GENERAL MEDICAL COUNCIL

FITNESS TO PRACTISE PANEL (MISCONDUCT)

On:

Friday 20 June 2008

Held at:

St James's Buildings

79 Oxford Street

Manchester M1 6FQ

Case of:

RAJENDRA DHWARKA PERSAUD MB BS 1986 Lond

Registration No: 3117660

(Day Five)

Panel Members:

Dr A Morgan (Chairman)

Mrs A Granne

Miss K Heenan

Dr A Vaidya

Mrs S Breach (Legal Assessor)

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MR R FRANCIS, Queen's Counsel, instructed by RadcliffesLeBrasseur, Solicitors, appeared on behalf of the doctor, who was present.

MR J DONNE, Queen's Counsel, instructed by GMC Legal, appeared on behalf of the General Medical Council.

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Transcript of the shorthand notes of

Transcribe UK Verbatim Reporting Services Ltd

Tel No: 01889 270708

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INDEX

Page

FITNESS TO PRACTISE

DETERMINATION on impairment 1

SANCTION

SUBMISSIONS by MR DONNE 5

BRUGGEN, Peter, affirmed

Examined by MR FRANCIS 6

SUBMISSIONS by MR FRANCIS 10

LEGAL ASSESSOR'S ADVICE 23

DETERMINATION 24

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STRANGERS HAVING BEEN READMITTED

THE CHAIRMAN: Good morning, everyone.

D E T E R M I N A T I O N

THE CHAIRMAN: Dr Persaud, the facts found proved are as follows:

At all material times you were employed as a Consultant Psychiatrist for the South London and Maudsley NHS Trust and held an honorary post as a senior lecturer at the Institute of Psychiatry, King's College, University of London.

In March 2003 your book `From the Edge of the Couch' was published by Bantam Books. Your book contained passages plagiarised from various sources, including:

Your article entitled `Why the Media Refuses to Obey' was published in the March 2005 edition of `Progress in Neurology and Psychiatry'. Your article entitled `Frailty that Allows Evil to Triumph' was published in The Times Educational Supplement on 18 February 2005. Your article entitled `The Man Who Shocked the World: the Life and Legacy of Stanley Milgram' was published in the British Medical Journal on 6 August 2005. On a date unknown before 30 December 2005 you submitted to the British Medical Journal for publication an article entitled `Do you Obey or Do you Rebel'. These articles contained passages plagiarised from an article and a book entitled `The Man Who Shocked the World' written by Professor Thomas Blass and material published on Professor Blass's website on Stanley Milgram.

Your article entitled `A Dangerous War on Psychiatry' was published in the Independent newspaper on 30 June 2005. This article contained passages plagiarised from an article entitled `The Globalization of Scientology; Influence, Control and Opposition in Transnational Markets' written by Professor Stephen Kent.

The sections of your book and the other articles, or portions thereof, were not your own work, but were copied and reproduced from another source.

Your actions as described above were inappropriate, misleading, dishonest and liable to bring the profession into disrepute.

The Panel has considered whether, on the basis of the facts found proved, your fitness to practise is impaired by reason of your misconduct. Mr Donne has submitted on behalf of the General Medical Council (GMC) that your fitness to practise is impaired. Mr Francis, on your behalf, submitted that your fitness to practise is not impaired.

The Panel has taken account of the advice of the Legal Assessor, who referred the Panel to the case of Harry v GMC [2006] in which Mr Justice Goldring stated:

“First, it must ask itself if there has been misconduct. If the answer is yes, it must go on to ask itself whether that misconduct has impaired the doctor's fitness to practise. In deciding whether there has been misconduct, it is not possible, in my view, to ignore the public interest in the wider sense. That interest is an integral aspect when deciding whether the particular facts proved have passed the threshold and amount to misconduct.”

The Legal Assessor also drew the Panel's attention to the case of Roylance v GMC [1999] in which Lord Clyde stated:

“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.”

The Panel has taken into account the GMC's publication Good Medical Practice (May 2001 edition applicable at the time) which states that doctors should be honest and trustworthy and that:

“serious or persistent failures to meet the standards in this booklet may put your registration at risk.”

The Panel acknowledges that patients have not been harmed. However, it is aware of its responsibility to protect the public interest, particularly with reference to maintaining public confidence in the profession and upholding proper standards of conduct and behaviour. Doctors occupy a position of privilege and trust in society and are expected to act with integrity and to uphold proper standards of conduct. The public is entitled to expect that doctors will be honest and trustworthy at all times and that they adhere to the highest standards of probity. Your conduct has fallen below the standards of behaviour that the public is entitled to expect from doctors and undermines public confidence in the profession.

The Panel has determined that your dishonest conduct in plagiarising other people's work on multiple occasions represents a serious breach of the principles that are central to Good Medical Practice. The Panel is in no doubt that this amounts to misconduct which is serious.

In determining whether your fitness to practise is impaired, the Panel has considered the GMC's Indicative Sanctions Guidance (April 2005). In particular, at paragraph 11 of section 1, it states that:

“Neither the Act nor the Rules define what is meant by impaired fitness to practise but for the reasons explained below, it is clear that the GMC's role in relation to fitness to practise is to consider concerns which are so serious as to raise the question whether the doctor concerned should continue to practise either with restrictions on registration or at all.”

Indicative Sanctions Guidance, paragraph 58 at page S3-14 states that a question of impaired fitness to practise is likely to arise if:

“A doctor has behaved dishonestly, fraudulently or in a way designed to mislead or harm others.”

The Panel recognises that it is entitled to take into account past conduct when considering current impairment on the basis that past conduct is relevant to a doctor's suitability to continue to practise.

Your dishonest conduct brings the profession into disrepute and the Panel has, pursuant to section 35C(2)(a) of the Medical Act 1983, as amended, concluded that your fitness to practise is impaired by reason of your misconduct.

The Panel will now invite further submissions from Mr Donne as to the appropriate sanction, if any, to be imposed on your registration. Mr Francis will then have an opportunity to respond on your behalf. Submissions on sanction should include reference to the Indicative Sanctions Guidance, using the criteria as set out therein to draw attention to the issues which appear relevant to this case. Mr Donne, please.

MR DONNE: Sir, the Panel will be aware that the submissions I make at this stage are no more than that. They are designed to assist you in reaching what you consider to be the appropriate sanction, exercising your independent judgment. It is clear, as you have stated, that no patient has been harmed by Dr Persaud's proven conduct and the gravamen of what he has done lies in the damage it has caused to the reputation of the profession as well as to his own.

This Panel is clearly alert to the need to maintain the trust of the public in the profession and to uphold proper standards of conduct and behaviour. To paraphrase Sir Thomas Bingham, as he then was, in a case concerning a solicitor, the well known case of Bolton v The Law Society, in most cases the order of the tribunal will be directed to one or other or both of two purposes.

One is to ensure that the offender does not have the opportunity to repeat the offence. This purpose is achieved for a limited period by an order for suspension. Plainly, it is hoped that experience of suspension will make the offender meticulous in his future compliance with the required standards. The purpose is achieved for a longer period by an order of striking-off.

The second purpose is the most fundamental of all. It is to maintain the reputation of the profession as one in which every member, of whatever standing, may be trusted. A profession's most valuable asset is its collective reputation and the confidence which that inspires.

Indicative Sanctions Guidance provides helpful assistance to you. It is clear that the purpose behind the order you will make is not punitive, even though it might have that effect and it must be proportionate to the wrongdoing that you have found proved as well as the particular circumstances of the doctor.

Paragraph 39 makes clear that the courts have endorsed the view that the most severe sanction is appropriate where the conduct of the doctor is a matter of serious concern and that includes dishonest conduct. That guidance is amplified by paragraph 44, which makes clear why dishonesty is regarded so seriously.

It is, I observe, perhaps a matter of a little concern that Dr Persaud seems to have lacked a degree of insight into just how serious his conduct was. However, these considerations should be balanced against a number of important factors: firstly, again as you have observed already, the fact that no patient has been or is likely to be harmed by Dr Persaud's conduct; secondly, the dishonesty did not occur in the perhaps more usual context of financial impropriety; thirdly, it did not occur in the field of research. Therefore there is no question of the profession's confidence in the science of medicine being undermined. Finally and fourthly, Dr Persaud and his employers have put in place measures to avoid a repetition of his misconduct.

In section 1 of Indicative Sanctions Guidance, undertakings, in our submission, simply do not arise here. Conditions on the doctor's registration, we submit, equally would be inappropriate because they simply do not meet the gravity of the conduct that has been found proved and, secondly, because to an extent steps have already been taken to avoid repetition of this conduct.

Erasure is of course considered appropriate when the doctor's behaviour is fundamentally incompatible with being a doctor and involves a serious departure from the relevant professional standards and has done serious harm to others, either deliberately or through incompetence, particularly where there is continuing risk, abuse of a position of trust or a violation of the rights of patients and offences of dishonesty, especially where persistent and covered up.

However, in the submission of the Council, a proportionate sanction in this case, bearing in mind the matters that I have already referred to, would be a period of suspension.

Suspension is appropriate, as the Panel will see in section 1, page 14, when a serious instance of misconduct has occurred and a lesser sanction is not sufficient. It is not fundamentally incompatible with continuing to be a registered doctor and, of course, the point has been made repeatedly in the course of this hearing that Dr Persaud's conduct had nothing to do with his clinical duties; where there is no evidence of harmful, deep-seated personality or attitudinal problems - and we accept that that is the position although I have made reference to a possible lack of insight; and there is no evidence of repetition of the behaviour since the incident.

Such a sanction, we submit, would send a clear signal to the doctor, the profession and the public of the Panel's determination to maintain the reputation of the profession and the well-founded trust of the public in it.

THE CHAIRMAN: Thank you, Mr Donne. Mr Francis, please.

MR FRANCIS: Sir, I want to do two things by way of putting further evidence before you. One is to call by way of the telephone from France Dr Bruggen, who is available as I speak, he being Dr Persaud's mentor. Secondly, I wish to put before you a bundle of written testimonials and also to ask you to take into account obviously the oral evidence you have already heard. With your permission, could I start with Mr Bruggen, please?

THE CHAIRMAN: You can. Can I ask you to do what you did before and introduce us and say thank you at the end?

MR FRANCIS: Only the latter if you tell me to at the time.

THE CHAIRMAN: I think I will say thank you to him as he has the courtesy to speak to us.

(The following evidence was given via telephone link)

PETER BRUGGEN, affirmed

Examined by MR FRANCIS

Q Good morning, Dr Bruggen.

A Good morning.

Q Can you hear me?

A Yes, I can hear you,

Q I have been asked by the Chairman of the Fitness to Practise Panel, Dr Morgan, to as it were welcome you and to thank you for coming to give evidence.

A Thank you.

Q I will ask you some questions first of all. You may be asked questions by others afterwards, but if that happens they will be introduced to you.

A Yes.

Q Dr Bruggen, can I first of all ask about you? Is it correct that you are a Fellow of the Royal College of Psychiatrists?

A Yes.

Q And have been since 1977?

A Yes.

Q Were you a Consultant Psychiatrist at the Hill End Hospital in St Albans up until 1994?

A Yes, that is correct.

Q And a Consultant Psychiatrist at the Tavistock Clinic at an earlier period?

A Yes.

Q Were you also up until 1993 the Medical Director of the Dacorum and St Albans Community Mental Health Trust?

A Yes, I was.

Q Do you know Dr Persaud?

A Yes.

Q When did you first meet him?

A We met when he was a medical student and I cannot give you the date. He was on a placement at Hill End Hospital and he spent a week or so in the Unit in which I worked, which was a regional adolescent unit.

Q Did you remain in contact after that time?

A We remained in slight contact. It was occasional sending notes about papers and acknowledgements and things like that.

Q Did you form an impression of him at the time?

A Yes, I did. He was a good visitor for us to have for a week, or however long it was. He was enthusiastic. He would join in anything. He was also very bright and would offer ideas or references and so on. He was very bright and he also seemed to be very sensitive to the experiences of the adolescents and the other staff and was very careful not to brush over or push into things.

Q Turning then to more recent times, in 2004 did you develop a somewhat closer relationship with Dr Persaud on a professional basis?

A Yes. He sent me an e-mail saying, as I knew, that there was a pressure and that consultants were being advised to get mentors and would I be his mentor and I replied immediately and said I would be pleased to do that.

Q What did that entail?

A It entailed us meeting regularly to discuss his work, the matters of his work, not his personal life, not his past life. It is how to handle his work. We arranged to meet and with this particular agenda of the relationship between him and the other consultants. He was a consultant at the Maudsley Hospital. There was a consultants' meeting and this was something which we could take as a focus, as a sort of mini world of him and the other consultants and that led to other things, to discussing various reports, negotiation with the management of the National Health Service, appearances at court and things like that and how he could do things differently or continue to do things the same but with more understanding.

Q How receptive was he to your input in relation to matters such as that?

A He seemed very receptive. My position was not a managerial position. I could only counsel. But he seemed to take up on a lot of ideas which I put forward. The most definite one of all of these that I remember was and I cannot tell you the date of it, when I suggested that we did some video work. I think it was before the present problems. I suggested that we do some video work to see if we could look at details of his behaviour which might give us clues about how to change his presentation when he negotiated with a manager, or Mental Health Tribunal, or whatever. I was a bit tentative in mentioning this and he grasped it immediately. He had no objection. He arranged a studio at the Institute of Psychiatry and we did that work together and I think he changed from that.

Q He changed in what way?

A In very simple ways like how he sat and how he sometimes lightened the expression on his face as he was thinking, rather than remaining in a pensive appearance.

Q Did there come a time when you became aware of allegations of plagiarism?

A Oh yes. He sent me an e-mail about this and I responded immediately and we spoke on the phone later, I think the same morning.

Q Can you remember roughly when that was?

A When?

Q Yes.

A Yes. It was roughly early spring of four years ago. Is that four years ago? Am I right? We started in 2004. I am sorry.

Q Dates are often difficult, but I think you have told us that the mentoring started about 2004?

A Oh yes, the mentoring started around March 2004.

Q How long after that did you become aware?

A It was roughly two years after that. I may be a year out in that.

Q Did those allegations and what lay behind them become the subject of conversation between you?

A Oh indeed. It is not the only thing we discussed but it was an intense preoccupation for both of us because it was very serious. He thought it was very serious. He was very alarmed. We discussed in great detail what to do, like I know he was consulting the Defence Union and lawyers and that there was never any question that what had happened had happened. He explained to me about how he thought it had happened in the rapidity of doing some stuff and that I suppose was not all that surprising because he did an enormous amount of writing and doing interviews and had a very strong pressure on him to respond to this and one of the things we talked about quite early was how to say no a bit more.

Q Since these allegations have arisen, have you noticed any changes in Dr Persaud?

A Oh yes. There have been a number of changes. First of all, we have met much more frequently. We have about twice as frequently as we did before. I think we have had more phone calls and e-mails, but that I do not have a record of in the same way. He seems to be much more serious. He appears to me to be appearing much more serious when we meet, which is a relief to me, much more prepared to think about things before he did them, or does them or considers doing them and started to be able and accomplished at saying no to various invitations and offers.

Q You are aware, I think, that this Panel has found that in relation to the plagiarism that Dr Persaud was dishonest?

A Yes, I am aware of that. Yes.

Q That is a preface to my next question, which is what assessment would you have of Dr Persaud's integrity?

A I have not had any doubt at all that he was somebody who was honest and a man of integrity and I understand that this verdict on the plagiarism is a definition that it is in itself a dishonesty.

Q Also that he knew that he was acting dishonestly - I think it would be fair to say that was part of the findings?

A I see. I had not understood that because I saw the things he did as examples of carelessness rather than thinking out something to do dishonestly.

Q What I am really asking you about and that is the background that we now have?

A Yes.

Q In relation to your assessment of Dr Persaud over the years that you have known him?

A Yes.

Q Bearing in mind this finding, what would you say about your views as to his integrity?

A About his integrity, I have no doubt about his integrity being sound and no suspicion or hint or indication that he was ever dishonest to me or covering up to me, nor to others, as far as I knew.

Q As far as the effect of these proceedings and these complaints against him are concerned, can you tell the Panel what you assess that to have been?

A The effect on him?

Q Yes.

A He is a very worried man. He has been much more worried, much more restless, complaining of a preoccupation with it, difficulty in concentrating, putting things off and needing to go over things again and again and suffering. Yes. He is a suffering person.

Q In relation to his workload, has that changed, would you say?

A Did that change with his work?

Q No. Sorry. Has his workload changed?

A Yes, his workload has changed. He has by a deliberate decision put more of his energies and time into clinical work and less into writing, broadcasting, responding to interviews. He has actually withdrawn from some things and does very much less of it and has frequently discussed potential things with me beforehand, whether to say yes or no and whether to say yes, about how to do it.

Q Finally, can I ask whether it is your intention that this mentoring relationship continues?

A Yes. I am available, yes. He has to be in charge.

Q Both of you has to be willing?

A He has to be in charge of it. I am available, yes.

Q Dr Bruggen, thank you very much. There may be questions, but not from Mr Donne, I think. I am happy to say no one else has any questions for you, but I am sure the Chairman would ask me once again to thank you for your assistance.

A Right and that is it?

Q That is it.

A All right.

Q Thank you very much.

A Goodbye.

(The telephone link was terminated)

MR FRANCIS: Sir, may I now put before you a bundle of testimonials which deal with a number of different aspects of Dr Persaud's character and activity and the views that other people have of him? (Same handed)

THE CHAIRMAN: This will be D5.

MR FRANCIS: Thank you. Sir, there are page numbers at the bottom right-hand corners, some of which have not copied very well, but I will try and refer to those as we go through these. You will be happy to know that I do not intend to read aloud everything in here, but there are certain passages in quite a number of the letters to which I wish to draw attention.

Sir, the first reference comes from Professor Robert Howard, who is a Professor of Old Age Psychiatry at the Institute of Psychiatry and the South London and Maudsley NHS Trust. He tells us that he was a trainee with Dr Persaud between 1989 and 1991 and later a contemporary of his in posts as lecturers at the Institute and subsequently Consultant Psychiatrists with the NHS Trust in South London.

He says:

“[Dr Persaud] has acted as a very skilful and compassionate Chair of the Question and Answer Panel sessions that we have run as part of our Dementia Research Open Days. The audience for these is made up of people from the local community, many of whom have dementia or are involved in the care of family members with the condition. Dr Persaud's skill and interest in facilitating involvement from all sections of the audience at these has been striking.”

Sir, in the next paragraph he says:

“[Dr Persaud] is a talented and ambitious colleague with an outstanding intellect who has chosen over the years to devote his energy and ability to his work with the media. His work with the media and his skills in communicating complex and sometimes controversial issues to a general audience have very much been to the benefit of Psychiatry and people with mental health difficulties. I would single out his work for Radio 4 as having been particularly beneficial to the professional and lay mental health community.

There is still an enormous stigma associated with mental illness and the widespread fear and ignorance that accompanies this is damaging to our patients. Dr Persaud has done more than probably any other single individual in recent years to counter this through his media work. His undoubted talent in this area has made him something of a celebrity and I would think that this is a difficult burden to carry alongside the more usual aspects of life as a doctor.

Certainly, I believe that the pressure of demands from the media would have led him, in the very specific areas that I believe to be the subject of the upcoming Fitness to Practise Panel hearing, to have cut corners in a way that I would have considered to be highly uncharacteristic of Dr Persaud's usual rather meticulous approach to his written work. I know from personal contact with him that he acknowledges that he has made mistakes and put measures in place to protect himself from a recurrence of the over-commitment that led to these mistakes.”

Sir, I will come to it right at the end, but there is a letter right at the end of the bundle from Professor Howard, dated yesterday, written in the knowledge of today's proceedings, from which it is clear that he stands by that reference in the light of your findings.

Sir, the second page is a letter from Professor Philip McGuire, who is Professor of Psychiatry and Cognitive Neuroscience at the Institute of Psychiatry. He says that he has known Dr Persaud since 1990 and has had numerous contacts with him in the context of research, although he has not worked with him in a clinical capacity.

“I had most contact with Raj when he was a junior researcher, when we shared an office… He was an outstanding clinical researcher. The research he conducted was of high quality and he had a rigorous scientific approach. He was very highly regarded by his academic colleagues. I found him enthusiastic, generous and helpful and highly professional in his interactions with colleagues.

At that time he was just beginning to write articles for the media. He told me then that he felt that the profession of Psychiatry and psychiatric patients were poorly represented in the media and I think that a key motivation behind his interest in this area has been a genuine desire to improve this.

When I have met Dr Persaud recently I have been struck by how distressed he was by the recent proceedings.”

Sir, the next letter is from Dr Cutting, a Consultant Psychiatrist, dated 19 June. He apologises for the handwritten status of this report.

“I have been informed that I need to prepare an urgent report for the purpose of proceedings on 20 June. I have been asked by Dr Persaud whether, in the light of his communication to me today, that he has been charged with dishonesty, my testimonial dated 5 June still stands. I can say that it does and that I still stand by what I said.”

Then over the page you have what he wrote on 5 June, which was that he was a Consultant Psychiatrist and was Dr Persaud's first Consultant when he started at the Maudsley as a junior Psychiatrist in the eighties.

“I have since left the Bethlem Hospital and am working as medico/legal expert and an Honorary Senior Lecturer at the Institute... I remember Dr Persaud very well as he is one of my best Registrars. I have kept up with him since and we wrote a joint scientific article about schizophrenia together. I remember him as a very good clinician and a very intelligent and personable doctor. I was pleased to hear that he himself became a Consultant.”

He goes on to say:

“I was particularly pleased also that he became a celebrated populariser of Psychiatry on the television and on the radio and in the press. In my view this is a very important aspect of our work as there is so much anti-Psychiatry feeling around. In fact now that Professor Tony Clare has died, Dr Persaud is the only representative of this aspect of our profession.

In my dealings with him, I have never had the slightest doubt about his intelligence and honesty and integrity and I was shocked to hear that he had been asked to attend this Hearing of the General Medical Council.”

He then says this that, were he to be erased:

“…this would be a disaster both for him and for Psychiatry in general. He himself would feel humiliated.”

More importantly, you might think:

“Psychiatry would be a great loser as he is one of the standard bearers of its public persona and such action by the General Medical Council would throw our profession into disarray. I hope sincerely that the General Medical Council will take a sympathetic view to his situation and recognise that he is a man of high moral standing, as I have indicated in this testimonial.”

The next is a short letter of 19 June from Professor Woodruff, who confirms that he is aware of the findings of dishonesty and stands by his letter of 11 June, which is at page 6. He is the Professor and Head of Academic Clinical Psychiatry at the University of Sheffield and an Honorary Consultant Psychiatrist in Sheffield. He says that he first met Dr Persaud as a trainee in Psychiatry at the Maudsley:

“He preceded me in a training exchange to Johns Hopkins Hospital, Baltimore.”

What he says, sir, is that he prepared and lodged a helpful guide on how to get as much as possible out of that and that he characterises as being a generous act.

“The clinical team at Johns Hopkins Hospital…was full of praise for his caring attitude to patients and clinical skills. It was a hard act to follow. Throughout our meetings whilst clinical trainees he was generous with his views and advice and I found my interactions with him professionally stimulating.”

They worked together when he was a junior researcher under the supervision of Professor Murray and collected data and did joint assessments.

“Throughout this time I had full confidence in his scientific integrity and had no reason to doubt [it]. The only comment I would make is that I thought he was enthusiastic, which I considered a positive contrast to some other researchers I met at the time.”

He says he kept in contact with Dr Persaud on a personal and professional level after he, Professor Woodruff, left London and invited him to speak at his own departmental seminars, which he did successfully. He also somehow contributed to the `All in the Mind' programme and an educational podcast for the Royal College. He ends with this:

“From my contacts with Dr Persaud detailed above, my impression of him is that he is someone who has a generous nature, who is enthusiastic and committed to Psychiatry and the need to disseminate knowledge to the Public about Psychiatry and the problems patients face. These are complex and sometimes controversial areas that demand real talent in balancing arguments and communication in order to convey something meaningful to the Public. Dr Persaud possesses these rare skills and my view is that Society would be worse off without his continued input in these areas.

He is engaging and cares deeply about his subject. I also believe that part of this caring is embedded in a deep concern for patients' well-being and the need to know more about psychiatric conditions in order to alleviate patients' suffering more effectively. I have had no personal reason to doubt his integrity in my direct dealings with him.”

Finally, he says:

“He is driven by intense enthusiasm and desire to disseminate knowledge.”

Then there is a letter dated 27 May from the President of the Royal College of Psychiatrists, Professor Sheila Hollins, who says:

“…although I do not know Dr Persaud in his clinical capacity, during this time”,

that is, since she has been President of the College,

“he has made a significant contribution to the public education activities within the Royal College of Psychiatrists. I am therefore limiting my comments to this area.

During my Presidency Dr Persaud has edited a highly successful book for the general public on mental health which Transworld published in partnership with the Royal College of Psychiatrists. Dr Persaud has also contributed regularly to the podcasts on our website using his interviewing skills.

I chaired the 'Images of Psychiatry' campaign and Dr Persaud made a valuable contribution to this. He is currently co-editing a reference book for parents and teachers on young people's mental health. There is no doubt that Dr Persaud is a very successful communicator with the general public.”

Sir, there is then a reference from Professor Murray, who is mentioned, I think, in an earlier letter. He is Professor of Psychiatry at the Institute and the Maudsley Hospital and he has been the Dean of the Institute and President of the Association of European Psychiatrists and has known Dr Raj Persaud for almost two decades. He says:

“I first met him when he became a junior doctor at the Maudsley and was immediately impressed by his enthusiasm, ability and clinical skill.”

Later, he was a researcher. He then says this:

“In my opinion Dr Persaud has done a great service for Psychiatry in that he has helped to educate the public about sensible theories concerning psychiatric illness. He has a great ability to convey quite complicated matters in an easy-to-understand fashion to the general public. In addition, the programmes which he has participated in such as `All in the Mind' I believe have been very beneficial in that his good rapport with the listening public enables him to introduce academics or researchers and enables them to convey their recent advances in psychiatric disorder widely.

In my view there is no other living Psychiatrist who has done so much to promote the public understanding of Psychiatry as Dr Persaud. This view is, I believe, widely shared within not only this Institute but also within the Royal College of Psychiatrists for whom Dr Persaud has also done a very great deal of work.

In my dealing with Dr Persaud I have always found him to be honest and also very generous with his time as instanced by support for many charities within Psychiatry. For example, he has donated a great deal of energy to helping the Psychiatry Research Trust which raises funds for research in our field.

I understand that Dr Persaud regrets very much his actions which have unfortunately caused the Scientologists to refer him to the General Medical Council. I very much hope that whatever the GMC's verdict, the GMC will not do anything to endanger the ongoing contribution that I believe Dr Persaud can make not only to his patients and to this Institute but also to the advancing of the public understanding of Psychiatry.”

Sir, then there is a letter dated 6 June from Dr Veale, who is a Consultant Psychiatrist in Cognitive Behaviour Therapy in Sound London and also an Honorary Senior Lecturer. He has published about sixty peer-reviewed publications and three books and has sat on the panel that produced the NICE Guidelines for Obsessive Compulsive Disorder. He says that he has known Dr Persaud on and off for about 15 years as a professional colleague. He says:

“He has also contributed to a charity for which I am a Trustee (OCD Action) by speaking at conferences for people with OCD. I have also known Dr Persaud through his work on radio (`All in the Mind') for which I have been interviewed by him on two occasions. I have also written a chapter for a book which he has edited. I have also known him as a Consultant colleague over the past two years at the Bethlem Royal Hospital….

In all my dealings with Raj, I have always found him to be honest and trustworthy. He has made an enormous contribution to the community and the public understanding of mental health problems. This has helped to reduce stigma and suffering of thousands of people with mental disorder.”

THE CHAIRMAN: Mr Francis, you did say you were not going to read them all out.

MR FRANCIS: Not some at the back.

THE CHAIRMAN: It is not that the Panel is not going to read them all itself, but it is just whether it is necessary to read them out.

MR FRANCIS: Sir, if I may, one of the purposes of this hearing is not only to inform you, but to inform the public about what is in these documents.

THE CHAIRMAN: I accept that. It is just purely what you said. That is all.

MR FRANCIS: I have been summarising quite a number of passages, if I may?

THE CHAIRMAN: Yes.

MR FRANCIS: Professor Gunn's reference tells you when he came into contact with him and describes him in the second paragraph as a congenial energetic colleague who has pursued a part-time career in the media, which has been successful and important. He also makes the point about ignorance and stigma. He says that he has had contact with Dr Persaud and his work at the Royal College, where he has pioneered the making of professional iPods.

“His high standard of work and his integrity have been appreciated by those who have worked with him.”

He ends by saying:

“…it is evident to me that Dr Persaud makes a much greater contribution than average in the field of Psychiatry.”

Sir, there then follows a very short note from six nurses on the ward, who say that they wish to support him.

I then turn to the reference of Dr Kemp. It is dated 19 June. She says that she is aware of the findings today and stands by the character reference below, which just by way of explanation was contained in an earlier letter. She has been friends with Dr Persaud since being at medical school. She describes at page 2 and I will not read this out, assistance that he has given her family in times of crisis.

She has never had reason to doubt his honesty and integrity. He readily went to give a lecture at her hospital in Oxford in aid of a school which was in need of funds. She says that he has found these proceedings extremely upsetting and unsettling.

Sir, the next reference is from Martin Bashir, a journalist, who says at the beginning - this also being dated 19 June - that it is to be presented here. His encounters began professionally, he says, but developed into a personal relationship for which he is deeply grateful. He says that he has always been struck by Dr Persaud's desire to focus attention on science and the best available research:

“Although he has always been generous towards those less qualified and less responsible in their discussion of mental health issue, he is only ever concerned that individuals are given the best and medically sound advice. Always up to date with the latest research and invariably generous in recommending the academic work of colleagues and other experts, he became the port of call for almost every broadcasting and media organisation in the UK.”

He then describes - and I will not read this out - assistance again in a professional capacity that Dr Persaud has given to members of Mr Bashir's family. He then deals with the Church of Scientology and he says this:

“In the ten years that I have known Dr Persaud, I have come to rely upon his expertise and judgment. If I had any concerns about his probity or honesty, I would have disclosed these to my employers and not included his contribution for fear of provoking a libel lawsuit. However, I have never had a single reason to doubt his integrity.

I do not know the detail of what he is alleged to have done but can only assume that this must have occurred as a result of overstretching himself or attempting to serve too many media outlets at the same time. As a professional broadcaster myself, I know intimately the pressures that are brought to bear by deadlines and the demand for copy at the most awkward of moments

And this is my sole profession. I cannot imagine how a busy Psychiatrist, working with the day-to-day stresses of the NHS, not only discharges all of his responsibilities but also spends so much of his time trying to demystify mental illness to the benefit of the wider public. Far from his efforts provoking censure, I would humbly suggest he is deserving of commendation.”

Sir, then you have two references from the Gresham College, of which you will remember that Dr Persaud is visiting Professor. The first is from the Academic Registrar, who talks of his genuine commitment to fostering public understanding and giving an enormous amount of time in sharing his expertise.

Then at page 17 you have a letter of yesterday also from the Academic Registrar but forwarding a statement from the Provost, Lord Sutherland of Houndwood, which says:

“Gresham College is aware of the GMC proceedings and the allegations... Gresham College feels that this matter does not in any way affect Dr Persaud's role in delivering lectures to foster the public understanding of Psychiatry. In this role he delivers high quality lectures which simply the worlds of Psychiatry and Psychology... The College is pleased that Dr Persaud has agreed to deliver further lectures at Gresham College…and has no intention of cancelling his future commitments.”

That, I think, is a reference to the College saying that, as opposed to Dr Persaud. Then there is a brief statement from Transworld Publishers, who you will appreciate are the publishers of this book that you have been concerned with, again dated yesterday. They are aware of the proceedings and continue to believe that Dr Persaud is an important author whose message is one to be heard.

“We are disappointed to hear of the panel's decision and would very much hope that no further sanctions will be imposed on Dr Persaud, as we would very much wish to be able to continue to support, promote and publish his works.”

There is then a letter from another journalist, Mr Clements, who was the editor of the `Good Health' section of the Daily Mail. He describes being impressed by hard work and continuing dedication to his patients even when he made a name for himself as an author or journalist.

There then follows at page 19 a reference from Lord Owen, who says that he has been Minister of Health and how he met Dr Persaud in 2007. He says in paragraph 3 that he has:

“…the highest regard for his skills as a populiser and explainer of psychiatric illness to the general public. This is a rare skill and something which not many doctors have. It involves, while being rooted in the science of mental ill health, being able to put the issues simply and straightforwardly in terms the lay person can understand.

I hope that when weighing the evidence over the charge of plagiarism, the GMC will bear in mind the important role he has built up in bridging the gap between the academic science and treatments in Psychiatry and building an important understanding of these issues amongst the general public.”

There is then a letter from Dr Simon Singh, who writes this on 19 June and stands by what he had previously written before hearing of the decision. He explains a lot about his background. He says at the bottom of page 20:

“I have found him to be a thoroughly decent man who has committed himself to communicating important ideas... He (like me) believes that it is crucial that the members of the general public understand the science...”

Over the page, he says:

“When misinformation is rife on a particular subject, Dr Persaud will go out of his way to find an avenue for promoting the facts based on the best available evidence. When an important issue is being ignored, he will strive to find a way of giving it a higher profile in the media. This can involve arduous trips to far-flung countries where he will make radio programmes for the BBC World Service. There is no glory, luxury or profit to be had in working on such programmes, but Dr Persaud believes passionately in his work as a science communicator and I am continually impressed by his efforts.

It does seem, however, that Dr Persaud's extreme efforts aimed at helping the public have led to errors in the recent past, which have received coverage in the mainstream press. Perhaps this was inevitable when we bear in mind the pressures on his time and his desire to write about so many subjects so frequently. This does not mean that it is acceptable to make such mistakes, but this problem has to be weighed up against the huge amount of positive work that Dr Persaud has done.”

Sir, that is Dr Singh. We then go to page 21a and Dr Sanders, who is in fact Dr Persaud's General Practitioner. He stands by the reference he gave, which is at page 22. He says that there is nothing he knows that would make him think he would ever do a dishonourable act, either personally or professionally.

Sir, then at pages 23 and 24 is a letter from Fiona Fox, Director of the Science Media Centre of the Royal Institution, who says:

“I have spoken with many of the UK's most respected science journalists about this case and they all feel that the accusations of plagiarism do not detract from Raj's considerable strengths as a populariser of science and psychiatry. No one I have spoken to in the media or in the psychiatry world believes that Raj Persaud is not fit to practise and there is a strong sense that society must not lose access to Raj's expertise because he made mistakes in his literary writings which were almost certainly down to the huge number of projects that Raj Persaud got involved in - many with tight deadlines.”

She describes him as being an unpaid adviser to the Centre on psychology and psychiatry issues and she says this:

“The reason we have such huge respect for Dr Persaud is that he is that rare thing - an eminent scientist who sees engaging the media and the public as a part and parcel of his role as a scientist.”

I will not read further from that, since similar sentiments are expressed to others. There is a very short statement from Richard Madeley and Judy Finnigan and Cactus Television, saying that they wish it to be known that Dr Raj Persaud will remain a valued contributor to their television programmes. I should say in parentheses that Dr Persaud wishes you to know that he has cut down and has not, in fact, in recent times appeared on this programme and he would, in fact, view this as one of the things to step back from in order to relieve pressure on him, but it is worth you knowing what their view is of him.

Then we come, you will be relieved to know, to a number of shorter ones, the theme of which is mental health charities that Dr Persaud has assisted by his involvement with public lectures and the like. I will just read the names of the charities: the Alzheimer's Research Trust, page 25; at page 26 the Association for Post-natal Illness; on page 27 ActionAid UK, which includes reference to visits to India and Bangladesh to undertake reports for them and speaking at a fund-raising dinner, raising a large sum of money; at page 29 his work with the Bipolar Organisation; at page 30, the Psychiatry Research Trust, giving a number of lectures, the OCD-UK charity, supporting that charity by appearances, the Institute of Ideas, where Dr Persaud has been a regular participant.

That is from Claire Fox. I will just read it:

“The Institute of Ideas relies on goodwill, so we always note those who go beyond simply doing the minimum. Dr Persaud can always be relied upon to take extra care in preparing speeches, in staying around after debates to speak to audiences informally and in participating in all the activities with gusto and real intellectual flair, far beyond the call of duty.”

Sir, then if I go to page 34 - you will be relieved to know this is the last one - and we end up where we started, with Professor Howard. He has made what you may think is a thought-provoking contribution in terms of yesterday. He says:

“I have just become aware of the outcome of yesterday's GMC hearing and wanted, in some haste, to reiterate my support for Dr Persaud and to confirm that I continue to stand by the comments that I have made in an earlier letter to you about his positive contributions…

I know that Dr Persaud has acknowledged his mistakes. The high degree of public and press interest in his case during this week has been unprecedented and humiliating for him. The resulting damage to his reputation - consequent of course upon his own mistaken actions - is a severe punishment.

I am writing as a senior member of the psychiatric profession - as an established clinical academic figure and as Dean-elect of the Royal College of Psychiatrists - to offer my help to the GMC hearing panel if they should consider that it would be appropriate to place limitations on Dr Persaud's future registration.

I am prepared to meet Dr Persaud on a monthly basis here at the Institute of Psychiatry to review all of his ongoing written output with him and to go through each piece and check with him that the work is indeed his own or that primary sources are acknowledged appropriately. I would prepare reports on a three-monthly basis for the GMC summarising the content of these supervision meetings and would of course undertake to report immediately any concerns that I had about Dr Persaud's behaviour in relation to his writing.

I should also say that my offer includes the point that I would be happy to go along with any conditions and measures that the panel thinks appropriate in Dr Persaud's particular situation.”

Sir, that concludes the references to be drawn to your attention. Sir, the themes to come from those testimonials are these. Dr Persaud is a man of many talents. He is a clinician, a researcher and a communicator. His outstanding gift, you may think, is one of being able to communicate to all types of people, professional colleagues, service users and the public.

Not only does he have that gift, but you may think there is overwhelming evidence that he has used that gift to the very considerable benefit of Psychiatry in propagating public understanding. A particular aspect of that is clearly his efforts to assist in the removal of stigma that mental illness can carry.

Clearly I submit he is a man who is shown in these testimonials to be a man who is generous in offering his time and talents for the benefit of others, whether they be professional colleagues, the profession generally through the Royal College, service users, charities and the public. This therefore is a man who has not sought to use celebrity for its own sake or for his own benefit but one who has sought to use it for the benefit of others. It is therefore, I submit, not surprising that he clearly retains the trust and confidence and admiration of his peers and others who know him well.

Unhappily the work that he has done has clearly been at a considerable cost. By that I mean the constant media demands to which he exposed himself had to be juggled with a busy and distinguished clinical practice as well as academic obligations. It appears, most unhappily, that this has led to a cutting of corners in some of the writing, as you have found.

Sir, I would pause there and say this, as a public opportunity on behalf of Dr Persaud that the finding you have made is clearly a great blow to him. He feels that deeply. It is sobering and saddening. It is bound to have an effect on the way in which others regard him and, as has been pointed out in some of these testimonials, that is in itself a considerable sanction.

In relation to the effect that this has had on the profession, Dr Persaud clearly deeply regrets that and wishes me to say so and through me and you in public to apologise for the misleading activity that took place. Sir, I would submit that despite these findings that you could be satisfied that Dr Persaud is fundamentally an honest man committed to doing what he can for his profession.

It is quite clear, I would submit, that the conduct that you have seen and that you are looking at in this case is quite at odds with his general professional and personal behaviour both before and since the events that you have been looking at. The evidence for this, you may think, is the overwhelming support contained in these testimonials from people who have received the advantage of his talents and clearly despite the findings intend to continue to do so, if they can.

Sir, the other theme that comes through the evidence is that he has indeed taken steps to ensure that there is, if I can put it this way, no temptation for this sort of thing to happen again, if steps needed to be taken. The first of those is the remedial action he told you about, but principally cutting down the work that he does and also taking steps to have it monitored. He told you about that when he gave his evidence.

Those steps combined are in themselves steps which can assure the public, I would submit, that this sort of thing is firstly very seriously considered not only by him but by those around him and secondly that it is highly unlikely to happen again. One can perhaps then add to that the possibility and it is the suggestion of Professor Howard that there will be some further, more rigorous monitoring, but that I will come back to.

Sir, this is a man whose talent, I would submit, is something that the profession and society and the public need. My submission to you today is that by reason of that, if that alone, steps should not be taken to prejudice his registration.

My learned friend has already said that the matter to be addressed today is not the safety of patients but public confidence in the profession and the declaration of proper standards of behaviour for members of the profession. Sir, the Panel need to consider of course how serious the behaviour they found proved is and you have already said quite properly, if I may say so, you have found that it is serious

As with everything that is serious, there are grades of seriousness. What I am about to say is not seeking to undermine the basic acceptance that a finding of dishonesty is clearly a very serious matter but, as my learned friend Mr Donne has said, this is different from some types of dishonesty in writing that are contemplated and perhaps expressly contemplated in the Sanctions Guidance that has been read to you. He put it so well that I do not seek to go behind or elaborate on what he said in that regard.

Sir, I would respectfully submit that in relation to the seriousness of the matter and in relation to what needs to be done now, you are entitled to take account of the reactions of others, who include his employers, distinguished employers as they are and those with a wider knowledge of Dr Persaud as to where on the scale of gravity this matter comes.

I would ask you to treat this, like them, as being an isolated matter which is out of character and I ask you to bear that in mind because he is clearly surrounded by people who are conscious of the need to preserve the reputation of their institutions and their profession.

Sir, as you have been reminded, you have to act proportionately, in other words to take only such steps as are necessary to protect the public interest. I ask you in looking at that to bear this in mind. The effect of the disapprobation caused by your finding and Mr Donne but it as highly as disgrace in his cross-examination the other day, is sanction in itself. It is a finding which will be a burden to Dr Persaud and a warning to others. Your finding of an impairment of fitness to practise is, you may think, sufficient because it is highly unlikely that this conduct will occur again and the importance and the significance of these events are readily recognised by Dr Persaud.

It is open to you, sir, to conclude the case with that disapprobation ringing in the ears of Dr Persaud and the public. Should you not find that sufficient and Mr Donne invites you not to find that sufficient, unlike him I would ask you to consider whether conditions are a possibility. I say no more about it than to point out to you that Professor Howard does propose a way forward.

My learned friend says that conditions do not reflect the gravity of the matter. At the end of the day, of course, that is a matter for you. What I would submit you cannot discount is the considerable effect of the disapprobation and the humiliation, rightly you may think, that will be heaped on Dr Persaud in any event and the handicap that that decision may have in relation to his future non-clinical activities.

If you feel it is necessary, however, to go further than that in relation to affecting the doctor's registration more radically, before you do that I do ask you to take this into account. Of course, you must take what steps you think are necessary to protect the public interest. The irony of the situation that you are faced with in this case is that the more extreme the measures you take, the more you take away Dr Persaud from what he has never had any reproach for, namely, his clinical contribution to his patients and his work for them as a clinical doctor, which after all occupy and you have heard little of it, most of his time.

If notwithstanding that you decide it is necessary to affect his registration to send out, as it were, the stronger signal that is referred to in the Guidance, I would respectfully submit that all that is necessary is what in the criminal courts is called a short, sharp shock, in other words, a short period of suspension which indicates by the fact of suspension happening at all the level of disapproval.

Sir, what I would submit and in this it seems Mr Donne and I are at one, is that this is not a matter which is so serious as to require erasure. It would be a tragedy not only for Dr Persaud but also I would submit for his patients, the hospitals he works for and, dare I say it, the wider public were such an extreme step to be taken, bearing in mind the facts of this case. I would ask you just briefly in relation to that and I am not going to go over submissions made earlier, to take into account the submissions made earlier in relation to the nature of this quite unusual form of plagiarism, if I may put it that way.

Sir, those are my submissions, unless I can assist you further. I apologise for the length of time I have taken but it is, as you might imagine, an important matter for the doctor.

THE CHAIRMAN: It is important, sir. When I intervened on the reading of the letter, it was in no respect with an intention of trying to limit what you were doing on behalf of your client. It was merely following on from your opening statement.

MR FRANCIS: Yes.

THE CHAIRMAN: Can I ask you for one point of clarification?

MR FRANCIS: Indeed.

THE CHAIRMAN: You referred to the suggestion of Professor Howard. I am not entirely clear whether that is different from what has already happened or I think and you may correct me, is already happening in terms of what Dr Persaud told us during his evidence about the monitoring of his activities.

MR FRANCIS: I think it is different, sir, in two regards. One is this would be monitored by a senior member of the psychiatric profession and it would be done on a more structured basis because it says it would be a monthly meeting and everything would go through him. Of course, the most important difference is the offer of making reports.

THE CHAIRMAN: To the GMC?

MR FRANCIS: Elsewhere, so that the circle is closed in a way, which it may not be at the moment. That I would suggest is the most important difference with regard to what is happening at the moment. If I may say so, it is suggesting in effect a degree of formality about it that may not be quite there at the moment.

THE CHAIRMAN: Thank you. In that case, I will ask the Legal Assessor to give us her legal advice before we retire to consider the matter.

THE LEGAL ASSESSOR: Thank you, Chairman. I shall give you advice on the sanction, as follows. You must first decide whether it is appropriate to conclude this case with no action being taken on Dr Persaud's registration. I advise you that this would be an exceptional course to take in the light of your finding.

If you deem this course of action insufficient to protect patients and the public interest you must then consider the appropriate sanction to impose. I remind you that despite submissions on the appropriate sanction by both counsel the decision is yours in the exercise of your professional judgment.

I will give you some general guidance on the imposition of a sanction and in doing so I commend the GMC's Indicative Sanctions Guidance to you, which I believe is behind Tab E in your green folder. The purpose of a sanction is not to be punitive but to protect patients and the public interest. You must be sure that the action you propose to take is sufficient to protect the public and the public interest. The public interest includes not only the protection of patients but also the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.

You must apply the principle of proportionality, weighing the interests of the doctor to practise his profession unfettered against the interests of the public to be protected.

You will also need to take account of the mitigation which has been advanced on behalf of Dr Persaud. The testimonials submitted will need to be weighed appropriately against the nature of the facts found proved by you. You should also take account of Dr Persaud's expressions of regret and any insight you believe he has shown.

You should approach the imposition of a sanction from the least restrictive first. You should only move on to a more onerous sanction if it is indicated. Accordingly you should first consider whether the imposition of conditions is sufficient to protect patients and the public interest. Conditional registration can be imposed for a maximum of three years.

On page 13 of section 1 of the Guidance there are set out factors which should be present. I remind you that the purpose of this sanction is to enable a doctor to remedy any deficiencies in his or her practice whilst protecting patients from harm and any conditions should be appropriate, proportionate, workable and measurable.

If you deem conditions to be insufficient then you must consider a more restrictive sanction. The next sanction up the tariff is suspension. It can be imposed for a maximum of twelve months. However, the length of the period of suspension is a matter for your discretion. Suspension has a punitive effect as it prevents a doctor from working during the period. It can be used to send out a signal to the doctor, the profession and the public about what is regarded as unacceptable behaviour. This sanction is likely to be appropriate for misconduct that is serious but not so serious as to justify erasure. On page 14 in section 1, relevant factors are set out.

The final sanction available to you is that of erasure. This should only be imposed where it is the only means of protecting patients and the wider public interest and where you consider the doctor's behaviour to be fundamentally incompatible with being a doctor. Accordingly, it should only be used for the most serious examples of misconduct. At page 15 in section 1 of the Guidance there are set out the types of issue which could lead to erasure. That concludes my advice.

THE CHAIRMAN: Thank you. Any comments on the advice?

MR DONNE: No.

MR FRANCIS: No.

THE CHAIRMAN: In that case the Panel will continue in camera. I cannot for the moment say when we will be able to announce our finding. Mr Donne.

MR DONNE: Just a matter of housekeeping. First of all, could I possible ask for the return of the book that I made available. The reason I do that is that I might not be able to remain throughout the remainder of this afternoon. If I am not here, first of all, I offer my apologies. It is no disrespect to the Panel and there will of course be appropriate cover, but it is not certain yet whether I can or cannot remain.

STRANGERS, THEN, BY DIRECTION FROM THE CHAIR, WITHDREW

AND THE PANEL DELIBERATED IN CAMERA

STRANGERS HAVING BEEN READMITTED

D E T E R M I N A T I O N

THE CHAIRMAN: Dr Persaud, having made and announced its finding that your fitness to practise is impaired by reason of your misconduct, the Panel has now considered what action, if any, it should take with regard to your registration.

The Panel has taken into account the submissions of Mr Donne, on behalf of the General Medical Council (GMC) and those of Mr Francis, on your behalf. Mr Donne submitted that suspension is both the appropriate and proportionate sanction in this case. Mr Francis, on your behalf, submitted that it is open to the Panel to conclude your case at this stage without taking any further action.

The Panel has also taken into account all the evidence in this case, including the references from your professional colleagues and various charities and the testimony from Dr Bruggen, your mentor.

The Panel considered whether to conclude your case and take no further action. However, in the light of the nature of your misconduct, it decided that to take no action on your registration would be wholly insufficient.

The Panel has had regard to the GMC's Indicative Sanctions Guidance (April 2005). It has borne in mind that any sanction must be proportionate and that its purpose is not to be punitive, though it may have a punitive effect. The Panel has balanced your interests with the wider public interest. The public interest includes not only the protection of patients but also the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.

The Panel considered whether it would be sufficient to impose conditions on your registration. The Panel concluded that there are no appropriate conditions that it could impose. It has determined that the imposition of conditions would be insufficient as they would not adequately reflect the gravity of your misconduct, or protect the public interest by maintaining public confidence in the medical profession.

The Panel then went on to consider whether it would be sufficient to suspend your registration.

The Panel has noted the submissions of Mr Francis on your behalf that you are a clinician with many talents and that you have worked enthusiastically as a communicator in the media to improve public understanding of mental illness. Mr Francis further submitted that you were under pressure with your writing and this led to your cutting corners. You have told the Panel that you now know that what you did was wrong, that you deeply regret your behaviour and apologise for it.

The Panel has noted that you have the support of your employers and that you have taken remedial action to ensure that you do not find yourself in a similar position again. You have cut down on your media and journalistic projects. Dr Bruggen, with whom you have regular contact, has informed the Panel that, since these events, you are more cautious about taking on extra work.

The Panel is impressed by the testimonial references submitted by eminent persons and colleagues, several of whom have confirmed their testimonials in the light of this Panel's finding of dishonesty.

Your misconduct occurred between three and five years ago and there has been no evidence that you have repeated this type of behaviour since. The Panel considers that it is highly unlikely that you would ever repeat your actions in future.

It has noted the words of Mr Justice Collins in paragraph 29 of his judgment in Giele v The GMC [2005]:

“I do not doubt that the maintenance of public confidence in the profession must outweigh the interests of the individual doctor. But that confidence will surely be maintained by imposing such sanction as is in all the circumstances appropriate. Thus in considering the maintenance of confidence, the existence of a public interest in not ending the career of a competent doctor would play a part.”

Although the Panel does not condone your dishonest actions, it has concluded that your behaviour, although serious, is not incompatible with your continuing to be a registered medical practitioner. The Panel is satisfied that it is appropriate, proportionate and sufficient to direct that your registration be suspended.

The Panel has considered the length of the period of suspension to be imposed, taking into account all the evidence and circumstances of this case. It has had regard to the fact that there has been no patient harm, that your plagiarism was not financially motivated, that it did not relate to research fraud and that there are measures in place to avoid repetition. The Panel has determined that a three month period of suspension is sufficient to send out a signal to you, the profession and the public that plagiarism is unacceptable behaviour.

The decision to suspend your registration for a period of three months will take effect 28 days from when written notice is deemed to have been served on you, unless you exercise your right of appeal. A note explaining your right of appeal will be supplied to you.

That concludes this case.

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