Acting outside one’s expertise
The appellant doctor (P) appealed against a decision by the GMC to suspend him from practice for three months. The suspension was made because P had been instructed to appear as an expert witness in a hearing about the psychiatric problems of a paramedic. He prepared a psychiatric report for a tribunal on the paramedic’s ability to practise. In the course of the hearing, an objection was taken to P’s ability to act as an expert psychiatrist to deal with the paramedic’s alleged impairment, which the tribunal upheld. As a result, P was subsequently the subject of misconduct allegations himself, arising from his appearance as an expert when not qualified to act.
The panel found that P was not an expert in the relevant field (general adult psychiatry). It concluded that he had failed to restrict his opinion to areas where he had relevant expertise and or direct experience, and that he had given evidence on matters outside his professional competence.
P appealed to the GMC, challenging the panel’s findings that he was not an expert and that his report was inadequate because he had failed to give reasons for his opinions.
The GMC allowed the appeal, but only in part. In particular, it held that the panel before whom P had appeared was well aware and accepted that P might be equipped to act as an expert either by reason of their training or day-to-day experience, but it had not erred in concluding that P’s qualifications and training did not equip him to be an expert. He was not on the relevant specialist register, had not completed any higher professional training, and his experience as a clinician was limited to the care of offenders and others with similar needs in secure units.
The panel had also set out its reasons for deciding that P’s report was inadequate, including that there was no full explanation for his opinions. In particular, the report failed to address the specific questions over which P had been appointed, and it failed to provide adequate reasons for his conclusions. The panel had been entitled to regard P’s misconduct as serious. It was correct in finding that there was a strong public interest in ensuring that doctors did not act outside their competence, and that they did not put themselves forward as experts in areas in which they did not have adequate knowledge and expertise. P’s actions could have had drastic consequences for X as she could have lost her professional registration and career. The GMC therefore directed that P’s registration be subject to a condition that he should not accept instructions to act as an expert in fitness to practise proceedings for three months.
A serious case with a serious outcome, and one which demonstrates the dangers of taking instructions outside of an expert’s direct field of expertise. P was obviously experienced, but not in dealing with persons such as X, and he also had not carried out the relevant training. In the circumstances, it is perhaps not surprising that P’s report also failed to answer the specific questions set. The consequences for X, the subject of his report, could have been disastrous, and in the circumstances it is not surprising that a suspension followed.
The reality of course is that experts are asked every day to report on issues when, perhaps, it is not always perfectly clear at the outset precisely what will be involved (although it seems unlikely that that is what happened to P here). It is important when taking on a new case to be sure that it something you are going to be happy drafting a report on and speaking to in court, and if not, to tell the legal team as quickly as possible. It is a rare problem that gets better for not being aired as soon as possible. It is likely, for example, that if P had thought carefully about whether he should really have taken the brief then it would have perhaps passed it on to someone with more direct experience.
As ever, identifying the key issues at the outset is the most important thing.