Dr Adnan Sadiq v The General Medical Council

Ms Justice Obi DBE: Introduction

1. This is an appeal against a decision (“the Decision”) of the Medical Practitioners Tribunal (“the Tribunal”) dated 10 November 2023. By that decision, the Tribunal directed that the name of Dr Sadiq be erased from the medical register, following a finding that his fitness to practise is impaired by reason of misconduct. Dr Sadiq admitted that: (i) he had sent Ms A various WhatsApp messages; and (ii) he had sent these messages despite Ms A confirming that he was “ not her type ”. He denied the remainder of the allegations. However, the Tribunal went on to find that Dr Sadiq had used his position as a doctor to try to gain the trust of Ms A (who he met online) and upon meeting Ms A, had touched her intimately without her consent. The Tribunal concluded that Dr Sadiq’s misconduct was fundamentally incompatible with continued registration; therefore, erasure was the only appropriate and proportionate sanction.

2. This appeal is brought pursuant to section 40 of the Medical Act 1983 (‘ the Act ’). Dr Sadiq challenges the Tribunal’s Stage 1 findings of fact on multiple grounds. He submits, in effect, that but for these ‘errors’ the impairment decision at Stage 2 would have been materially different, which in turn would have affected the sanction imposed at Stage 3.

3. In advance of this appeal hearing both parties submitted skeleton arguments. At the outset of the hearing Dr Sadiq provided two additional documents: (i) a supplemental note addressing witness contamination in response to the GMC’s skeleton argument; and (ii) a 32-page document titled “Brief document for hearing” (“Brief document”) which included references to various legal authorities. Dr Sadiq also sought to rely on additional evidence (notice having been served), which was not before the Tribunal. This comprised: (a) the Rule 7 bundle which includes the police log, summary and what he described as ‘ crucial evidence ’ (I shall refer to these documents collectively as the “Police Summary”); and (b) a copy of his passport and wedding photographs. In support of his application to rely on this material, Dr Sadiq referred to the principles set out in Ladd v Marshall [1954] 1 WLR 1489 submitting that the additional evidence could not have been obtained with reasonable diligence for use before the Tribunal, would likely influence the outcome and was credible. Ms Hearnden, for the GMC, outlined the circumstances surrounding the removal of the Rule 7 bundle from the Tribunal bundle and Dr Sadiq’s non-attendance at Stage 2 due to his wedding. She submitted that the additional evidence was either available at the time of the Tribunal hearing and/or would have made no difference to the outcome. Nevertheless, she invited the court to admit the additional evidence provisionally.

4. Having considered the submissions, I admitted the additional evidence on a provisional basis. Factual Background

5. The background circumstances are not in dispute and can be summarised as follows.

6. Dr Sadiq qualified in 2020 from the University of Szeged in Hungary. He moved to the UK and took up his first medical post in October 2020. Dr Sadiq was practising at the Royal Surrey County Hospital NHS Foundation Trust (“the Trust”) and was in the second year of the Foundation Programme at the time of the allegations.

7. Dr Sadiq met Ms A online via the dating app, Tinder. Dr Sadiq and Ms A exchanged messages in which Dr Sadiq stated that he was a doctor. They met for the first (and only) time at Ms A’s university campus on 19 November 2020. Dr Sadiq and Ms A engaged in consensual kissing. It was alleged that Dr Sadiq then inserted his fingers into Ms A’s vagina without her consent, put his hands around her neck and applied pressure, exposed his penis, placed her hand on his penis, pushed her head towards his exposed penis, and said to Ms A “ you should have sorted it out ”, or words to that effect, referring to his erection. It was alleged that his conduct was sexually motivated.

8. Dr Sadiq was referred to the GMC by the Trust on 5 May 2021 following his arrest for sexual assault. The police took no further action.

9. The GMC sent a Rule 7 letter to Dr Sadiq on 4 August 2022. This letter sets out the allegations and invites the registrant to provide a response. At that stage of the fitness to practise proceedings Dr Sadiq was represented by Adkirk Law. Dr Sadiq responded to the Rule 7 letter on 28 September 2022 and provided a document titled “Reflections”. Adkirk Law remained instructed at the Rule 8 stage when the Case Examiners determined that there was a case to answer and referred the matter to the Medical Practitioners Tribunal Service (MPTS). Adkirk Law came off the record in February 2023. Around March 2023, Mr McCaffrey of Kings View Chambers was instructed to act on behalf of Dr Sadiq. Mr McCaffrey is authorised to conduct litigation. The Stage 1 hearing bundle was sent to Dr Sadiq’s representatives on 25 May 2023 and was agreed before being uploaded to the MPTS on 13 July 2023.

10. Dr Sadiq’s representatives, in an email dated 28 June 2023, stated as follows with regard to Stage 2: “We are working on his reflection and gathering up to date testimonials for Stage 2 and will serve asap. The reflection is limited to what he has accepted in his statement i.e. inappropriate messaging in terms of content and frequency. Therefore, it will clearly have limited value should the other allegations be found proved ” [emphasis added].

11. On 20 July 2023, a further email in similar terms was sent by Dr Sadiq’s representatives. However, no Stage 2 bundle was ever served.

12. The virtual hearing before the Tribunal commenced on 24 July 2023. It took place in three tranches: 24 July 2023 – 4 August 2023; 29 August and 1 September 2023 and 6 – 11 November 2023.

13. Dr Sadiq was represented by counsel (Mr Edmund Walters instructed by Kings View Chambers) until the determination on the facts was delivered on 1 September 2023. When the hearing reconvened on 6 November 2023 for Stage 2, Dr Sadiq did not attend and was not represented. The GMC was represented throughout by Ms Shirlie Duckworth of counsel.

14. On Day 1 of the hearing the GMC made an application for special measures under Rule 36(1)(e) of the GMC Fitness to Practise Rules 2004, which permits such measures in cases involving allegations of a sexual nature where the witness is the alleged victim. Although the application was not based on any mental disorder or impairment, GMC counsel drew the Tribunal’s attention to Ms A’s diagnosis of autistic spectrum condition, and the associated need for breaks and careful communication. Dr Sadiq had been notified in advance, on 20 July 2023, that adjustments may be required in light of Ms A’s vulnerabilities. No objections were raised in response to the special measures’ application. Having received legal advice from the Legally Qualified Chair (LQC) , the Tribunal issued the following directions: (i) Dr Sadiq was not to be visible on screen while Ms A gave evidence; (ii) his name was not to be displayed on screen during her evidence; (iii) Ms A’s mother could be present while she gave evidence, except during questioning about the police interview; and (iv) the Tribunal would provide frequent breaks to Ms A on request.

15. Later on Day 1, the Tribunal was provided with a document which had been co-produced by counsel for both parties. This document was referred to as ‘further agreed facts.’ It stated: “In December 2021 Ms A alleged she was the victim of a sexual assault whilst she was sedated. She alleged that she was made aware of the assault by other evidence. This alleged incident is wholly unrelated to the case against Dr Sadiq and to Dr Sadiq, and the Panel are only being informed about the alleged incident to provide proper context to the Complainant’s presentation. Ms A was not the only alleged complainant in that case. Another alleged complainant, who was a friend of Ms A, allegedly committed suicide. Ms A. has reported that she is suffering from further anxiety and distress as a result of the aforementioned incidents”.

16. Ms A gave her evidence on Day 2 (25 July 2023). On the following day, the Tribunal heard evidence from Friend X and Friend Y. At the close of the GMC’s case a ‘half-time’ submission (i.e. a submission of no case to answer) was made on behalf of Dr Sadiq. The Tribunal upheld the submission in respect of Allegation 1 only – namely, the alleged encouragement of Ms A to breach Covid-19 restrictions. Dr Sadiq then gave evidence over the course of three days commencing on 1 August 2023. It became apparent that the hearing could not be concluded within the originally allocated timeframe. Therefore, on 3 August 2023, discussions commenced regarding the identification of further listing dates. It was agreed that the determination on the facts would be handed down on 1 September 2023, with Stage 2 provisionally scheduled for 6 – 10 November 2023.

17. When the Tribunal reconvened on 1 September 2023 to deliver its factual findings, Dr Sadiq was represented but did not attend due to an unexpected illness that required a visit to A&E. The Stage 2 hearing dates of 6 – 10 November 2023 were confirmed. The Tribunal’s determination from 1 September 2023 was emailed to Dr Sadiq on 4 September 2023, along with confirmation of the reconvened hearing date and a time estimate of five days. The accompanying acknowledgment form included provision for written submissions to be made.

18. No application to adjourn was made until 23 October 2023. The request was made on the basis that Dr Sadiq was due to marry in Dubai on 7 November 2023, followed by a religious pilgrimage in Saudi Arabia. That application was refused on 31 October 2023. A renewed application was made on 3 November 2023, the same day Dr Sadiq’s legal representatives formally withdrew from the case. In correspondence with the GMC, Mr McCaffrey explained that he had withdrawn from representing Dr Sadiq due to lack of communication from him. He also stated that he had no recollection of being informed of Dr Sadiq’s marriage, nor did his records contain any reference to it.

19. When the hearing resumed on 6 November 2023, Dr Sadiq was neither present nor represented. The start of the hearing was delayed to allow the MPTS to contact him and invite his attendance. Having refused the adjournment application, the Tribunal nevertheless indicated that the invitation to Dr Sadiq to attend remotely should be renewed the following day. On 7 November 2023, having received no communication from Dr Sadiq, the Tribunal proceeded in his absence. The Tribunal found misconduct and in relation to impairment found that Dr Sadiq had provided no evidence of apology, remorse, insight, or remediation. It concluded that his actions breached a fundamental tenet of the medical profession, namely maintaining public trust, and that his misconduct was incompatible with continued registration. The Tribunal directed that his name be erased from the medical register. Grounds of Appeal

20. Dr Sadiq maintains his denial of the underlying facts. His grounds of appeal, as originally drafted, remained unchanged by the time of the appeal hearing (save where noted below) and can be grouped into seven principal areas of challenge. While each ground raises a distinct issue (or cluster of related concerns), there is a degree of overlap, particularly in relation to procedural fairness and the reliability of witness evidence. The grounds may be summarised as follows: • Ground 1: Counsel was unable to “thoroughly cross examine” Ms A - Counsel for Dr Sadiq was interrupted and asked to reformulate his questions during cross examination on numerous occasions. It is alleged that this significantly undermined counsel’s presentation of Dr Sadiq’s case. • Ground 2: Limited time was given for the presentation of closing arguments - Dr Sadiq contends that his counsel was only given 15 minutes to present oral submissions at the fact-finding stage, whereas GMC counsel was not made subject to any time constraints. • Ground 3: The Tribunal’s factual findings were wrong - Dr Sadiq challenges several aspects of the Tribunal’s factual findings, alleging that they were either incorrect, unsupported by the evidence, or based on misinterpretations. The alleged factual error relating to a non-existent WhatsApp message, purportedly sent on 3 February 2021, has been superseded by Ground 6. • Ground 4: The Tribunal was critical of his lack of insight, which was unfair - Dr Sadiq alleges that the Tribunal did not consider the Reflections document he submitted at the Rule 7 stage, and therefore the criticism of his lack of insight, apology and remorse was unfair. Furthermore, he was not informed by MPTS or GMC regarding at what stage he would need to submit further reflections. • Ground 5: Unfair questions put to Ms A and Dr Sadiq - Ms A was asked questions to evoke an emotional response. Furthermore, Dr Sadiq alleges that he was asked inappropriate questions including questions relating to his sexual orientation and hypothetical questions. • Ground 6: Contamination and Collusion - This ground was advanced for the first time during the hearing. It was in response to the GMC’s concession that the ‘missing’ WhatsApp message (previously referenced in Ground 3) was in fact a Snapchat message (it had been incorrectly described as a WhatsApp message by the Tribunal). Dr Sadiq alleges that the Snapchat messages sent to Friend X and Friend Y, in which Ms A sets out her recollection of events, had the potential to influence their accounts and represents a clear risk of contamination. He is also critical of the reliance placed on notes made by Ms A’s mother. • Ground 7: Procedural irregularity due to technical issues – This ground was also advanced for the first time during the hearing. Dr Sadiq argues that, because the LQC’s camera was disconnected during the hearing, the Tribunal was not properly constituted and the MPTS Remote Hearing Guidance was not followed. The Legal Framework Statutory Provisions

21. Public protection is at the heart of the regulation of doctors. Section 1 (1A) of the Act ) sets out this overarching purpose. Section 1 (1B) identifies the GMC’s statutory objectives: • to protect, promote and maintain the health, safety and well-being of the public; • to promote and maintain public confidence in the medical profession; and • to promote and maintain proper professional standards and conduct for members of that profession.

22. Under section 40 of the Act , a doctor may appeal to the High Court against a sanction imposed by the Tribunal. Section 40(7) provides that upon hearing such an appeal, the Court may: • dismiss the appeal; • allow the appeal and quash the direction appealed against; • substitute for the direction appealed any other direction which could have been given by the Tribunal; or • remit the case for the Tribunal to dispose of the case in accordance with the directions of the Court. Nature of the Appeal

23. The appeal proceeds by way of re-hearing, not review (see - PD 52D, paragraph 19.1). The Court is therefore entitled to reconsider the evidence and reach its own conclusions, rather than merely assess whether the Tribunal made an error.

24. In accordance with CPR 52.21(3), the Court will allow an appeal where the Tribunal's decision was either: • wrong in law or fact; or • unjust because of a serious procedural or other irregularity. Case Law Principles

25. In Sastry v General Medical Council [2021] EWCA Civ 623 , Nicola Davies LJ, delivering the judgment of the Court of Appeal, summarised the principles governing appeals under section 40 of the Medical Act 1983 at paragraph 102: i. The right of appeal is unqualified. ii. The High Court’s jurisdiction is appellate, not supervisory. iii. The appeal proceeds by way of rehearing. iv. The Court may substitute its own decision. v. Deference to the Tribunal’s judgment is context dependent. vi. The court must assess whether the sanction imposed was appropriate and necessary in the public interest, or excessive and disproportionate. vii. If excessive, the court may substitute a different sanction or remit the matter to the Tribunal for reconsideration.

26. The approach to fact finding was summarised by Cranston J in Yassin v the General Medical Council [2015] EWHC 2955 (Admin) , at paragraph 32: “The authorities establish the following propositions: i) The Panel's decision is correct unless and until the contrary is shown: Siddiqui v. General Medical Council [2015] EWHC 1996 (Admin) , per Hickinbottom J, citing Laws LJ in Subesh v. Secretary of State for the Home Department [2004] EWCA Civ 56 at [44]; ii) The court must have in mind and must give such weight as appropriate in that the Panel is a specialist tribunal whose understanding of what the medical profession expects of its members in matters of medical practice deserves respect : Gosalakkal v. General Medical Council [2015] EWHC 2445 (Admin) ; iii) The Panel has the benefit of hearing and seeing the witnesses on both sides, which the Court of Appeal does not ; The questions of primary and secondary facts and the overall value judgment made by the Panel, especially the last, are akin to jury questions to which there may reasonably be different answers: Meadows v. General Medical Council [197], per Auld LJ; iv) The test for deciding whether a finding of fact is against the evidence is whether that finding exceeds the generous ambit within which reasonable disagreement about the conclusions to be drawn from the evidence is possible : Assucurazioni Generali SpA v. Arab Insurance Group [2003] 1 WLR 577 , [197], per Ward LJ; v) Findings of primary fact, particularly founded upon an assessment of the credibility of witnesses, will be virtually unassailable : Southall v. General Medical Council [2010] EWCA Civ 407 , [47] per Leveson LJ with whom Waller and Dyson LJJ agreed; vi) If the court is asked to draw an inference, or question any secondary finding of fact, it will give significant deference to the decision of the Panel, and will only find it to be wrong if there are objective grounds for that conclusion : Siddiqui, paragraph [30](iii). Reasons in straightforward cases will generally be sufficient in setting out the facts to be proved and finding them proved or not; with exceptional cases, while a lengthy judgment is not required, the reasons will need to contain a few sentences dealing with the salient issues: Southall v. General Medical Council [2010] EWCA Civ 407 , [55]-[56]. vii) A principal purpose of the Panel's jurisdiction in relation to sanctions is the preservation and maintenance of public confidence in the medical profession so particular force is given to the need to accord special respect to its judgment: Fatnani and Raschid v. General Medical Council [2007] EWCA Civ 46 , [19], per Laws LJ. [emphasis added]”

27. Further guidance was provided by Warby J (as he then was) in Dutta v General Medical Council [2020] EWHC 1974 (Admin) at paragraph 21: “(1) The appeal is not a re-hearing in the sense that the appeal court starts afresh, without regard to what has gone before, or (save in exceptional circumstances) that it re-hears the evidence that was before the Tribunal. "Re-hearing" is an elastic notion but generally indicates a more intensive process than a review: E I Dupont de Nemours & Co v S T Dupont (Note) [2006] 1 WLR 2793 [92-98]. The test is not the "Wednesbury" test. (2) That said, the Appellant has the burden of showing that the Tribunal's decision is wrong or unjust : Yassin [32(i)]. The Court will have regard to the decision of the lower court and give it "the weight that it deserves": Meadow [128] (Auld LJ, citing Dupont [96] (May LJ)). (3) A court asked to interfere with findings of fact made by a lower court or Tribunal may only do so in limited circumstances. Although this Court has the same documents as the Tribunal, the oral evidence is before this Court in the form of transcripts, rather than live evidence. The appeal Court must bear in mind the advantages which the Tribunal has of hearing and seeing the witnesses and should be slow to interfere . See Gupta [10], Casey [6(a)], Yassin [32(iii)]. (4) Where there is no question of a misdirection, an appellate court should not come to a different conclusion from the tribunal of fact unless it is satisfied that any advantage enjoyed by the lower court or tribunal by reason of seeing and hearing the witnesses could not be sufficient to explain or justify its conclusions : Casey [6(a)]. (5) In this context, the test for deciding whether a finding of fact is against the evidence is whether that finding exceeds the generous ambit within which reasonable disagreement about the conclusions to be drawn from the evidence is possible: Yassin [32(v)]. (6) The appeal Court should only draw an inference which differs from that of the Tribunal, or interfere with a finding of secondary fact, if there are objective grounds to justify this: Yassin [32(vii)]. (7) But the appeal Court will not defer to the judgment of the tribunal of fact more than is warranted by the circumstances; it may be satisfied that the tribunal has not taken proper advantage of the benefits it has, either because reasons given are not satisfactory, or because it unmistakably so appears from the evidence: Casey [6(a)] and cases there cited, which include Raschid and Gupta (above) and Meadow [125-126], [197] (Auld LJ). Another way of putting the matter is that the appeal Court may interfere if the finding of fact is "so out of tune with the evidence properly read as to be unreasonable": Casey [6(c)], citing Southall [47] (Leveson LJ). [emphasis added].”

28. Those principles were subject to further consideration by Morris J in Byrne v GMC [2021] EWHC 2237 (Admin) : “17. First, the credibility of witnesses must take account of the unreliability of memory and should be considered and tested by reference to objective facts, and in particular as shown in contemporaneous documents . Where possible, factual findings should be based on objective facts as shown by contemporaneous documents: Dutta §§39 to 42 citing, in particular, Gestmin and Lachaux.

18. Secondly, nevertheless, in assessing the reliability and credibility of witnesses, whilst there are different schools of thought, I consider that, if relevant, demeanour might in an appropriate case be a significant factor and the lower court is best placed to assess demeanour. Despite the doubts expressed in Dutta §42 and Khan §110, the balance of authority supports this view: Gupta §18 and Southall at §59.

19. Thirdly, corroborating documentary evidence is not always required or indeed available. There may not be much or any such documentary evidence. In a case where the evidence consists of conflicting oral accounts, the court may properly place substantial reliance upon the oral evidence of the complainant (in preference to that of the defendant/appellant) : Chyc at §23. There is no rule 9 that corroboration of a patient complainant’s evidence is required: see Muscat §83 and Mubarak §20.

20. Fourthly, in a case where the complainant provides an oral account, and there is a flat denial from the other person concerned, and little or no independent evidence, it is commonplace for there to be inconsistency and confusion in some of the detail . Nevertheless, the task of the court below is to consider whether the core allegations are true: Mubarak at §20.” [emphasis added] Submissions and Discussion Ground 1 – inadequate cross examination of Ms A Dr Sadiq’s Submissions

29. Dr Sadiq argues that his counsel was unable to conduct a thorough cross-examination of Ms A due to procedural constraints and repeated interruptions during the hearing by both the LQC and GMC counsel, Ms Duckworth. Dr Sadiq contends that these interventions disrupted the flow of questioning and prevented his counsel from pursuing key lines of inquiry, including clarification of inconsistencies between Ms A’s police interview and her GMC witness statement. He further submits that counsel was unable to explore matters relating to Ms A’s memory, credibility, and the potential influence of external factors, such as her communications with friends. Although the Tribunal acknowledged the challenges faced by counsel and directed that allowances be made, Dr Sadiq maintains that these measures were insufficient to secure a fair hearing. GMC Submissions

30. Ms Hearnden submits that Dr Sadiq’s counsel, Mr Walters, was given clear and timely notice of Ms A’s vulnerabilities. She contends that the cross-examination was extensive and the requirement to conduct it in accordance with established guidance for questioning vulnerable witnesses did not prevent Dr Sadiq’s case from being properly presented. The interventions made during the hearing were proportionate and did not give rise to any procedural unfairness. Discussion

31. The GMC took appropriate steps to inform Dr Sadiq’s legal team of Ms A’s autism diagnosis and the communication adjustments likely to be required. These included a supplemental witness statement from Ms A served on 21 March 2023 and a pre-hearing conference on 20 July 2023. Ms A’s vulnerabilities were also clearly identified in the agreed facts document and the special measures application. The Tribunal was therefore properly informed of the need for procedural safeguards.

32. It is clear from the transcripts that Mr Walters, was interrupted on several occasions during his cross-examination of Ms A. Mr Walters was asked to simplify questions to avoid leading, compound, or negatively framed formulations, and adhere to guidance for questioning vulnerable witnesses. For example, the LQC intervened occasionally, to ensure questions were succinct and clear and did not involve multiple parts. Speculative questions – such as those inviting Ms A to interpret Dr Sadiq’s intentions - were also discouraged. GMC Counsel intervened where questions risked confusing Ms A or where previous answers were mischaracterised. During the lunchtime adjournment, the LQC circulated a brief note of guidance for questioning vulnerable witnesses to both parties. Mr Walters acknowledged that he had been taken by surprise by Ms A’s presentation and confirmed that he had reviewed the formal guidance in the Advocates’ Gateway. GMC counsel reiterated a prior suggestion that, if Mr Walters felt inhibited by Ms A’s vulnerabilities, a list of questions could be submitted to the Tribunal. No such list was provided, and at no stage was it suggested to the Tribunal that any particular aspect of the defence case had not, or could not, be put. The LQC advised, prior to consideration of the ‘half-time’ submission, that: “Ms A could not be questioned in the usual way because of her presentation and the special measures in place. This does not mean that her evidence was not disputed by Dr Sadiq. To be fair to Dr Sadiq, the Tribunal should make allowances for difficulties faced by counsel in asking Ms A questions.”

33. The Tribunal’s interventions were consistent with its duty under Rule 36 of the GMC Fitness to Practise Rules 2004 to ensure the welfare of a vulnerable witness and to maintain the fairness of proceedings. The right to cross-examine is not absolute and must be balanced against the need to protect witnesses who may be adversely affected by the process. Tailoring questions to suit a witness’s vulnerabilities are neither unusual nor improper. The Tribunal was entitled to intervene where questioning risked confusion, unnecessary distress or procedural unfairness. Although the interruptions may have disrupted the flow of cross-examination, they did not prevent Mr Walters from advancing Dr Sadiq’s case. Ms A’s cross-examination spanned 84 pages of transcript and covered all material aspects of the allegations including the alleged digital penetration, the application of pressure to her neck, and the exposure and physical contact with Dr Sadiq’s penis. She was asked to clarify her recollection of these events, the sequence in which they occurred, and her responses at the time. She described experiencing a “ freeze response ” and stated that she vividly remembered the removal of Dr Sadiq’s fingers. She also maintained that he placed her hand on his penis, pushed her head towards it, and applied pressure to her neck despite her objections. Mr Walters further questioned her about inconsistencies between her account and those of Friends X and Y, particularly regarding the location of the meeting and her disclosures immediately afterwards.

34. I am satisfied that the interruptions were proportionate and targeted and did not deprive Dr Sadiq of a fair hearing. Moreover, there was no ‘ tilt ’ of the balance in favour of Ms A. The Tribunal’s own directions and procedural safeguards demonstrate that it was alert to the challenges posed by Ms A’s vulnerabilities and took reasonable steps to ensure fairness to both parties.

35. During oral submissions, Dr Sadiq expressed criticism of his counsel, suggesting that the interruptions materially undermined the presentation of his case. However, it is well established that appellate courts will only entertain such criticisms in exceptional circumstances. As Choudhury J observed in Ahmed v GMC [2022] EWHC 424 (Admin) , hindsight-based disagreement with the conduct of representation rarely renders a process unfair or the outcome unjust. The threshold for establishing procedural unfairness based on the quality of representation is high and requires clear evidence that the representation fell below an acceptable standard and caused material prejudice. In this case, there is no such evidence. Mr Walters is an experienced advocate who pursued Dr Sadiq’s case with appropriate diligence. Conclusion

36. There was no serious procedural irregularity in the conduct of cross examination. Therefore, this ground does not provide a proper basis for allowing the appeal. Ground 1 therefore fails and must be dismissed. Ground 2 - Curtailment of closing argument Dr Sadiq’s Submissions

37. Dr Sadiq contends that his counsel was afforded insufficient time to present closing submissions at the conclusion of the fact-finding stage. He asserts that counsel was limited to just 15 minutes and that this constraint materially hindered the presentation of his case particularly in addressing issues of credibility and evidential inconsistencies. In contrast, counsel for the GMC was permitted to deliver her submissions without any time restriction. Dr Sadiq argues that this disparity in treatment undermined the fairness of the proceedings. Given the gravity of the allegations and the potential impact on his professional future, he submits that the Tribunal ought to have ensured parity of treatment. GMC Submissions

38. The GMC submits that the Tribunal’s handling of closing submissions was fair. Both parties were invited to provide written submissions and informed that oral submissions would be accommodated. Counsel for Dr Sadiq requested one hour for oral argument, which was granted without objection. He delivered his submissions without interruption and, when a misunderstanding later arose regarding the completion of his closing argument, the Tribunal allowed him to make further submissions. The GMC maintains that there was no curtailment, no disparity in treatment, and no pressure applied regarding timing. Discussion

39. At the conclusion of Day 9, the LQC invited both parties to provide short written submissions on the facts overnight. It was made clear that skeleton arguments would suffice, as there would be an opportunity to make oral submissions the following day. The hearing was scheduled to begin at 10:00 am on Day 10, with the expectation that counsel would be released by lunchtime to allow the Tribunal to deliberate in camera. Both counsel confirmed that, having already addressed key issues during the ‘half time’ submissions, it would not be necessary to repeat every point.

40. The next day proceedings commenced as planned. GMC counsel provided written submissions and made a brief oral address to the Tribunal. Mr Walters requested additional time to finalise his written submissions after hearing the GMC’s remarks. This request was granted, and he indicated that he would require approximately one hour for oral submissions. No objection was raised. The transcript reveals that there was then a misunderstanding between the Tribunal and Mr Walters. He began by stating that he would “ firstly ” address paragraphs 7 (sexual motivation) and 8 (harassment) of the Allegation and once he had done that he stated: “ I think that’s sufficient to cover my arguments on those, unless you have any questions .” Following Tribunal questions, the LQC asked the clerk to upload a draft copy of her legal advice and discussed releasing the parties at 1.30pm. It seems that the LQC thought that Mr Walters had said all he wanted to say. After a short break, Mr Walters informed the LQC that he had not finished his Stage 1 submissions and wished to respond to the GMC’s arguments, particularly on credibility. The LQC expressed concern that further submissions time might delay the delivery of the findings of fact and asked how much time he needed. Mr Walters replied, “ Only 15 minutes, 20 minutes at the most. I can do it in 15 minutes .”

41. The Tribunal retains discretion to manage the hearing timetable, but that discretion must always be exercised in a manner consistent with fairness. While the Tribunal expressed a preference to release counsel by lunchtime this was a scheduling aim rather than a procedural restraint. The Tribunal remained under a duty to ensure that both parties were given a fair opportunity to present their cases. Although the misunderstanding regarding the completion of closing submissions was regrettable, it did not materially affect the fairness of the proceedings. Mr Walters was permitted to complete his submissions, including those addressing credibility and factual disputes. Furthermore, it is worth noting that Mr Walters himself stated that he needed only 15-20 minutes of additional time. While the need for counsel to assertively request additional time reflects a lapse in procedural clarity, the Tribunal’s willingness to accommodate the request mitigated any potential prejudice. There is no indication that the outcome was influenced by the timing or structure of the submissions. Accordingly, the misunderstanding does not amount to a material irregularity capable of rendering the outcome unsafe or unjust.

42. To the extent that this ground criticises counsel for curtailing submissions under perceived pressure, as discussed at paragraph 35, appellate courts are slow to entertain criticisms of representation unless there is clear evidence of sub-standard advocacy causing material prejudice. No such evidence has been identified. Conclusion

43. In these circumstances, there is no proper basis for concluding that there was serious procedural irregularity, unfairness, or inequality in the handling of closing submissions. Ground 2 is therefore dismissed. Ground 3 - Wrong factual findings Dr Sadiq’s Submissions

44. Dr Sadiq raises six specific criticisms of the Tribunal’s factual findings which for convenience can be grouped under Ground 3 of his appeal. These criticisms are summarised below.

45. First, the Tribunal relied on messages sent after the meeting on 19 November 2020 to retrospectively prove an event that occurred before those messages were even sent. He argues that none of those messages refer to digital penetration, motive or intention relevant to the core allegations. Secondly, he submits that the Tribunal failed to adequately address inconsistencies in Ms A’s evidence particularly the contrast between her description of a ‘ freeze response ’ and her police interview statements indicating active resistance. He also highlights the lack of explanation as to how digital penetration could have occurred without the removal of clothing. In addition, he points to a material change in Ms A’s account: in her police interview she stated that the non-consensual sexual contact occurred whilst both parties were standing whereas in her supplemental witness statement (given two years later) she stated that she may have been forced to her knees. Dr Sadiq relies on Ms A’s reference to “ thinking logistically ” during her police interview when asked about the sequence of events, submitting that this reflects speculative reconstruction rather than genuine recollection. He also highlights inconsistencies between the evidence of Friend Y and Ms A regarding the location of the meeting and notes that Ms A misread a message from him stating “ sorry for not strangling you ” as “ sorry for strangling you ”. He argues that these discrepancies were not properly evaluated and undermine the credibility of Ms A’s account. Thirdly, although the allegation that Dr Sadiq sent Ms A a photograph of his penis was not found proved, the Tribunal’s reference to ‘ uncertainty as to the sender ’ contradicts Ms A’s specific assertion that the image was sent by him. Fourthly, the Tribunal did not consider all relevant messages and those it did consider were taken out of context - for example, the “ you can trust me ” message. He submits that the Tribunal overlooked messages that reflected mutual interest. Fifthly, the Tribunal conflated “ touching/touched ” and “ inserting ” and used terms such as ‘ choking ’ and ‘ violence ’ which had not been alleged by the GMC. He also criticises the Tribunal’s reliance on consensual sexual behaviour in his private life. Sixthly, Dr Sadiq contends that the Tribunal failed to take proper account of Ms A’s memory limitations, as documented in the Police Summary, which he argues undermines the reliability of her account. GMC Submissions

46. The GMC submits that the Tribunal’s findings fell within the range of conclusions reasonably open to it on the evidence. The Tribunal considered the relevant evidence, including inconsistencies identified by Dr Sadiq and addressed them in its determination. It acknowledged discrepancies, such as the location of the meeting and variations in witness accounts but was entitled to assess their significance in context. It is submitted that the Tribunal’s conclusions were supported by the evidence. The GMC further submits that the Tribunal did not mischaracterise the evidence and that its findings were neither irrational nor procedurally flawed. Discussion

47. The Tribunal concluded that Dr Sadiq used his position as a doctor to try to gain the trust of Ms A, and upon meeting her engaged in a series of non-consensual acts including applying pressure to her neck, digitally penetrating her, exposing his penis and physically directing her towards it. The sole direct evidence underpinning these findings was Ms A’s account. The central issues for determination are: (i) whether it was open to a reasonable Tribunal to accept Ms A's evidence on the core allegations; (ii) whether the Tribunal failed to consider material evidence that contradicted her account; (iii) whether the Tribunal relied on irrelevant inadmissible material in reaching its conclusions; and (iv) whether any other factor renders the Tribunal’s findings on the core issues wrong.

48. Having carefully reviewed the transcripts and the Tribunal’s reasoning, including its half-time ruling, I am satisfied that the findings reached were properly open to it on the evidence and cannot be characterised as either factually incorrect (the inaccurate reference to the Snapchat message was a minor error and inconsequential) or unreasonable. The Tribunal’s acceptance of Ms A’s core account and rejection of Dr Sadiq’s evidence was not irrational. There is no indication that material evidence was overlooked or that irrelevant matters were considered. As a specialist body with the benefit of hearing live evidence, the Tribunal is entitled to a degree of deference in its evaluative judgment. Many of the criticisms now raised on appeal were canvassed before the Tribunal and addressed in its determination. The Tribunal conducted a balanced analysis of the evidence, applying the correct legal framework and attributing appropriate weight to the competing accounts. I do not accept that Dr Sadiq has demonstrated any misreading of the evidence or that the findings fell outside the generous ambit within which reasonable disagreement is permissible. Accordingly, I do not find that the Tribunal erred in its conclusions under Ground 3.

49. As to Dr Sadiq’s specific criticisms: i. In assessing whether Dr Sadiq digitally penetrated Ms A, the Tribunal was required to evaluate their competing accounts, including the suggestion that Ms A had fabricated her complaint following rejection. The Tribunal adopted a holistic approach, considering not only the immediate events of 19 November 2020 but also the broader context of their interactions—both prior to and following that meeting. This included contemporaneous messaging, oral evidence and third-party witness evidence. The Tribunal’s approach was consistent with its duty to make findings on the balance of probabilities. Accordingly, the criticism that the Tribunal relied on messaging sent after the meeting to retrospectively prove the incident is misplaced. Those messages were not treated as direct proof of penetration but considered as part of the wider evidential context relevant to credibility, motive, and sexual intent. This approach was not unfair. ii. Ms A gave clear and specific evidence that Dr Sadiq inserted his fingers into her vagina. She described experiencing a “ freeze response ” and stated that she vividly remembered the sensation of his fingers being removed but in her police interview did not recall the insertion itself, attributing this to sensory limitations or fear. She was asked about her clothing and confirmed that her jeans were not undone, and that she was standing at the time. Although she could not recall the precise mechanism of insertion, she maintained that the contact was internal. The Tribunal did not consider this lack of mechanical detail to undermine the reliability or plausibility of her account. Rather, it found her evidence to be specific and credible, particularly in light of her consistent description of the incident across her police interview, witness statements, and oral testimony. The Tribunal was entitled to reach this conclusion. The Tribunal also considered the apparent contradiction between Ms A’s “ freeze response ” and her police interview statements indicating active resistance including her claim that she tried to grab Dr Sadiq’s hands and said “ stop ”. The Tribunal was entitled to consider Ms A’s reasoning as part of her broader account, particularly her acknowledgment of memory limitations and the distressing nature of the incident. The Tribunal did not treat her ‘ logistical ’ reasoning as standalone proof of any specific act. It assessed her credibility by taking into account her oral testimony, contemporaneous messaging, and third-party disclosures. The Tribunal recognised that Ms A was unable to recall exact timings or whether she was standing or kneeling and noted that both parties accepted the situation was dynamic. It is well established that tribunals are not required to resolve every inconsistency in a witness’s account, particularly where the core allegations are supported by credible evidence. As Morris J observed in Byrne v GMC [2021] EWHC 2237 (Admin) , inconsistencies in detail are commonplace in contested oral accounts and do not necessarily undermine the reliability of the core narrative. The Tribunal’s approach was consistent with this principle and with its duty to make findings on the balance of probabilities. The Tribunal considered corroborative messaging and the testimony of Friends X and Y, who gave evidence of Ms A’s disclosures shortly after the incident. While the Tribunal acknowledged inconsistencies in their accounts—particularly regarding the location of the meeting—it was entitled to assess the significance of those discrepancies in context. The friends’ evidence was not treated as determinative but considered as part of a broader evidential picture. iii. The Tribunal was required to assess whether the allegation that Dr Sadiq sent Ms A a photograph of his penis via Snapchat was proved on the balance of probabilities. Ms A gave clear oral evidence that she had received such an image and attributed it to Dr Sadiq. However, the image itself was not produced in evidence, despite Ms A’s assertion that it had been provided to the police. The GMC did not adduce the image, nor was there any supporting metadata, forensic analysis, or corroborative material to establish its origin or link it to Dr Sadiq. In these circumstances, the Tribunal considered whether the allegation had been proved to the required standard. It noted the prevalence of unsolicited images on social media platforms and the absence of any identifying features in the image itself. I am satisfied that the Tribunal’s reference to “ uncertainty as to the sender ” was not a rejection of Ms A’s credibility on this issue, but a reflection of the evidential gap in the GMC’s case. The Tribunal did not find that Ms A was dishonest or mistaken; it concluded that the GMC had failed to discharge the burden of proof in relation to this specific allegation. That conclusion was reasoned and proportionate, and consistent with the Tribunal’s duty to make findings based on reliable evidence. The Tribunal’s approach was balanced. iv. I do not accept the submission that the Tribunal’s treatment of the messaging was selective or misleading. The Tribunal was required to assess whether Dr Sadiq used his professional status to gain Ms A’s trust in order to facilitate a meeting. In doing so, it considered the full sequence of communications exchanged via WhatsApp, including messages in which Dr Sadiq referred to himself as a doctor, stating “ I save lives ”, and “ you can trust me ”. These messages were not treated in isolation but were assessed in the context of Ms A’s supplemental witness statement, in which she explained that such messaging influenced her decision to meet him. The Tribunal did not find that Ms A was coerced into meeting Dr Sadiq, nor did it suggest that the message “ you can trust me ” was inherently improper. It concluded that the messaging formed part of a pattern of communication that reasonably supported the inference that Dr Sadiq sought to leverage his professional identity to build Ms A’s trust. That inference was open to the Tribunal on the evidence. The suggestion that the Tribunal ignored other messages indicating Ms A’s willingness to meet is not borne out by the transcript or the determination. The Tribunal acknowledged that Ms A had expressed interest in meeting prior to the “ you can trust me ” message, but it was entitled to find that the message reinforced her decision and contributed to the dynamic of trust that preceded the meeting. The Tribunal did not rely on isolated phrases but considered the messaging in its entirety alongside oral and documentary evidence. Its approach was consistent with the principles of fair and balanced fact-finding and does not disclose any error of law or reasoning. v. The Tribunal’s determination demonstrates a clear understanding of the distinction between external and internal contact. Ms A’s evidence was explicit in describing the touching as internal, and the medical member of the Tribunal took steps to ensure that this was properly understood. The Tribunal’s findings were expressed using the language of the Allegation, which referred specifically to insertion. Where the Tribunal later used the term “ touching ” in its summary of findings or submissions, this was not a departure from its factual conclusions but a shorthand reference to the conduct already found proved. The Tribunal’s reasoning demonstrates that it was alert to the seriousness of the allegation and did not conflate lesser forms of contact with the act of digital penetration. Its conclusion that insertion occurred was supported by Ms A’s account, the surrounding messaging, and the limited corroborative evidence from Friends X and Y. The Tribunal also made adverse factual findings in relation to the specific allegation that Dr Sadiq “ put both your hands around Ms A’s neck and applied pressure ”. The Tribunal, described the conduct as “ effectively choking ” Ms A. This was not a departure from the factual finding, but a characterisation of the seriousness of the conduct found proved. The use of the term “ choking ” was consistent with the evidence, including Ms A’s account of pressure being applied to her neck and her reaction. Similarly, the reference to “ violence ” was not a new or separate allegation but a descriptor used in the context of assessing the seriousness of the misconduct and its implications for public confidence and professional standards. Findings of fact may be summarised or characterised in evaluative terms, provided they remain anchored to the evidence and the charges as framed. The Tribunal did not purport to find additional facts beyond those alleged; it used appropriate language to convey the seriousness of the conduct found proved. There was no conflation, misdirection or procedural unfairness in its reasoning. vi. Although the Police Summary was available at the time of the Tribunal hearing, it was removed from the agreed bundle at the express request of Dr Sadiq’s legal representatives. No application was made to reintroduce it, nor was any indication given that Dr Sadiq intended to rely on it. Therefore, the first limb of the Ladd v Marshall principles (could not have been obtained with reasonable diligence), is plainly not satisfied. The document was in existence, known to the parties, and deliberately excluded. Furthermore, the second limb (the evidence would likely have an important influence on the result) is also not met. The Police Summary offered a more detailed account of Ms A’s memory limitations, but the Tribunal was already aware of her autism diagnosis and associated vulnerabilities. These matters were raised in the special measures application and reflected in the procedural safeguards adopted. The Tribunal’s written determination demonstrates that it considered Ms A’s evidence in the round, acknowledged inconsistencies, and made appropriate allowances. The additional material does not materially alter the evidential landscape and would not have affected the outcome. Accordingly, the omission of the Police Summary does not render the proceedings unfair or the findings unsafe. Conclusion

50. In light of the above, I am satisfied that the Tribunal considered the evidence appropriately and reached findings that were open to it. The conclusions cannot be said to be wrong, unsupported, or otherwise unreasonable.

51. Therefore, Ground 3 is dismissed. Ground 4 – Failure to consider Reflections document Dr Sadiq’s Submissions

52. Dr Sadiq states that the Tribunal’s assessment of his insight, apology and remorse was procedurally unfair, as it failed to consider his Reflections document, dated 28 September 2022. He contends that this document which acknowledged the inappropriateness of his WhatsApp messaging and expressed contrition, was relevant to the Tribunal’s evaluation of his insight and ought to have been considered at Stage 2. Dr Sadiq further argues that he was not informed by the GMC or MPTS of the need to re-submit or re-adduce this document at Stage 2 or Stage 3. His absence from Stage 2, due to personal circumstances, should not have resulted in a complete disregard of previously submitted mitigation. In support of his explanation for non-attendance, Dr Sadiq sought to rely on additional evidence including his passport and wedding photographs. GMC Submissions

53. The GMC acknowledges that the Reflections document submitted by Dr Sadiq at the Rule 7 stage was not available to the Tribunal, and that this was a procedural irregularity. However, it submits that the omission was immaterial. The document addressed only the inappropriate nature of the WhatsApp messaging and did not engage with the core findings of non-consensual sexual conduct. Given the seriousness of the Tribunal’s factual conclusions and Dr Sadiq’s continued denial of those findings on appeal, the GMC argues that the Reflections document could not have materially influenced the Tribunal’s assessment of insight, remorse or mitigation. It is further submitted that there is no general obligation on the Tribunal to adjourn or provide a registrant with an opportunity to make submissions in mitigation of sanction once adverse findings have been made. Discussion

54. Dr Sadiq sought to rely on new evidence, namely his passport (confirming entry into Pakistan on 27 October 2023) and wedding photographs, to explain his absence from Stage 2. I admitted this evidence provisionally. The authenticity of this evidence was not in dispute. Applying the test in Ladd v Marshall , the passport stamp was available at the time the Tribunal was considering Dr Sadiq’s renewed application to adjourn but the wedding photographs were not. However, I am satisfied that neither document would have made a material difference to the outcome.

55. The Tribunal had taken reasonable steps to facilitate Dr Sadiq’s participation. Despite these accommodations, no written submissions were provided, and no mitigation materials were served. Moreover, there is no direct challenge to the Tribunal’s decision to proceed in absence. The substance of this ground of appeal is that the Tribunal was unaware of the Reflections document, as it was not included in the agreed bundle. No application was made to introduce it, and no Stage 2 bundle was served. I do not accept that Dr Sadiq was unaware that he could make written submissions or re-submit his Reflections documents (with or without amendment) as he had the benefit of legal advice for a significant period. Nonetheless, the GMC acknowledges that there was a procedural irregularity in that the Reflections document should have been identified and put before the Tribunal. I have no doubt that this was an appropriate concession. Both the GMC and the Tribunal should take reasonable steps to ensure that all relevant mitigation materials provided by an absent registrant are available for consideration. As Simler LJ (as she then was) stated in Sanusi v General Medical Council [2019] 1 WLR 6273 at [84], this duty does not require archival searches or the review of unindexed material. It extends only to reasonable searches for material that is objectively relevant and readily identifiable.

56. In this case, the Reflections document was clearly titled and had previously been served. Its retrieval would not have required significant effort. However, its contents were limited to acknowledging inappropriate messaging, expressing regret for continued contact and reading GMC guidance on professional boundaries. Given that it was written before the findings of fact it was limited in its scope and could not have demonstrated insight into the seriousness of the misconduct found by the Tribunal.

57. I am satisfied that the Reflections document would not have made any material difference to the Tribunal’s finding of impairment at Stage 2. That finding was based on non-consensual sexual contact. The Tribunal went on to conclude that Dr Sadiq’s behaviour was fundamentally incompatible with continued registration. The Reflections document did not address or mitigate these conclusions. Conclusion

58. Accordingly, while there was a procedural irregularity, it was immaterial and did not affect the fairness or outcome of the proceedings. Ground 4 is therefore dismissed. Ground 5 – Unfair questions Dr Sadiq Submissions

59. Dr Sadiq alleges that he was asked inappropriate and unfair questions during the hearing, including a question about his sexual orientation. He submits that certain lines of questioning were irrelevant to the allegations, emotionally charged, and served only to prejudice him. In particular, he objects to a series of hypothetical questions posed by the LQC, including: “ If you heard about a teenage relative being sexually assaulted on a Tinder date, how would you react? ”, “ Would you be sympathetic to the relative, or would you think that it’s one of the consequences on Tinder? ”, and “ Do you want to tell the Tribunal what you think that female relative might experience in consequence of being sexually assaulted on a Tinder date? ”. He argues that these questions were not directed at clarifying evidence but instead invited moral judgment and emotional association, thereby undermining the neutrality of the proceedings.

60. Dr Sadiq further complains that the Tribunal asked Ms A, at the close of her evidence, how she felt after meeting him on 19 November. Her response— “ I felt weirdly relieved that it hadn’t gone further… I feared for my life… it took me a while to realise that what had happened was not ok ”—was not part of her earlier testimony and could not be tested in cross-examination. Nevertheless, the Tribunal cited this response in its final determination as corroborative of her credibility. Dr Sadiq submits that this approach was procedurally unfair. He argues that the Tribunal’s reliance on Ms A’s emotional narrative introduced an unbalanced emotional influence into the fact-finding process. Taken together, with the restrictions on cross examination, he was deprived of a fair opportunity to test the evidence against him. GMC Submissions

61. The GMC submits that the questions posed to Dr Sadiq were neither unfair nor procedurally irregular in the context of the case. The Tribunal had heard evidence concerning sexual preferences, and in that context, Dr Sadiq was asked whether he preferred to be dominant in sexual relationships and whether he had experience of choking. These questions were directly relevant to the allegations. The hypothetical questions were intended to explore Dr Sadiq’s understanding of the impact of sexual assault and the risks associated with online dating. They were not designed to elicit sympathy or moral judgment but to assess insight and attitude. The GMC submits that the Tribunal was entitled to ask such questions in the context of evaluating Dr Sadiq’s understanding of the seriousness of the allegations and their potential impact on others. Discussion

62. Having reviewed the transcript, the parties’ submissions, and the relevant authorities, I am satisfied that the questions posed to Dr Sadiq were not improper or unfair when considered in context. The Tribunal had heard evidence from Ms A concerning sexual preferences, including references to dominant/submissive dynamics and strangulation. These topics were also discussed in the messaging exchanged between Ms A and Dr Sadiq. In that context, the Tribunal did not ask Dr Sadiq about his sexual orientation but did ask whether he had a preference for dominance and whether he had experience of choking in a sexual context. These questions were directly relevant to the allegations, particularly whether Dr Sadiq was seeking to initiate a sexual ‘relationship’ with Ms A and whether it was likely that he would have placed his hands around her neck, as alleged. Objections were raised by counsel, and the LQC explained that the questions were relevant to allegation 2(b)(ii) (“ put both your hands around Ms A’s neck and applied pressure ”). The Tribunal was entitled to explore these matters in assessing motive and likelihood.

63. The further exchange cited by Dr Sadiq—namely, the hypothetical questions about how he would react if a teenage relative were sexually assaulted on a Tinder date—were posed by the LQC. While emotive in tone, the questions were clearly framed to explore Dr Sadiq’s understanding of the impact of sexual assault and the risks associated with online dating. They were not directed at establishing factual guilt but at assessing insight and attitude. This is particularly important as Dr Sadiq denied the core allegations. The Tribunal is permitted to ask questions that probe a registrant’s understanding of the seriousness of the allegations and their potential consequences. The questions were put professionally, and Dr Sadiq was represented by experienced counsel who was able to object and did so when appropriate.

64. I do not accept that counsel for Dr Sadiq was not given the opportunity to challenge Ms A’s response to Tribunal questions. Although the question about how Ms A felt was posed towards the end of her evidence, counsel for Dr Sadiq did have an opportunity to ask follow-up questions but chose not to. The Tribunal did not prevent further questioning. The emotive content of her response was one of several factors considered in assessing credibility, alongside contemporaneous messaging, third-party witness evidence, and her oral testimony. The Tribunal did not treat Ms A’s emotional response as determinative, but rather as part of a broader evidential picture. Furthermore, it expressly stated that it did not give weight to the demeanour of any witness. Conclusion

65. There was no serious procedural irregularity or unfairness in the questioning of Dr Sadiq or Ms A by the Tribunal. The approach taken was within acceptable bounds of clarification and exploration of relevant issues. Furthermore, Dr Sadiq was not deprived of a fair opportunity to ask follow-up questions. Accordingly, Ground 5 is dismissed. Ground 6 – Contamination and Collusion issue Dr Sadiq’s submissions

66. Dr Sadiq submits that the Snapchat messages sent by Ms A to Friend X and Friend Y represent a clear risk of contamination, particularly given the Tribunal’s reliance on the consistency between Ms A’s account and those of her friends. He argues that these messages (sent several months after the alleged incident) contained Ms A’s version of events and may have shaped the recollections of her friends, who did not witness the incident themselves. He further contends that Ms A’s mother played an active role in preparing notes for the police interview, some of which were written in her own handwriting, and that this involvement may have influenced Ms A’s account and compromised its independence.

67. In support of this ground, Dr Sadiq relies on several authorities, including R v H [1995] 2 AC 596 , R v Lamb [2007] EWCA Crim 1766 , PSA v GMC & Dr Garrard [2025] EWHC 318 (Admin) , and R v Chopra [2006] EWCA Crim 2133 with regard to ruling out the risk of contamination. He submits that the Tribunal’s failure to consider the contamination risk undermines the reliability of its factual findings. GMC Submissions

68. The GMC submits that the significance of the evidence of Friend X and Friend Y was that it provided an account of what Ms A said and did shortly after her meeting with Dr Sadiq. The messages that Dr Sadiq criticises reflect a friend-to-friend communication and include a concern that they may “ feel bad ”. It is argued that there was no deliberate or inadvertent attempt to influence the evidence and the discrepancies in the friends’ evidence was acknowledged in the Tribunal’s determination.

69. The GMC further submits that Ms A’s mother played a significant supportive role, and the unusual feature of the aide memoire was one of many factors the Tribunal considered. Discussion

70. Evidence from one allegation may be cross-admissible to another allegation in the same proceedings where (i) it may establish propensity to commit that kind of conduct and/or (ii) it may rebut coincidence ( Freeman [2008] EWCA Crim 1863 at [14] and [15]). The LQC advised on propensity but did not address coincidence. However, the Tribunal noted in its facts determination that the flaws in the evidence of Friends X and Y may indicate an absence of collusion. The Tribunal was informed that Ms A took notes to the police interview as an aide memoire, some of which had been written by her mother the night before at Ms A’s request. The Tribunal took the view that the fact the aide memoire was not in evidence was one of many issues to be taken into account when assessing the veracity of Ms A’s account.

71. The authorities cited by Dr Sadiq ( H , Lamb , Chopra , and Garrard ) concern cases involving multiple complainants, where the similarity of accounts may improperly bolster credibility. In such cases, the Tribunal must expressly consider and exclude the possibility of contamination or collusion before relying on the consistency of witness accounts to rebut coincidence. However, that principle does not apply here. This was a single-complainant case. Friends X and Y were not eyewitnesses to the alleged incident and could only relay what Ms A told them. Their evidence was not treated by the Tribunal as independent corroboration of the assault, but rather as evidence of early disclosure. The Tribunal had access to the relevant messaging, including the Snapchat communications, and was aware of the timing and content of Ms A’s contact with her friends. It was entitled to assess the weight and reliability of their accounts in context. The Tribunal’s written determination demonstrates that it considered the credibility of each witness, acknowledged inconsistencies, and did not treat the friends’ statements as determinative. Unlike in Garrard , where the Tribunal failed to apply the correct legal test for cross-admissibility and did not exclude contamination before treating similar allegations as mutually reinforcing, the Tribunal in this case did not rely on similarity between multiple complainants to support its findings. Its findings were based on the evidence of a single complainant. In that context, the absence of an express direction on contamination or collusion does not amount to a material procedural irregularity.

72. Furthermore, no party at the hearing suggested collusion or contamination was in issue. The LQC’s duty was to advise the Tribunal on matters of law and fairness; it did not extend to raising factual hypotheses which had not been advanced and for which there was no clear evidential foundation. The possibility that the evidence of Friends X and Y were informed by Ms A’s account was apparent from the evidence and would have been obvious to a fair-minded Tribunal. In those circumstances the absence of an express direction does not amount to a procedural irregularity. The issue goes to weight, not admissibility and the Tribunal could fairly proceed without express legal advice on this point.

73. In any event, as this appeal proceeds by way of re-hearing, I have considered the matter afresh and taken into account any potential influence in assessing the weight and reliability of the supporting evidence. I find no basis to conclude that the friends’ accounts were improper or that the outcome was affected by any failure to address contamination expressly. The consistency between Ms A’s account and those of her friends was one factor among many, and the Tribunal’s overall approach to credibility was sufficiently robust. The same applies to the absence of the ‘aide memoire’. Conclusion

74. There was no serious procedural irregularity or unfairness. I do not accept that the Tribunal erred in not addressing contamination or collusion. This ground is misconceived. Accordingly, Ground 6 is dismissed. Ground 7 – Technical issues and Breach of MPTS Remote Hearing Guidance Dr Sadiq’s Submissions

75. Dr Sadiq submits that the LQC’s camera was switched off during part of the hearing. He argues that this compromised the integrity of the proceedings, as it created uncertainty about whether the Tribunal was properly constituted and fully attentive during the evidence. He contends that the MPTS Remote Hearing Guidance requires hearings to be paused if any panel member loses visual or audio connection, and that the reason and duration should be recorded. In this case, the hearing was not formally paused, and no record was made of the duration of the disconnection. Dr Sadiq submits that this amounts to a procedural irregularity and undermines the appearance of fairness. GMC Submissions

76. The GMC submits that there is no indication that any evidence was missed or that any critical submission was overlooked, during the period in which the LQC’s camera was switched off. It is further argued that minor technical interruptions are an inevitable feature of remote proceedings and were appropriately managed to ensure the hearing remained on track. Discussion

77. It is clear from the transcript that on Day 2 of the hearing, during Ms A’s cross examination by Mr Walters, the LQC’s camera was temporarily switched off, prompting concern from GMC counsel who noticed the disconnection. The LQC explained that she had to plug in her device due to low battery and apologized for the interruption. The Tribunal paused briefly while the LQC reconnected.

78. Although the precise duration of the disconnection cannot be determined from the transcript, the context indicates that it occurred during a procedural pause in proceedings rather than while substantive evidence was being given. No substantive questioning or evidence was presented during this interval. Upon reconnection, the LQC resumed her role and confirmed she was back online. Having reviewed the circumstances, I am satisfied that the LQC’s temporary absence was momentary, and the explanation was placed on the record. While the absence of a formal record of the duration of the disconnection may have fallen short of best practice under the MPTS Remote Hearing Guidance, it was promptly addressed. The hearing continued without objection from either party and no procedural challenge was raised at the time.

79. In my judgment, this constituted a minor departure from procedural guidance which did not compromise the fairness or integrity of the proceedings. There is no evidence that any material evidence was missed or misunderstood, nor that the Tribunal’s composition or attentiveness was affected. Accordingly, this aspect of the appeal does not disclose any serious procedural irregularity. Conclusion

80. There was no serious procedural irregularity. Accordingly, Ground 7 is dismissed. Summary

81. Due to the necessarily detailed analysis required by the seven pleaded grounds of appeal, I summarise my principal conclusions as follows. (i) The procedural challenges (Grounds 1, 2, 4, 5 and 7) were wide-ranging in nature. Two procedural irregularities were identified: the omission of the Reflections document and the temporary loss of the LQC’s video connection. One was significantly more serious than the other but neither affected the fairness or outcome of the proceedings. The remaining procedural complaints related to issues which regularly arise in regulatory proceedings and were properly managed by the Tribunal. None of them deprived Dr Sadiq of a fair hearing. (ii) The challenges to the findings of fact (Grounds 3 and 6) fail to recognise the thorough and holistic evidential analysis the Tribunal undertook. The criticisms advanced largely reflect disagreement with the outcome.

82. Standing back and considering the appeal in its entirety, this was, at its core, a contest of credibility between Ms A and Dr Sadiq. The central evaluative task for the Tribunal was to determine whether the inconsistencies in Ms A’s evidence were so significant as to undermine her credibility in its entirety. That was a difficult judgment, but the Tribunal’s findings fall well within the range of reasonable conclusions open to it. Ultimately, the Tribunal concluded that Ms A’s evidence was sufficiently credible and reliable on the key issues in preference to Dr Sadiq’s denials which it considered evasive and, in certain respects, implausible. Disposal

83. As the Tribunal’s factual findings were properly made, there is no sustainable basis for challenging the Stage 2 impairment decision. However, in accordance with Sastry , the court must determine whether the sanction was appropriate and necessary in the public interest or excessive and disproportionate. If the appellate court finds that the sanction was clearly inappropriate it may substitute some other penalty or remit the case to the Tribunal for reconsideration.

84. During his oral submissions, Dr Sadiq invited the Court to consider the tribunal case of Dr Foy, which, like the present matter, involved non-consensual sexual contact with a person who was not a patient - albeit the allegation in that case was one of rape. He submitted that the Tribunal’s decision in Dr Foy’s case, which resulted in a 12-month suspension, demonstrated a degree of parity with his own case. Ms Hearnden informed the Court that the Dr Foy case was subject to appeal (both a s40 appeal against the factual findings and a s40 A cross appeal by the GMC on the grounds that the sanction was unduly lenient) before Ritchie J who had reserved judgment.

85. Judgment in the Dr Foy case was handed down by Ritchie J on 31 October 2025 [see - [2025] EWHC 2846 (Admin)] . I note that it resulted in remittal for reconsideration, but I do not find that case to be of any assistance with regard to sanction, not least because the factual matrix in each case must be independently assessed.

86. The Tribunal's analysis in determining the appropriate sanction to impose on Dr Sadiq was logical and principled. It took into account the Sanction Guidance and reminded itself that the purpose of a sanction is not punitive. It took account of the aggravating and mitigating factors specific to the circumstances of the case by reference to the Sanctions Guidance before moving through the sanction options in ascending order of severity in the light of its factual findings.

87. I consider that the sanction of erasure was appropriate. This is a case where the Tribunal made findings of sexual misconduct which impacts on the reputation of the profession. It undermines public trust in the profession. It is accordingly more difficult to remediate than poor clinical performance and mitigation is afforded limited weight as the reputation of the profession is more important than the fortunes of the individual member. The Tribunal noted that there was no evidence of repetition of similar behaviour since the incident, but it also took account of paragraph 97 of the Sanctions Guidance which states that suspension may be appropriate where there is: " A serious breach of Good medical practice, but where the doctor’s misconduct is not fundamentally incompatible with their continued registration , therefore complete removal from the medical register would not be in the public interest …” [emphasis added]. The Tribunal concluded that a period of suspension would not be sufficient to maintain public confidence in the profession, nor promote and maintain proper professional standards and conduct for members of the profession. Accordingly, erasure was necessary in Dr Sadiq's case to protect the reputation of the profession.

88. The Tribunal’s reasoning was brief, but in my judgment its approach to sanction cannot be faulted; it was an evaluative judgment which it was fully entitled to reach on the evidence. The Tribunal's determination that Dr Sadiq's name be erased from the medical register has not been shown to be wrong. Indeed, I consider it to be fully justified in all the circumstances.

89. It is no doubt a matter of considerable regret to Dr Sadiq and his family that he has lost his medical career, but the facts as found by the Tribunal justify erasure.

90. The appeal is dismissed.