained. 48. It was also not disputed that on the evening of 14 May 2016 and in the early hours of 15 May 2016 a physical altercation took place at Dr B’s flat between Dr B and Dr Basit, in which Dr A was caught up. However, the details of that altercation, which form the basis of paragraphs one and two of the allegation, are disputed. Paragraph 1 49. Dr A, Dr B and Dr Basit all accept that on the evening of 14 May 2016, after they had returned to Dr B’s flat, Dr Basit and Dr A were in the bedroom of the flat while Dr B was in the living room. Dr A’s evidence was that Dr Basit was screaming


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at her, that she was crying, and that Dr B, having heard the commotion, knocked on the bedroom door to ask if everything was OK. Dr B’s evidence was that he was in the living room and could hear shouting, screaming and crying and that Dr Basit was admonishing Dr A about her academic success. Dr Basit’s evidence was that he was talking to Dr A about Dr B’s behaviour at the restaurant XXX. It was accepted that when Dr B knocked on the bedroom door Dr A left the bedroom and spoke with him in the living room about what was happening. 50. Dr Basit’s evidence was that he could hear the conversation that took place between Dr A and Dr B from the bedroom. His evidence was that he could hear Dr A ‘blaming [him]’ and Dr B using ‘abusive language about [him] XXX. The Tribunal has already set out above, the differences in his accounts of how what followed came to be recorded. 51. Dr A’s evidence was that when Dr Basit entered the living room from the bedroom he started ‘provoking’ Dr B to a fight. Similarly, Dr B’s evidence was that Dr Basit ‘confronted’ him and that Dr Basit was being ‘very aggressive’ and was pointing at Dr B ‘in an intimidating manner’. Dr Basit’s evidence was that he entered the living room and pulled up a chair and said to Dr B that if he had any issues with Dr Basit they should discuss them calmly. Dr Basit’s evidence was that Dr B reacted to this by pointing his finger at him. It was accepted that Dr Basit and Dr B subsequently engaged in pushing and shoving which the Tribunal noted is apparent from the audio recording. 52. The evidence of Dr A and Dr B was that Dr Basit was the aggressor in what followed, in that Dr Basit deliberately hit Dr A in the face and on the ear. Dr Basit contends that if Dr A was struck it was by Dr B, who he asserts was the aggressor. All three witnesses agree that while Dr Basit and Dr B were pushing and shoving each other Dr A at some point stood between them. Dr A and Dr B assert that she did so in order to try to stop Dr Basit hitting Dr B, while Dr Basit asserts that Dr A stood between him and Dr B in order to ‘stop [Dr B’s] aggression’. 53. Dr A’s evidence was that while she was standing between Dr Basit and Dr B, Dr Basit struck a blow which caught her on her left cheek and ear and caught Dr B on the face. Dr Basit’s evidence was that Dr B had ‘aggressively tried to punch [him] in the face with his right fist’ and as Dr Basit dodged that blow, Dr A was struck on her face by Dr B. Dr Basit’s evidence was that he was trying to push Dr B off him ‘in self-defence’ rather than ‘actively fighting back’. Dr B’s evidence, and that of Dr A, was that Dr B restrained Dr Basit on the sofa after Dr A had been hit. 54. The evidence of both Dr A and Dr B was that Dr A sustained physical injuries from the blow from Dr Basit, namely swelling and bruising over her left eye which worsened over the following days.


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55. The Tribunal found Dr A’s description of being hit in Brighton to be compelling. She described being hit and told the Tribunal that she had found it shocking and humiliating as it was the first time she had ever been hit in the face. The Tribunal found her oral evidence upon this to be persuasive. Having had regard to Dr A’s statement XXX, in which she describes being hit in Brighton, the Tribunal considered that the details of the incident contained therein were consistent with her account to the Tribunal, particularly in respect of her ear ringing afterwards for a short period which she also explained to the Tribunal during her evidence. 56. Dr B described him and Dr A as standing ‘in unity’ against Dr Basit, with Dr A standing with her back to Dr B and facing Dr Basit. The Tribunal considered that this description of how Dr A and Dr B were standing supported their version of events. Had Dr A been standing with her back to Dr Basit, as he maintained, the Tribunal determined it was unlikely that he would have been positioned to hit her in the face causing a swelling around her left eye. The Tribunal did not accept Dr Basit’s version of events that Dr A was caught by a blow aimed at him by Dr B. 57. The Tribunal accepted that Dr A did not wish to make a statement to Sussex Police when they arrived at the scene and it accepted her evidence XXX. The Report from Sussex Police confirms that Dr B was the complainant. Consequently, the focus of their attention and later report was on Dr B and the injuries he sustained, and not on Dr A. While Dr A did not report what happened in Brighton or her injuries to the Police at the time or to Northumbria Police when she was interviewed by them a number of times, she did describe what happened in XXX. The Tribunal was satisfied that since disclosing this violence and the injuries caused, Dr A’s evidence about it has been consistent. 58. The Tribunal was not able to determine why the police did not document any injury caused to Dr A. The Tribunal did not draw any inference from a lack of independent corroboration of Dr A’s injuries, for example by way of a statement from Dr D or others. There could have been any number of explanations as to why this was the case and the Tribunal did not speculate. 59. In all the circumstances, the Tribunal was satisfied that Dr A and Dr B’s versions of events were more credible than Dr Basit’s, and it considered, on the balance of probabilities, that it was more likely than not that Dr Basit did hit Dr A in the face and on the ear on the night of 14-15 May 2016. The Tribunal therefore found paragraph 1 of the allegation proved. Paragraph 2 60. The Tribunal has already found that on or about 15 May 2016 Dr Basit hit Dr A on the face and on the ear during his altercation with Dr B in Dr B’s flat in Brighton. Dr B’s evidence was that Dr Basit deliberately aimed a blow which connected with Dr A’s face, and that it was the same blow that carried through to


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his face. Dr B’s evidence was that while he did not know if Dr Basit punched or slapped him, he definitely felt Dr Basit’s hand come into contact with his face during the altercation. 61. The Tribunal had regard to Sussex Police’s log of Dr B’s 999 call made at 00:50 on the morning of 15 May 2016. The log states as follows: ‘XXX’ [Dr Basit] has hit me [Dr B] in the face and assaulted XXX [Dr A] (XXX)’. The Tribunal noted that when asked if the assault had been ‘deliberately targeted’ Dr B answered in the affirmative. 62. The Tribunal also had regard to the witness statement of PC E, who attended the scene following Dr B’s 999 call. PC E wrote that upon arrival at the scene Dr B ‘had an injury above his left eye, scratches to his neck and a bruise on his forehead’. PC E cautioned Dr Basit, who was taken into custody in Brighton, and in his statement described Dr Basit as ‘an Asian male, five foot seven tall with short dark hair. He was wearing a light brown long sleeved cotton top and cotton trousers of the same colour’. There was no description of any injury to Dr Basit. In Sussex Police’s report, it was confirmed that Dr Basit was arrested for assault and that both Dr A and Dr B both confirmed that they did not wish to pursue a formal police complaint and/or provide a statement to the Police. 63. Sussex Police’s call log, the witness statement of PC E, and the Police Report are all contemporaneous evidence of an assault having taken place on the evening in question and support Dr B’s account of events; namely, that Dr Basit was the aggressor who hit Dr B in the face, whom Dr B then went on to attempt to restrain, incurring both the bruise to his head from the ‘headbutt’ he described using on Dr Basit and scratches to his neck as a result. As noted above, the Tribunal considered Dr A and Dr B to be more credible and reliable witnesses than Dr Basit. The Tribunal determined that it was more likely than not that Dr Basit did hit Dr B in the face and accordingly it found paragraph two of the allegation proved. Paragraph 3 64. The GMC’s case is that on one or more occasions Dr A was subjected to various acts of physical violence by Dr Basit XXX. 65. XXX. Dr A’s evidence was that the physical acts she was subjected to, and which are the subject of paragraph 3 of the Allegation, took place against the backdrop of a pattern of emotional, psychological, and verbal abuse. Dr A’s further evidence was that the acts of physical violence became more frequent after the events that occurred in Brighton on or about 15 May 2016 which the Tribunal has found proved as described and determined above. The GMC contends that Dr A’s evidence about the abuse she suffered is supported by the independent and objective evidence of Dr D, who observed a change in Dr A throughout the time XXX.


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66. XXX. 67. It was not disputed that the following day, 9 July 2016, officers from Cumbria Police attended at XXX Dr Basit’s home in XXX. 68. XXX. 69. XXX. Dr A referred to the ‘first and worst’ incident of violence occurring in May 2016, which the Tribunal has found was when Dr Basit hit her in the face and on the ear. 70. Importantly for the Tribunal’s considerations, Dr A reports the nature of the physical acts she alleges against Dr Basit. In that second Police statement she said that she wished ‘to pursue the assaults that happened to [her] XXX […]’. She went on to describe that Dr Basit ‘had physically assaulted [her] on many occasions. The nature of these assaults [was] a lot of pushing and initially grabbing me by the throat on four or five occasions’. Dr A stated that when threatened with her going to the Police Dr Basit stopped grabbing her by the throat, but that he ‘did continue to push [her] and grab [her] face on three occasions’. She stated that Dr Basit ‘regularly rushed towards [her] raising his hand but not actually hitting [her]’. 71. In her next witness statement for Northumbria Police, dated 6 November 2016, Dr A confirmed that none of the assaults had resulted in a physical injury, but she still wanted to pursue her complaint. XXX. 72. The Tribunal was satisfied that once Dr A disclosed and reported the acts of physical violence her evidence about them has been consistent since, including during her oral evidence to the Tribunal. In her GMC witness statement Dr A stated that that ‘on approximately five or more occasions Dr Basit put his hand around [her] throat and squeezed his hand around it’. Dr A’s further evidence was that ‘on several other occasions Dr Basit pushed or shoved [her]’ and that ‘each occasion of pushing and shoving was during the course of an argument XXX. Additionally, Dr A’s evidence was that none of the incidents left any physical mark or injury. Dr A reiterated these descriptions in her oral evidence to the Tribunal. In respect of sub-paragraph 3(c), the Tribunal found Dr A’s description of being grabbed by the neck by Dr Basit to be particularly persuasive and it was satisfied that what she demonstrated to the Tribunal was not just a grab by the neck, but also a squeeze. In addition, the Tribunal found Dr A’s description of Dr Basit squeezing her neck and asking her how it felt, XXX, to be extremely compelling. 73. As noted above, the Tribunal found Dr A to be a credible witness overall. In addition, it found Dr D to be a credible, reliable, and independent witness whose evidence supported that of Dr A in respect of the nature of her relationship with Dr Basit, although not in respect of the specific incidents of physical violence.


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74. In all the circumstances, and for the reasons set out above, the Tribunal concluded that it was more likely than not that between February and July 2016 Dr Basit pushed and/or shoved and/or squeezed Dr A’s neck with his hand on more than one occasion. Accordingly, the Tribunal found paragraph 3 of the allegation proved in its entirety. The Tribunal’s Overall Determination on the Facts 75. The Tribunal has determined the facts as follows:

That being registered under the Medical Act 1983 (as amended):

1. On or about 15 May 2016 in Brighton you hit Dr A:

a. In the face, Determined and found proved

b. On the ear. Determined and found proved

2. On or about 15 May 2016 you hit Dr B in the face. Determined and found proved

3. On one or more occasions between February 2016 and July 2016 you:

a. Pushed Dr A and/or Determined and found proved

b. Shoved Dr A and /or Determined and found proved

c. Squeezed Dr A’s neck with your hand. Determined and found

proved

And in relation to the above your fitness to practice is impaired because of your misconduct. To be determined

Determination on Impairment - 05/03/2020 1. The Tribunal now has to decide in accordance with Rule 17(2)(l) of the Rules whether, on the basis of the facts which it has found proved as set out previously, Dr Basit’s fitness to practise is impaired by reason of misconduct. The Evidence


MPT: Dr BASIT 17

2. The Tribunal has taken into account all the evidence received during the facts stage of the hearing, both oral and documentary. In addition, the Tribunal received further evidence as follows:

• XXX; • Course Module: Tips and techniques For Dealing with Difficult People; • Professional Boundaries in Health & Social Care Level 2 Certificate, dated

25/02/20; • Personal statement setting out Dr Basit’s reflections upon the facts found proved.

3. Shortly after the Tribunal had begun its deliberations, it reconvened at the request of the parties to hear submissions and accept further agreed documentary evidence. Ms Dudley-Jones submitted that a statement from Dr Basit’s Responsible Officer was relevant to correct an impression given in Mr Jenkin’s submissions that “there was no suggestion of problems at work” regarding Dr Basit. On behalf of Dr Basit, Mr Jenkins produced documentary evidence of a number of emails and text exchanges clarifying the comments made by the Responsible Officer. As none of these documents were relevant to the issues for determination by the Tribunal at this stage, it took no account of them. Submissions on Behalf of the GMC 4. In the course of her submissions on behalf of the GMC, Ms Dudley-Jones referred the Tribunal to the relevant authorities, setting out a summary of applicable principles when making decisions upon misconduct and impairment. 5. Ms Dudley-Jones submitted that the facts admitted and found proved in this case amount to serious misconduct, and that Dr Basit’s fitness to practice is currently impaired as a result of that serious misconduct. 6. Ms Dudley-Jones submitted that Dr Basit did not make admissions at the outset of the case and denied the allegations in their entirety. She reminded the Tribunal that it has made significant findings against him in respect of his actions over a six month period towards Dr A , which included hitting her during an altercation in which [Dr B] was also hit, pushing and shoving her and squeezing her throat on five occasions between February and July 2016. She invited the Tribunal to look at the serious nature of its findings of violence when assessing Dr Basit’s impairment. 7. Ms Dudley-Jones submitted that Dr Basit’s actions were deliberate, particularly the Brighton incident, which she described as premeditated, and involved numerous physical acts of violence rather than a single, impulsive or isolated incident. She further submitted that the background of threats and psychological abuse significantly aggravate the physical abuse Dr A endured over a six month period.


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8. She referred the Tribunal to Dr Basit’s reflective statement and submitted that Dr Basit has very limited insight given the stage the document was produced and that he has offered no specific apology in his reflective document. She stated that he had denied all the allegations and made [Dr A] relive the experience in the witness box. She opined that true insight might have been demonstrated in earlier admissions and earlier courses and interventions. She referred the Tribunal to the evidence provided by Dr Basit of the XXX he had arranged, pointing out that this was a short course, undertaken after the facts against Dr Basit had been found proved, the scores contained therein were subjective, and there did not appear to be any XXX in place. 9. Ms Dudley-Jones submitted that Dr Basit’s failings are capable of remediation but submitted that this Tribunal has been provided with very little and late evidence of remediation, and accordingly, could not be satisfied that his misconduct would not be repeated. Ms Dudley-Jones submitted that, in all the circumstances of this case, Dr Basit’s actions amount to serious misconduct. Accordingly, she invited the Tribunal to find that Dr Basit’s fitness to practice is currently impaired as a result of that serious misconduct. Submissions on Behalf of Dr Basit 10. Mr Jenkins submitted that he disagreed with Ms Dudley-Jones submissions which suggested there was a much wider background to the allegations and invited the Tribunal to concentrate on the facts found proved. With regard to the incident in Brighton, Mr Jenkins submitted that evidence of premeditation was not borne out. He reminded the Tribunal of the audio recording, where, he said, Dr B can be clearly heard shouting at Dr Basit and using the word ‘tum’ which the Tribunal learnt in evidence was insulting. He further submitted that clearly the episode in Brighton was disgraceful and never should have happened but there was wrong doing on both sides. He accepted that physical aggression could never be justified. 11. Mr Jenkins reminded the Tribunal of the written evidence given by Dr D, XXX but that the physical aggression was totally unacceptable and Dr Basit realises that it could never be justified. 12. Mr Jenkins submitted that Dr Basit has clearly reflected on what has happened and has, in his reflective piece, offered apologies. He has taken steps to remediate by undertaking relevant courses and XXX. He invited the Tribunal to consider that the misconduct was confined to the issues within an unhappy marriage, and that whilst remediation and insight are perhaps incomplete, Dr Basit was on his way to demonstrating that he possessed insight. The Relevant Legal Principles


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13. The Tribunal reminded itself that at this stage of proceedings, there is no burden or standard of proof and the decision of impairment is a matter for the Tribunal’s judgement alone. 14. In approaching the decision, the Tribunal was mindful of the two-stage process to be adopted: first whether the facts as found proved amounted to misconduct and that the misconduct was serious, and then whether the finding of that misconduct could lead to a finding of impairment. 15. At both stages of the process, the Tribunal was mindful of the overarching objective set out in section 1 of the Medical Act 1983 (as amended) to:

a. Protect, promote and maintain the health, safety and well-being of the public,

b. Promote and maintain public confidence in the medical profession, and

c. Promote and maintain proper professional standards and conduct for members of that profession.

16. The Tribunal must determine whether Dr Basit’s fitness to practise is impaired today, taking into account Dr Basit’s conduct at the time of the events and any relevant factors since then such as whether the matters are remediable, have been remedied and any likelihood of repetition. The Tribunal’s Determination on Impairment Misconduct 17. The Tribunal first considered the guidance in the case of Roylance v GMC [2001] 1 AC 311.

“‘Misconduct’ is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a medical practitioner in the particular circumstances.”

18. The Tribunal also considered paragraph 65 of Good Medical Practice (2013) (‘GMP’). It concluded this was of relevance to this case;

65 You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.


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19. The Tribunal considered that it’s findings of Dr Basit’s violent behaviour, in a domestic context, comprising of hitting Dr A and Dr B in the course of an argument in Brighton, and the violent acts of pushing, shoving and the squeezing of Dr A’s neck over a six month period, constituted conduct unbecoming of a doctor, that was morally culpable, and that fellow practitioners would find deplorable. It concluded that such conduct was particularly serious when considered in the light of the Tribunal’s previous acceptance of the evidence of Dr A that Dr Basit’s behaviour towards her during that period could be categorised as coercive, controlling and psychologically abusive. 20. The Tribunal considered that Dr Basit’s conduct fell far below the standards of behaviour expected of a doctor and undermined public confidence in the profession. 21. The Tribunal found that for the reasons set out above, the findings made in Dr Basit’s case amounted to misconduct that was serious. Impairment 22. The Tribunal having determined that the facts found proved amounted to serious misconduct, went on to consider whether, as a result of that misconduct, Dr Basit’s fitness to practise is currently impaired. 23. The Tribunal had regard to the factors for consideration as set out in the case of Cohen v General Medical Council [2008] EWHC 581:

1) Whether the conduct in the Allegation is easily remediable 2) Whether it has been remedied (or evidence to that effect) 3) Whether that conduct is highly unlikely to be repeated

24. It considered that Dr Basit’s misconduct could potentially be remediated. It noted that Dr Basit had accepted the Tribunal’s findings in his reflective statement, albeit that there was no evidence whatsoever of remorse or regret until after its determination on the facts. However, the Tribunal considered his recent reflections to be comprehensive in that he covered the impact of his actions on the people directly involved, but also on the reputation of the profession and how his own patients may be affected if they knew of the proven facts. The Tribunal therefore concluded that Dr Basit’s reflections represented a significant attitudinal shift, and the development of some insight into his misconduct. 25. The Tribunal further considered Dr Basit’s undertaking XXX, directed towards better anger management. XXX. 26. It determining the likelihood of repetition, the Tribunal took account of the recent efforts made by Dr Basit in remediating, and of the development of some insight. It concluded that whilst it could not rule out a repetition of similar


MPT: Dr BASIT 21

misconduct, it did not consider that the misconduct was highly likely to be repeated, noting the time since these events had occurred. 27. The Tribunal next reminded itself of the questions posed by Dame Janet Smith in the Fifth Shipman Report and adopted by the High court in CHRE v NMC and P Grant [2011] EWHC 927 (Admin) and considered the following to be highly relevant to this case:

‘Do our findings of fact … show that his/her fitness to practise is impaired in the sense that s/he:

a. …………………………………………………………………. b. has in the past brought and/or is liable in the future to bring the

medical profession into disrepute; and/or c. has in the past breached and/or is liable in the future to breach

one of the fundamental tenets of the medical profession d. ……………………………………………………………………………….

28. The Tribunal concluded that Dr Basit’s violent behaviour in the past had brought the medical profession into disrepute, and had breached a fundamental tenet of the medical profession, namely that the public should be able to trust in the high standards of a doctor’s behaviour. The Tribunal determined that Dr Basit’s misconduct would be considered unacceptable by members of the profession and the public alike. Despite his recent efforts to remediate, and the development of some insight into his actions, the Tribunal concluded that public confidence in the profession would be undermined if a finding of impairment were not made. 29. The Tribunal has therefore determined that Dr Basit’s fitness to practise is impaired by reason of his misconduct. Determination on Sanction - 06/03/2020 1. Having determined that Dr Basit’s fitness to practise is impaired by reason of misconduct, the Tribunal now has to decide in accordance with Rule 17(2)(n) of the Rules on the appropriate sanction, if any, to impose. The Evidence 2. The Tribunal has taken into account all the evidence received at each of the stages of the hearing, both oral and documentary. In addition, the Tribunal received further evidence as follows:

• Testimonials and references;

http://www.bailii.org/ew/cases/EWHC/Admin/2011/927.html

http://www.bailii.org/ew/cases/EWHC/Admin/2011/927.html


MPT: Dr BASIT 22

• Reference of Dr F, dated 02/03/20; • Reference of Dr G, dated 02/03/20; • Numerous patient questionnaires and CT1 Mini -Pat.

Application to submit further evidence 3. Before the Tribunal heard submissions upon what sanction, if any to impose, an application to admit a summary of the outcomes of MPTS cases featuring violent conduct over the last two years (‘the summary’) was made by Mr Jenkins, on behalf of Dr Basit. 4. Mr Jenkins submitted that the summary would be of assistance to the Tribunal in its deliberations on sanction, particularly when there was little mention made of violence in the Sanctions Guidance (November 2019 edition) (“the SG”). He acknowledged that each case rests on its own facts, but suggested that the cases were a matter of public record and the Tribunal should not be precluded from seeing his summary of them. He explained he had emailed the GMC and the Tribunal Clerk with the full determinations of the cases in case they were required. The emails were received at approximately 1.30pm when the Tribunal was adjourned for lunch, returning at 2.00pm. 5. The application was opposed by Ms Dudley-Jones. She submitted that she had not been afforded the opportunity to assess the summary of cases provided, she knew not whether other cases existed, and had insufficient time to review the full determinations given the time at which the documents were served upon her. She further submitted that each case is factually distinct and that sanction is a matter of judgement for the Tribunal with the assistance from the guidance provided in the Sanctions Guidance. She told the Tribunal that it was highly unusual and unprecedented for the Tribunal to be directed to previous sanction outcomes and outlined that some of the cases were dissimilar in nature, as they were conviction cases as opposed to misconduct. She urged caution in admitting the document. 6. The Tribunal accepted the advice of the Legally Qualified Chair (LQC), who reminded it that each case turns on its own unique facts and that there was no precedent set by previous sanction decisions, therefore the Tribunal was not obliged to take account of them. The Tribunal were reminded of Rule 34(1) of the General Medical Council (Fitness to Practise) Rules 2004 (“the Rules”).

34.(1) Subject to paragraph (2), the Committee or a Panel may admit any evidence they consider fair and relevant to the case before them, whether or not such evidence would be admissible in a court of law

7. The Tribunal determined not to admit the summary. It considered that the late service of the summary and the accompanying cases, and the consequential result that the GMC had had no opportunity to properly appraise them, would cause


MPT: Dr BASIT 23

unfairness if the Tribunal were to admit them. Furthermore, The Tribunal did not consider that the summary or the determinations were relevant to its deliberations. The Tribunal would use its own judgement in determining the appropriate and proportionate sanction in Dr Basit’s case, based upon all the evidence it has heard, the facts it has found and the information before it unique to his case. 8. Mr Jenkins also submitted testimonials and references. On behalf of the GMC, Ms Dudley Jones did not object to the Tribunal accepting them, however, the late receipt of them meant the GMC were unable to verify their contents. The Tribunal were directed to the relevant paragraphs of the SG namely paras 34 -38, which provide helpful guidance. Submissions on Behalf of the GMC 9. In the course of her submissions on behalf of the GMC, Ms Dudley-Jones referred the Tribunal to the paragraphs in the SG. In summary, she submitted that the appropriate sanction in this case is erasure. 10. Ms Dudley-Jones reminded the Tribunal that in deciding whether to impose a sanction on Dr Basit’s registration, it will do so exercising its own independent judgement, considering all of the evidence before it and by considering each possible sanction in ascending order, starting with the least restrictive. 11. Ms Dudley Jones highlighted the aggravating factors in the case, in that Dr Basit’s violent behaviour happened in a domestic context and comprised of hitting Dr A and Dr B in a course of an argument in Brighton. She reminded the Tribunal that the violent acts of pushing, shoving and squeezing Dr A’s neck occurred over a six-month period. She submitted this was particularly serious as Dr Basit repeatedly denied the behaviour, caused injuries to two people and his conduct towards Dr A XXX. She submitted that his actions were persistent and deliberate and that XXX. She reminded the Tribunal of its categorisation of the behaviour as coercive, controlling and psychologically abusive. She submitted Dr Basit had shown little insight into his misconduct. Submissions on Behalf of Dr Basit 12. In summary, Mr Jenkins submitted that testimonials and patient feedback had described Dr Basit as a hardworking and reliable doctor. He reminded the Tribunal that this misconduct happened 4 years ago in context XXX. He submitted that it was wholly inappropriate to act in an aggressive and violent way, but it was wholly out of character and the Tribunal have seen nothing to suggest he will repeat his behaviour. Dr Basit has taken steps to reflect on his conduct and to remediate. Mr Jenkins submitted that Dr Basit has stepped out of training in the meantime and will reflect on what the future holds for him. None the less, he submitted, Dr Basit is working in a good, useful way as a doctor and this country needs doctors.


MPT: Dr BASIT 24

13. Mr Jenkins invited the Tribunal to consider if it was necessary to impose any kind of sanction in this case. Mr Jenkins submitted that the Tribunal’s finding of impairment was sufficient to send a message to the profession and the wider public about behaviour and that the impairment decision would remain on the doctor’s registration. Mr Jenkins submitted if no action was inappropriate, then an order of conditions could be appropriate to protect the public interest, as it was unlikely that Dr Basit XXX and there was a low risk of repetition. He submitted that the Tribunal could require Dr Basit to continue his re-education, take further steps towards remediating and be reviewed by another Tribunal. If the Tribunal considered that an order of conditions was not appropriate, then it must move to consider an order of suspension. He submitted that if a suspension were to be imposed then, in other cases, a short period of one month had been seen to be appropriate to protect the public interest. Dr Basit does not have family or financial support in this country and a period of suspension for any longer would have a significant impact upon him financially and would be purely punitive. He submitted that erasure would be wholly inappropriate given all the circumstances of this case and would deprive the public of a good doctor. The Tribunal’s Determination on Sanction 14. The decision as to the appropriate sanction, if any, to impose is a matter for the Tribunal alone, exercising its own judgement. In so doing, it has given consideration to its findings of fact and misconduct and impaired fitness to practise as well as the submissions made by both parties. When making its decision the Tribunal paid particular attention to the paragraphs 56 and 56d.

56. Tribunals are also likely to take more serious action where certain conduct arises in a doctor’s personal life, such as (this list is not exhaustive):

… d. misconduct involving violence…’

15. In making its decision, the Tribunal had regard to the principle of proportionality, weighing Dr Basit’s interests with those of the public. Before considering what action, if any, to take in respect of Dr Basit’s registration, the Tribunal identified and balanced the mitigating and aggravating factors in this case. Aggravating Factors 16. The Tribunal considered the following to be aggravating factors in this case:


MPT: Dr BASIT 25

• Dr Basit did not accept his misconduct or express remorse until after the factual findings of the Tribunal, which meant Dr A had to give evidence and relive her experiences;

• The violent conduct towards Dr A was against a background of coercive controlling and psychologically abusive behaviour XXX.

• Dr Basit’s misconduct resulted in XXX;

• The violent conduct occurred on several occasions between February and July

2016 XXX. Mitigating Factors 17. The Tribunal considered the following to be mitigating factors in this case:

• There is no evidence of other instances of violent behaviour given Dr Basit is of previous good character and as there has been no evidence of repetition of this behaviour since 2016;

• Dr Basit has reflected on his behaviour and apologised to the people it has

affected through his reflective statement;

• XXX;

• Dr Basit has provided evidence of progress in remediation and shown that he has developed some insight into his misconduct.

18. The Tribunal also had regard to the testimonials and personal references, all attesting to Dr Basit’s positive character traits. The Tribunal took into account that the GMC did not have the opportunity to verify those which were submitted at this stage in the proceedings. However, the Tribunal accepted their contents at face value. It noted that the authors appeared to be aware of the allegations faced by Dr Basit. 19. In deciding what sanction, if any, to impose the Tribunal considered each of the options available to it, starting with the least restrictive. No Action 20. In coming to its decision as to the appropriate sanction, if any, to impose in Dr Basit’s case, the Tribunal first considered whether to conclude the case by taking no action.


MPT: Dr BASIT 26

21. The Tribunal found that there were no exceptional circumstances capable of justifying taking no action against Dr Basit’s registration. The Tribunal determined that, in view of the serious nature of the Tribunal’s findings, and in particular the aggravating factors it has identified, it would be neither sufficient, proportionate nor in the public interest, to conclude this case by taking no action. Conditions 22. The Tribunal next considered whether it would be sufficient to impose conditions on Dr Basit’s registration. It has borne in mind that any conditions imposed would need to be appropriate, proportionate, workable and measurable. 23. The Tribunal considered that it would be difficult to formulate workable conditions to address violent conduct. The Tribunal was of the opinion that a period of conditional registration would not adequately reflect the serious nature of Dr Basit’s misconduct, which it considers to be conduct unbecoming of a doctor. In light of the aggravating factors it has identified, it determined that a period of conditional registration would not maintain public confidence or declare and uphold proper standards in the medical profession and was therefore inappropriate. It concluded that imposing conditions was not sufficient or proportionate. Suspension 24. The Tribunal then went on to consider whether suspending Dr Basit’s registration would be appropriate and proportionate. 25. The Tribunal considered that paragraphs 91, 92, 93, 97 of the SG were of particular relevance to Dr Basit’s case.

91 Suspension has a deterrent effect and can be used to send out a signal to the doctor, the profession and public about what is regarded as behaviour unbefitting a registered doctor. Suspension from the medical register also has a punitive effect, in that it prevents the doctor from practising (and therefore from earning a living as a doctor) during the suspension, although this is not its intention.

26. The Tribunal considered that Dr Basit’s violent conduct, aggravated by XXX and the effect it had upon Dr A, required a deterrent sanction, which sends a clear signal to the doctor himself, the profession and the public that such misconduct is wholly inappropriate.

92 Suspension will be an appropriate response to misconduct that is so serious that action must be taken to protect members of the public and maintain public confidence in the profession. A period of suspension will be appropriate for conduct that is serious but falls short of being fundamentally


MPT: Dr BASIT 27

incompatible with continued registration (ie for which erasure is more likely to be the appropriate sanction because the tribunal considers that the doctor should not practise again either for public safety reasons or to protect the reputation of the profession)

93 Suspension may be appropriate, for example, where there may have been acknowledgement of fault and where the tribunal is satisfied that the behaviour or incident is unlikely to be repeated. The tribunal may wish to see evidence that the doctor has taken steps to mitigate their actions 97 Some or all of the following factors being present (this list is not exhaustive) would indicate suspension may be appropriate.

a. A serious breach of Good medical practice, but where the doctor’s misconduct is not fundamentally incompatible with their continued registration, therefore complete removal from the medical register would not be in the public interest. However, the breach is serious enough that any sanction lower than a suspension would not be sufficient to protect the public or maintain confidence in doctors. b… c… d… e No evidence that demonstrates remediation is unlikely to be successful, eg because of previous unsuccessful attempts or a doctor’s unwillingness to engage

f. No evidence of repetition of similar behaviour since incident.

g. The Tribunal is satisfied the doctor has insight and does not pose a significant risk of repeating behaviour

27. The Tribunal considered that although the doctor’s misconduct was undoubtedly serious, it was capable of remediation, that it had been remedied in part by the doctor’s positive steps in undertaking XXX and attending courses, and that he had developed some insight into his behaviour and its impact upon others. 28. The Tribunal has found that Dr Basit did breach a fundamental tenet of the profession in breaching the trust the public are entitled to have in the standards of a doctor’s behaviour. The Tribunal considered that Dr Basit has acknowledged the seriousness of his conduct, albeit after the Tribunal found the facts proved against him. It has also identified that Dr Basit has developed some insight, there has been no repetition of his behaviour since 2016, and that there wasn’t a high risk of


MPT: Dr BASIT 28

repetition. As such, it did not consider his misconduct was such that it was fundamentally incompatible with continued registration. 29. Before concluding that suspension was the appropriate sanction, the Tribunal went on to consider paragraph 109g of the SG that indicated that erasure may be an appropriate sanction.

109g Offences involving violence 30. The Tribunal were satisfied that although Dr Basit’s conduct was violent, the mitigating factors identified were such that erasure was disproportionate. 31. The Tribunal therefore concluded that, when weighing the doctors interests against the public interest, and when balancing the aggravating and mitigating factors it has identified, a period of suspension was the proportionate and appropriate response, which is sufficient to maintain confidence in the profession and send out the necessary signal to maintain proper standards of behaviour. 32. The Tribunal then went on to consider the length of suspension to impose on Dr Basit’s registration. It bore in mind the principle of proportionality as set out in paragraph 20 of the SG.

20 In deciding what sanction, if any, to impose the tribunal should consider the sanctions available, starting with the least restrictive. It should also have regard to the principle of proportionality, weighing the interests of the public against those of the doctor (this will usually be an impact on the doctor’s career, eg a short suspension for a doctor in training may significantly disrupt the progression of their career due to the nature of training contracts).

33. In determining the appropriate and proportionate length of the suspension to impose, the Tribunal had regard again to the aggravating and mitigating factors of Dr Basit’s misconduct. It gave weight to the inherent seriousness of violent conduct, the period over which it took place and the effect upon Dr A. The Tribunal balanced this against the mitigating factors it had found, in particular the length of time that had passed without any repeat of such conduct and the significant attitudinal shift evidenced by both Dr Basit’s reflective statement and his attendance upon courses and XXX. It balanced the public interest, in declaring standards and maintaining confidence, with the interests of Dr Basit, taking into account the submissions made upon his behalf of the severe financial impact a suspension would cause him in his particular circumstances and of his usefulness to the community as a good doctor. The Tribunal determined that the proportionate length, which marks the seriousness of the misconduct and takes into account the mitigation it has found, is a period of four months.


MPT: Dr BASIT 29

34. The Tribunal next considered whether a review was appropriate in this case. It had regard to paragraph 164 of the SG.

164 In some misconduct cases it may be self-evident that, following a short suspension, there will be no value in a review hearing. However, in most cases where a period of suspension is imposed, and in all cases where conditions have been imposed, the tribunal will need to be reassured that the doctor is fit to resume practice – either unrestricted or with conditions or further conditions. A review hearing is therefore likely to be necessary, so that the tribunal can consider whether the doctor has shown all of the following (by producing objective evidence): a they fully appreciate the gravity of the offence b they have not reoffended c they have maintained their skills and knowledge d patients will not be placed at risk by resumption of practice or by the imposition of conditional registration.

35. It considered that in this case, there was no requirement for a review. The suspension itself serves to send out a clear message to Dr Basit and the profession as a whole that violent conduct is unacceptable. There is no risk to patients and no evidence that Dr Basit has not maintained his skills. Whilst the Tribunal found that Dr Basit’s insight was not fully developed, it also found that the risk of repetition was not high and is satisfied that the regulatory process and the sanction of suspension will have a salutary and deterrent effect upon him. The Tribunal considered that the four-month period of suspension will also afford Dr Basit further time in which to fully reflect on his actions before returning to work. The sanction of suspension upholds and maintains confidence in the profession. Determination on Immediate Order - 06/03/2020 1. Having determined to suspend Dr Basit’s registration for a period of 4 months, the Tribunal has considered, in accordance with Rule 17(2)(o) of the Rules, whether Dr Basit’s registration should be subject to an immediate order. Submissions 2. On behalf of the GMC, Ms Dudley-Jones referred the Tribunal to the relevant paragraphs of the SG to consider in regard to imposing immediate orders. She submitted an immediate order was necessary in order to uphold the public interest, particularly in the light of the Tribunal’s finding of serious misconduct and Dr Basit’s limited insight.


MPT: Dr BASIT 30

3. Mr Jenkins submitted that this is not a case requiring an immediate order. There has been no repetition of the concerns, and no suggestion that Dr Basit would present a risk to the public if allowed to practise for the next four weeks. Mr Jenkins submitted that an immediate order would have a detrimental effect on Dr Basit’s financial situation. The Tribunal’s Determination 4. The Tribunal had regard to paragraphs 172-178 of the SG which provide guidance about when an immediate order might be necessary to protect members of the public, or is otherwise in the public interest. 5. The Tribunal noted that Dr Basit has been working during the course of the investigation and these proceedings and that there has been no suggestion of any risk to patient safety. It therefore considered whether it was otherwise in the public interest to impose an immediate order. The Tribunal considered that an immediate order of suspension was not necessary as it considered that the substantive order was sufficient to address the public interest concerns, particularly the maintenance of public confidence in the medical profession. 6. This means that Dr Basit’s registration will be suspended 28 days from when notice of this decision is deemed to have been served upon him unless he lodges an appeal. In the event of an appeal, the substantive determination will take effect from the conclusion of that appeal. 7. There is no interim order to revoke. 8. That concludes this case. Confirmed Date 06 March 2020 Mrs Jayne Wheat, Chair

Documents

PUBLIC RECORD · give further evidence to the Tribunal by means of a video link given his availability and clinical commitments. Mr Jenkins did not object to this application and