Record of Determinations –
Medical Practitioners Tribunal
PUBLIC RECORD
Dates: 23/01/2017 – 26/01/2017
Medical Practitioner’s name: Dr Martin PEVERLEY
GMC reference number:
3320075
Primary medical qualification:
MB BS 1989 University of Newcastle upon
Tyne
Type of case
New - Conviction / Caution
XXX
Outcome on impairment
Impaired
XXX
Summary of outcome
Suspension, 6 months.
Review hearing directed
Tribunal:
Lay Tribunal Member (Chair)
Mr Sean Ell
Lay Tribunal Member:
Mrs Anna Crawley
Medical Tribunal Member:
Dr Gabrielle Downey
Legal Assessor:
Mr Toby Davey
Tribunal Clerk:
Mr David Salad
Attendance and Representation:
Medical Practitioner:
Present and represented
Medical Practitioner’s Representative:
Mr Jonathan Holl-Allen, Counsel,
instructed by the MDU
Mr Kevin Slack, Counsel
GMC Representative:
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Allegation and Findings of Fact
That being registered under the Medical Act 1983 (as amended):
1. On 27 April 2016 in Teesside Magistrates Court you were convicted of the
following offence:
‘On 15 April 2016 at Middlesbrough drove a motor vehicle on a road, namely
A19 and A689, after consuming so much alcohol that the proportion of it in
your breath, namely 153 microgrammes of alcohol in 100 millilitres of breath,
exceeded the prescribed limit. Contrary to section 5(1)(a) of the Road Traffic
Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988.’ Admitted
and found proved
2. On 27 April 2016 you were sentenced to eight weeks imprisonment
suspended for 12 months. Admitted and found proved
3. XXX
4. XXX
And that by reason of the matters set out above your fitness to practise is impaired
because of your:
a. conviction in respect of paragraphs 1 and 2;
b. XXX
Attendance of Press / Public
The tribunal agreed, in accordance with Rule 41 of the General Medical Council
(Fitness to Practise) Rules 2004, that the press and public be excluded from those
parts of the hearing where matters under consideration were deemed confidential.
Determination on Facts - 24/01/2017
Dr Peverley
1.
At the outset of the hearing, Mr Slack, GMC Counsel, applied for XXX parts of
this hearing XXX to be heard in private in accordance with XXX the GMC Fitness to
Practise Rules 2004 (as amended)(‘the Rules’). Mr Holl-Allen, Counsel, acting on
your behalf, concurred with Mr Slack’s application.
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2.
The tribunal acceded to Mr Slack’s application. This determination will
therefore be read in private. As this case also relates to your conviction, a redacted
version will be published XXX.
3.
XXX
4.
XXX
5.
XXX
6.
XXX
7.
XXX
8.
XXX
9.
XXX
Admissions
10.
At the outset of the hearing, following the first application to amend the
allegation, Mr Holl-Allen made admissions on your behalf to paragraphs 1, 2 XXX of
the allegation. The tribunal therefore announced these paragraphs as admitted and
found proved.
Background
11.
The events covered by the allegation occurred whilst you were employed as a
sole General Practitioner at a practice in Hartlepool, at which you had worked since
2005.
12.
You self-referred to the GMC via an email dated 19 April 2016, setting out
that you had been charged with a criminal offence. You stated that on 15 April 2016
you were stopped by Cleveland Police Force in Nunthorpe, Middlesborough, and
were subsequently charged with driving whilst under the influence of excess alcohol.
13.
The Police Summary of your arrest set out that at 18:50 hours on 15 April
2016 you were observed driving along the A19 by a witness who was travelling
behind you. Your vehicle was observed to be ‘braking and speeding up with no
cause, swerving across the road narrowly missing other vehicles.’ You were observed
parking up on your drive way and remaining in the driver’s seat of the vehicle. The
Police attended and tried to speak to you. Due to your intoxication, the attending
Police Officer had to ‘physically pull you out of the driver’s seat where you fell to the
floor’, resulting in you being carried to the Police vehicle.
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14.
You were arrested and, on arrival at Middlesborough Custody Office, you
undertook a breath test procedure, providing a specimen, giving a lowest reading of
153ug/100ml.
15.
The GMC received a further referral, dated 25 April 2016, from Dr A, Assistant
Medical Director and Deputy Responsible Officer, NHS England – North (Cumbria &
North East). Dr A set out that you had informed him of your arrest, and admitted to
being four times over the legal drink driving limit. You also XXX, advising of stresses
at work which have contributed to this. Dr A stated that you had been suspended
from the National Medical Performers List, effective 19 April 2016. XXX.
16.
You appeared at Teesside Magistrates Court on 27 April 2016, pleaded guilty
to the offence of driving under the influence of excess alcohol, and received an 8
weeks prison sentence suspended for 12 months. You had to pay a victim surcharge
of £115 + £85 costs. You were disqualified from holding or obtaining a driving
licence for 36 months. Your driving record was endorsed under Sections 34(1) & 34A
of the Road Traffic Offenders Act 1988.
XXX
Determination on Impairment - 25/01/2017
Dr Peverley
1.
At the outset of the hearing, Mr Slack, GMC Counsel, applied for XXX parts of
this hearing XXX to be heard in private in accordance with XXX the GMC Fitness to
Practise Rules 2004 (as amended)(‘the Rules’). Mr Holl-Allen, Counsel, acting on
your behalf, concurred with Mr Slack’s application.
2.
The tribunal acceded to Mr Slack’s application. This determination will
therefore be read in private. As this case also relates to your conviction, a redacted
version will be published, XXX.
3.
Having announced its findings on the facts, the tribunal has now considered
whether your fitness to practise is impaired by reason of your conviction. XXX.
Application under Rule 41(2)
4.
In the course of hearing your oral evidence, Mr Holl-Allen made an application
for a section of your evidence relating to your financial position to be heard in
private session. He submitted that there was no particular public interest in
information about your financial arrangements to be given in public as such matters
were normally confidential.
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5.
Mr Slack submitted that, although your finances are matters which you may
wish to be kept private, to the extent that you were relying on those matters as
relevant to the matter of impairment, they should be heard in public session as
evidence which may affect any determination the tribunal makes. He submitted
there was a strong public interest in these parts of your evidence being heard in
public session.
6.
The tribunal noted that, under Rule 41(2), it had the power to determine to
hear evidence in private, should it consider that the particular circumstances of the
case outweigh the public interest in holding the hearing in public.
7.
The tribunal bore in mind that, under Rule 41(1), Medical Practitioners
Tribunal hearings are to be held in public as a starting point. It considered that it
had been provided with no good reason to depart from this position. It was of the
view that any wish you may have to keep your financial circumstances private was
outweighed by the public interest in hearings being held in public.
The tribunal’s approach
8.
The issue of impairment is one for the tribunal to determine exercising its
own judgement. The tribunal is aware of its responsibility to have regard to the need
to protect the public interest, to protect patients, maintain public confidence in the
profession and to declare and uphold the proper standards of conduct and
behaviour.
9.
In considering the question of impairment by reason of your conviction, the
tribunal has taken account of all the evidence, both oral and documentary, including
your oral evidence given at this stage and the parties’ submissions.
Submissions
10.
Mr Slack submitted that the circumstances which led to your conviction were
such that you have brought the profession into disrepute and public confidence
would be undermined if a finding of impairment were not made in your case. He told
the tribunal that there was a clear potential risk to patient safety as you drank vodka
at work, continued to see patients, then became progressively more inebriated as
you addressed patient-related paperwork. He submitted that the suspended
custodial sentence ultimately imposed by the Court reflected the severity of the
offence of driving having consumed excess alcohol. He reminded the tribunal that
you are still subject to a suspended sentence and will be so for a further three
months, contending that it could take this into account in its consideration of current
impairment.
11.
He submitted that any steps you had taken to ensure that the situation never
happened again should carry less weight than a case in which, for example, a clinical
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error had been made which might be much more easily remediable. He said that the
tribunal may feel that you had not yet gained full insight into how you had damaged
the confidence that former patients had in you. He submitted that the tribunal may
have sympathy for the work pressures you were under when you returned to work
in April 2016, but whatever pressures you were experiencing did not excuse your
getting drunk at work and driving home.
12.
Mr Holl-Allen told the tribunal that you accepted that the offence was serious,
submitting that you had been open about the circumstances of having drunk vodka
at work and then driving home. He said that you had made a very serious error of
judgement, but invited the tribunal to accept that your actions were out of character
and occurred against a background of accumulating stress, caused by professional
and financial problems, which had ‘come to a head’ on 15 April 2016. He said that
you had taken steps to deal with the stress, including that on your own initiative you
have XXX, and have the support of your wife at home.
13.
Mr Holl-Allen invited the tribunal to conclude that, in the particular
circumstances of this case, you do not continue to present a risk to members of the
public because the risk of recurrent behaviour of the type exhibited on 15 April 2016
is extremely low. He accepted that it is open to the tribunal to conclude that your
fitness to practise remains impaired on public confidence grounds. He submitted that
it does not follow as a matter of course that an informed member of the public,
aware of not just the circumstances of the offence but also the context of your
professional and financial burdens at the time it occurred, would necessarily lose
confidence in the profession if a finding of impairment were not made in the
particular circumstances of your case.
The tribunal’s decision
14.
The tribunal was in no doubt that the actions which led to your conviction
were very serious, and had the potential to cause harm to members of the public.
The tribunal did not have any direct allegation of you having caused harm to your
patients. You have admitted in your evidence to the tribunal that at lunchtime on 15
April 2016 you purchased a 70cl bottle of vodka. You proceeded to drink two double
measures of vodka, then had consultations with a number of patients. You
addressed some paperwork whilst drinking more vodka, in total consuming
approximately three quarters of the bottle. You then then drove home, a journey of
some 40 - 50 minutes, whilst drunk. You were arrested and provided a breath test
which showed that you were four times over the legal limit.
15.
The tribunal was of the view that the suspended custodial sentence you were
given along with endorsements on your driving license and a fine, although given by
a Magistrates Court, rather than being referred to a higher authority, reflected the
seriousness with which the court considered what was a first drink driving offence.
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16.
The tribunal noted that you were under significant professional pressure at
the time of the incident, having been solely responsible, following the retirement of
your GP partner, for 3,500 patients at your surgery for over two years without
consistent support from a permanent second GP. It also took into account the
financial pressures you had been under, following a misunderstanding over funding
from NHS England which led to the practice accruing considerable debt through
locum fees. However, the tribunal found that these circumstances did not excuse
your actions on 15 April 2016.
17.
XXX. However, it is clear that on the day of your arrest that you displayed an
extreme and concerning reaction to the pressures upon you, consuming a significant
amount of alcohol in a short period of time whilst at your workplace, and then
driving home on a journey of 40 - 50 minutes, with the obvious potential to cause
serious harm to the public.
18.
The tribunal considered that you have shown some insight into the
seriousness of these actions and their potential consequences. You told the tribunal
that you would never act in such a manner again, stating that you would, should you
be permitted to return to practice, only work in larger GP surgeries, allowing you
access to much improved support from colleagues and significantly reducing the
amount of stress placed upon you professionally. The tribunal accepted that this
demonstrated some measure of insight, but it was not satisfied that your insight into
your actions was sufficient.
19.
The tribunal was provided with little evidence, XXX, that you have developed
alternative strategies to cope with stress. This led the tribunal to conclude that there
remains a real risk of repetition of your behaviour. Further, the tribunal noted that
you have been out of work since April 2016 and have not made efforts to keep up to
date with your professional development and medical knowledge through courses or
other learning opportunities.
20.
The tribunal was of the view that an informed member of the public would be
shocked, even having taken into account the financial and professional pressures
which you were under, that you had driven home whilst four times over the legal
limit for driving. It was satisfied such a member of the public would lose confidence
in the profession upon hearing of the actions leading to your conviction, and that
you were still subject to a suspended sentence for a further three months, if a
finding of impairment were not made in the particular circumstances of this case.
21.
The tribunal considered that the actions which led to your conviction have
brought the profession into disrepute. It found that there was a clear need to make
a finding of impairment in order to declare and uphold proper standards, and to
maintain public confidence in the medical profession.
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22.
In the circumstances, the tribunal has determined that your fitness to practise
remains impaired by reason of your conviction pursuant to Section 35C(2)(c) of the
Medical Act 1983, as amended.
Determination on Sanction - 26/01/2017
Dr Peverley
1.
Having determined that your fitness to practise is impaired by reason of your
conviction, the tribunal deliberated on what action, if any, to take with regard to
your registration.
2.
In so doing, the tribunal gave careful consideration to all the evidence
adduced, together with Mr Slack’s submissions on behalf of the GMC and Mr HollAllen’s submissions on your behalf.
Submissions
3.
Mr Slack drew the tribunal’s attention to paragraphs of the Sanctions
Guidance (July 2016) (the SG) which he considered to be relevant in your case. He
submitted that yours was not an exceptional case in which taking no action would be
appropriate. He told the tribunal that this was not a case in which conditions are
obviously appropriate or could be easily devised bearing in mind the need to
maintain public confidence in the profession.
4.
He submitted that a period of suspension would be the appropriate sanction.
He acknowledged that your conviction related to an isolated incident, but stated that
aggravating features were present, such as your drinking in the workplace, and that
your decision to drive home after consuming a significant amount of alcohol created
a serious risk to the public.
5.
Mr Holl-Allen told the tribunal that, from the outset of this hearing, you had
been open in admitting to not just the fact of your conviction, but other cogent
information regarding your actions on 15 April 2016, which the GMC had cited as
aggravating factors. He reminded the tribunal that there was no evidence that you
were inebriated when seeing patients that afternoon, and no evidence had since
come to light of any harm to patients.
6.
He accepted on your behalf that you put public safety at risk by driving whist
intoxicated, and that it was likely that the tribunal would ultimately be deliberating
on the imposition of a period of suspension. He provided testimonials to the tribunal,
submitting that they were consistent with the picture that your actions on 15 April
2016, although very serious, were entirely out of character and ‘a blemish on an
otherwise unblemished career’ as a GP extending back as far as 1990. He stated that
the offence occurred some nine months ago, submitting that the intervening period
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had allowed you to reflect upon your actions, develop some degree of insight into
them, and begin the process of remediation.
Tribunal’s approach
7.
The decision as to the appropriate sanction, if any, is a matter for this tribunal
exercising its own judgement. In reaching its decision, the tribunal has taken
account of the SG and the statutory over-arching objective, which includes
protecting and promoting the health, safety and wellbeing of the public, promoting
and maintaining public confidence in the medical profession, and promoting and
maintaining proper professional standards and conduct for the members of the
profession. The tribunal recognises that the purpose of a sanction is not to be
punitive, although it may have a punitive effect.
8.
Throughout its deliberations, the tribunal has applied the principle of
proportionality, balancing your interests with the public interest. As advised by the
Legal Assessor, it reminded itself that it should only impose the minimum sanction
necessary to achieve the over-arching objective. In deciding what sanction, if any, to
impose the tribunal considered each of the sanctions available, starting with the
least restrictive. It also considered and balanced the mitigating and aggravating
factors in this case.
Taking no action
9.
The tribunal first considered whether to conclude your case by taking no
action with regard to your registration. The tribunal has already determined that
your fitness to practise is impaired by reason of your conviction. It determined that
given the serious nature of the actions leading to this conviction, and in the absence
of any exceptional circumstances, it would be wholly inappropriate to conclude this
case by taking no action.
Conditions
10.
The tribunal next considered whether it would be sufficient to impose
conditions on your registration. Any conditions imposed would need to be
appropriate, proportionate, workable and measurable. It gave due regard to the SG,
particularly paragraphs 73 - 84 which cover the imposition of conditions. It was of
the view that it could not formulate conditions to address the issues raised by your
conviction. Further, given the seriousness with which it views the actions leading to
your conviction, and the fact that you remain subject to a suspended sentence, it
determined that a period of conditional registration would not adequately protect
public confidence in the profession.
Suspension
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11.
The tribunal moved on to consider whether it would be sufficient to impose a
period of suspension on your registration. In doing so, it bore in mind paragraph 86
of the SG:
86 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
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).
12.
Although this paragraph refers to misconduct, the tribunal was satisfied that it
was also appropriate in its deliberations on the matter of your conviction. It was in
no doubt that your actions on 15 April 2016 were very serious, and were
aggravated, as you openly informed the tribunal, by the fact that you brought
alcohol into your workplace, drank a significant amount and then drove home whilst
intoxicated. These actions had the clear potential of causing serious harm to the
public.
13.
The tribunal found that there were mitigating features in your case. It
accepted that your actions on 15 April 2016 were directly connected to an
accumulation of professional and financial pressures in your life. The tribunal has
acknowledged that you have shown a degree of insight into your actions. In your
oral evidence at this hearing, you recognised that what you did was ‘stupid’ and
‘ridiculous,’ telling the tribunal that you would not try to justify it in any way. The
tribunal also paid particular attention to the testimonials provided by Mr B and Dr C.
Dr C, a GP and GP trainer, who has known you for 32 years, stated that he had
visited you shortly after the incident, and that you had told him that you ‘deeply
regretted’ your actions and felt ‘extremely ashamed’ of yourself, realising the
implications of your actions and the harm they could have caused.
14.
The tribunal also noted that it has seen no evidence of previous drink driving
incidents, and there has been no repetition of such incidents since April 2016. It was
satisfied, given the mitigating factors present and the isolated nature of this incident,
that erasure would be a disproportionate sanction in your case. Your actions were
very serious, but in the tribunal’s view, fell short of being incompatible with
continued registration.
15.
In all the circumstances, the tribunal determined to suspend your registration
for 6 months. In deciding on this period of time, the tribunal took into account the
seriousness of your actions and the need to demonstrate clearly to you, the
profession and the public that your actions on 15 April 2016 were unacceptable. It
determined that a suspension of this length would promote and maintain both public
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confidence in the profession and standards and conduct for members of the
profession.
16.
The tribunal also considered that a period of 6 months would provide you
with an opportunity to develop further insight into the seriousness of your actions. It
has expressed concern that there remains a risk of repetition of your behaviour if
you were to be put under similar pressures. A period of 6 months will allow you time
to embrace alternative strategies to cope with this kind of stress, ensuring that there
is a reduced risk that you will repeat your actions. The tribunal also considered that
this period will also allow you the opportunity to re-engage with continuing
professional development and bring your medical knowledge up to date.
Review hearing directed
17.
The tribunal has directed that, shortly before the end of the period of
suspension, your case will be reviewed by a Medical Practitioners Tribunal. It
considered that a future tribunal reviewing this matter would be assisted by:



a written reflective statement demonstrating that you have developed
further insight into your actions and embraced alternative strategies to
cope with stress;
evidence that you have begun to undertake continuing professional
development activities and brought your medical knowledge up to date,
e.g. clinical attachments, attending courses or training sessions;
testimonials, which may be personal or professional.
18.
The effect of this direction is that, unless you exercise your right of appeal,
this decision will take effect 28 days from when written notice of this determination
is deemed to have been served upon you. A note explaining your right of appeal will
be supplied to you.
Determination on Immediate Order - 26/01/2017
Dr Peverley
1.
Having determined to suspend your registration for a period of 6 months, the
tribunal deliberated in accordance with Section 38(1) of the Medical Act 1983, as
amended, whether to impose an immediate order of suspension on your registration.
Submissions
2.
Mr Slack, on behalf of the GMC, told the tribunal that he was not instructed
that an immediate order is appropriate in this case.
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3.
Mr Holl-Allen, on your behalf, submitted that an immediate order was not
necessary in your case. He told the tribunal that you had been suspended at a local
level for a period of six months following the offence, and then had restrictions
imposed on your membership of the performers list in autumn of 2016. He stated
that you had previously been able to return to work during this period but had
chosen not to so in the period leading up to these proceedings this week. He
confirmed that your intention was that you would not seek to work in the next 28
days.
Tribunal decision
4.
In deliberating on the matter, the tribunal noted paragraphs 166 -172 of the
Sanctions Guidance (July 2016) dealing with the matter of immediate orders. It had
regard to the principle of proportionality and balanced your interests with the public
interest.
5.
The tribunal was of the view that the substantive suspension of six months
was sufficient to demonstrate clearly to you, the profession and the public that your
actions on 15 April 2016 were unacceptable. It has noted that you have not worked
since April 2016, despite having had the opportunity to do so, and would be required
to disclose your pending suspension to any potential employer. It has found no
specific risk to patient safety in this case, and is satisfied in these circumstances that
an immediate order is not necessary to protect the public interest.
6.
That concludes this case.
Confirmed
Date 26 January 2017
MPT: Dr PEVERLEY
Mr Sean Ell, Chair
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