PUBLIC RECORD · 2020. 8. 28. · Record of Determinations – Medical Practitioners Tribunal MPT:...

Record of Determinations –

Medical Practitioners Tribunal

MPT : Dr AZIZ

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PUBLIC RECORD Dates: 21/10/2019 – 25/10/2019 04/02/2020 – 07/02/2020

24/08/2020 – 25/08/2020

Medical Practitioner’s name:

Dr Hassan AZIZ

GMC reference number: 7601139

Primary medical qualification: MB BS 2018 University College London

Type of case Outcome on facts Outcome on impairment New - Misconduct Facts relevant to impairment

found proved

Not Impaired

Summary of outcome

No warning

Tribunal:

Legally Qualified Chair Mrs Fiona Barnett

Lay Tribunal Member: Mrs Aaminah Khan

Medical Tribunal Member: Dr Neil Smart

Tribunal Clerk: Mr Stuart Peachey (21/10/2019)

Ms Jean Gleeson (22/10/2019 – 24/10/2019 and 05/02/2020)

Ms Jan Smith (25/10/2019) Ms Esther Morton (04/02/2020 and

06/02/2020 – 07/02/2020)



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Mr Matt O'Reilly (24/08/2020 – 25/08/2020)

Attendance and Representation:

Medical Practitioner: Present and represented

Medical Practitioner’s Representative: Anthony Haycroft, Counsel, instructed by DAC Beachcroft LLP

GMC Representative: Ms Elizabeth Dudley-Jones, Counsel

Attendance of Press / Public

In accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004 the hearing was held in public.

Overarching Objective Throughout the decision making process the tribunal has borne in mind the statutory

overarching objective as set out in s1 Medical Act 1983 (the 1983 Act) to protect, promote and maintain the health, safety and well-being of the public, to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional

standards and conduct for members of that profession. Determination on Facts - 07/02/2020

1. This hearing began on 21 October 2019 and was due to conclude on 25 October 2019. Due to issues with witness timetabling the hearing adjourned part-heard on 25 October 2019 at the

Facts stage. The hearing resumed on 4 February 2020 and will continue until 7 February 2020; it will then adjourn again, to resume on 14 April 2020. Background

2. Dr Aziz graduated in 2018 from University College of London Medical School (‘UCL’) with an MBBS Medicine and iBSc Neuroscience. Following his graduation he obtained a Foundation Year

1 (‘FY1’) placement at Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust (‘the Trust’). Dr Aziz began work at the Trust on 1 August 2018; on 30 August 2018 he was suspended from practice by an Interim Orders Tribunal (‘IOT’), and he has remained

suspended since. At the time of the events which gave rise to these proceedings, Dr Aziz was a final year medical student at UCL.

3. As part of his MBBS degree Dr Aziz had the option to undertake an overseas elective placement. Dr Aziz applied to undertake this placement at Kilimanjaro Christian Medical Centre



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(‘KCMC’), Tanzania (‘the placement’). In June 2018, on return from the placement, Dr Aziz submitted a post-elective placement report (‘the report’) to UCL.

4. On 25 July 2018 Dr B, Divisional Tutor for the Medical School at UCL (referred to as ‘Dr B’ in the Allegation) received an email from Dr C, the Head of the Paediatric Department at KCMC. In

this email, Dr C raised concerns about Dr Aziz’s attendance during the placement. In subsequent email correspondence Dr C raised concerns about the validity of the report. 5. On 1 August 2018 Dr B raised Dr C’s concerns with the GMC, writing:

‘I am afraid that I have just discovered that one of our students, who graduated this month, has submitted a forged end of placement form for his elective, which has allowed him to

graduate with an MBBS when he was not eligible so to do.’ 6. Dr B subsequently emailed Dr Aziz, informing him of Dr C’s concerns, as well as the referral

Dr B had made to the GMC. 7. The GMC alleges that, in or around June 2018, Dr Aziz submitted the report to UCL stating

that he had completed the mandatory six-week elective placement at KCMC. The GMC alleges that the report contained information that was untrue, in that Dr Aziz had not attended KCMC for six weeks, had left the placement early, and had not completed the placement. The GMC further

alleges that Dr Aziz asked Ms A to complete and sign off the report, despite knowing that she was not authorised to do so. It alleges that Dr Aziz’s actions, in so doing, were dishonest. 8. The GMC further alleges that, in a conversation with Dr B in August 2018, Dr Aziz

untruthfully described Ms A as a ‘visiting overseas doctor’ and/or someone who ‘had been in the faculty’ at KCMC. It again alleges that his actions, in so doing, were dishonest.

The Outcome of Applications Made during the Facts Stage 9. On day one of the hearing, the GMC made an unopposed application for Dr B’s

evidence to be heard via video link. Dr B was initially due to attend in person on day one of the hearing to give evidence, but due to timetabling difficulties his evidence was moved to day 2. Dr B had clinical commitments in London on day 2 of the hearing, and the Tribunal was

content to hear his evidence via video link in these circumstances. 10. On day 6 of the hearing Mr Haycroft, for Dr Aziz, applied to hear Ms A’s and Ms D’s evidence via telephone link. Ms Dudley-Jones, for the GMC, did not oppose this application.

The Tribunal granted this application, and its full reasoning is set out at Annex A. 11. Also on day 6 of the hearing, Mr Haycroft applied to adduce Dr E’s witness statement

and associated exhibits into evidence as hearsay. Ms Dudley-Jones opposed this application on behalf of the GMC. The Tribunal determined to admit Dr E’s witness statement into evidence, but it rejected Mr Haycroft’s application to admit the associated exhibits (namely a



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transcript of WhatsApp messages) into evidence. The Tribunal’s full reasoning for this decision is set out at Annex B.

The Allegation and the Doctor’s Response

12. The Allegation made against Dr Aziz is as follows:

Paragraph One In or around June 2018, whilst studying at University College of London Medical School, you submitted an elective placement report (‘the Report’), stating that you had completed the mandatory six week elective clinical placement (’the Placement’) at

Kilimanjaro Christian Medical Centre (‘KCMC’) between 23 April 2018 and 15 June 2018. Admitted and found proved

Paragraph Two You knew that the Report contained information that was untrue, in that you had:

a. not attended at KCMC for a period of six weeks; To be determined

b. left the Placement early without seeking confirmation that this was approved; To be determined

c. not completed the Placement. To be determined

Paragraph Three You asked Ms A to complete and sign the ‘Elective Supervisor’ and ‘Supervising Member of Staff’ section of the Report. Admitted and found proved

Paragraph Four You knew that Ms A was not:

a. your elective supervisor and/or supervising member of staff; Admitted and found proved

b. authorised to sign the Report. To be determined

Paragraph Five Your action, as referenced at paragraph:

a. 1 was dishonest by reason of paragraph 2; To be determined

b. 3 was dishonest by reason of paragraph 4. To be determined

Paragraph Six On or around 1 August 2018, during a conversation with Dr B, when questioned about the information in the Report, you said that Ms A was a ‘visiting overseas doctor’



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and/or ‘had been in the faculty whilst you had undertaken your placement’, or words to that effect. To be determined

Paragraph Seven You knew that the information you gave Dr B on 1 August 2018 was untrue. To be

determined

Paragraph Eight Your action, as referenced at paragraph 6 was dishonest by reason of paragraph 7. To be determined

The Admitted Facts

13. At the outset of these proceedings Dr Aziz, through his counsel, made a number of admissions to the Allegation, as set out above, in accordance with Rule 17(2)(d) of the

General Medical Council (GMC) (Fitness to Practise) Rules 2004, as amended (‘the Rules’). In accordance with Rule 17(2)(e) of the Rules, the Tribunal announced that these paragraphs and sub-paragraphs were found proved.

The Facts to be Determined

14. In light of Dr Aziz’s response to the Allegation, the Tribunal is required to determine whether Dr Aziz submitted the report knowing that it contained information that was untrue and whether, if proved, his actions in so doing were dishonest. The Tribunal must also

determine whether Dr Aziz knew that Ms A was not authorised to sign the report, and whether he dishonestly misled Dr B about her role. Factual Witness Evidence

15. The Tribunal received witness statements and oral evidence on behalf of the GMC from the following witnesses:

• Dr B, via video link;

• Dr C, via video link.

16. Dr Aziz provided his own witness statement dated 16 September 2019 and also gave oral evidence at the hearing. In addition, the Tribunal received evidence from the following witnesses called on Dr Aziz’s behalf:

• Ms A (referred to as ‘Ms A’ in the Allegation), qualified nurse in Sweden and former intern/ student nurse at KCMC, via telephone;

• Ms D, qualified nurse in Sweden and former intern/ student nurse at KCMC, via telephone.



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17. The Tribunal also received a witness statement from Dr E, Board Certified Paediatric

Physician in the USA and former attendee at KCMC. Dr E did not give oral evidence at the hearing.

Documentary Evidence 18. The Tribunal had regard to the documentary evidence provided by the GMC and on behalf of Dr Aziz. This evidence included, but was not limited to:

• Correspondence between Dr C and UCL staff;

• Dr B’s email dated 1 August 2018 referring Dr Aziz to the GMC;

• Correspondence between Dr Aziz and UCL staff;

• An undated note of the telephone call between Dr Aziz and Dr B, compiled by Dr B;

• The elective placement report form submitted by Dr Aziz to UCL;

• The pre-elective approval form and the elective placement form submitted to UCL by Dr Aziz;

• Pre-placement documentation sent to Dr Aziz from KCMC;

• Transcripts of WhatsApp messages, including those between Dr Aziz and his mother and between Dr Aziz and Dr C;

• Copies of Dr Aziz’s travel documents.

The Tribunal’s Approach 19. In reaching its decision on facts the Tribunal has borne in mind that the burden of proof rests on the GMC and it is for the GMC to prove the Allegation. Dr Aziz does not need to prove

anything. The standard of proof is that applicable to civil proceedings, namely the balance of probabilities. Applying this standard, the Tribunal must ask itself whether it is more likely than not that the events occurred as alleged.

20. The Tribunal accepted the advice of the Legally Qualified Chair who advised that, when considering dishonesty, it should adopt the approach set out by Lord Hughes in the case of Ivey v

Genting Casinos (UK) Limited [2017] UKSC 67 (‘Ivey’), as follows:

‘When dishonesty is in question the fact-finding Tribunal must first ascertain

(subjectively) the actual state of the individual’s knowledge or belief as to the facts. The



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reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional

requirement that his belief must be reasonable; the question is whether it is genuinely held. When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be

determined by the fact-finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.’

The Tribunal’s Overall Determination on the Facts 21. The Tribunal considered each outstanding paragraph of the Allegation separately and

evaluated the evidence in order to make its findings on the facts. 22. The Tribunal began by considering Dr Aziz’s credibility. The Tribunal found Dr Aziz to

be a credible witness overall. He took time to think about the answers to questions put to him and gave careful and considered responses. He seemed to gain confidence during questioning and gave increasing detail in his responses as the questioning progressed.

23. The Tribunal had been told that Dr Aziz is a person of good character. It reminded itself that good character is not a defence to the Allegation. However, it decided that this was

a factor to which it could attach some weight when assessing Dr Aziz’s evidence, both in relation to his credibility as a witness, and in relation to his propensity to commit the matters alleged.

24. The Tribunal will address the credibility and reliability of the remaining witnesses during its consideration of their evidence in relation to each of the denied matters.

25. The Tribunal has determined the facts as follows:

Paragraph One In or around June 2018, whilst studying at University College of London Medical School, you submitted an elective placement report (‘the Report’), stating that you had completed the mandatory six week elective clinical placement (’the Placement’)

at Kilimanjaro Christian Medical Centre (‘KCMC’) between 23 April 2018 and 15 June 2018. Admitted and found proved

Paragraph Two You knew that the Report contained information that was untrue, in that you had:

a. not attended at KCMC for a period of six weeks; Found not proved

26. Dr B’s evidence was that students were allocated an 8-week block of time and that

during that block, they were required to attend their placement for 6 weeks.



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27. Dr Aziz’s evidence was that he first attended KCMC on 25 April 2018 and that he left on 26 May 2018. The Tribunal accepted Dr Aziz’s evidence in relation to these dates. His flight

booking showed that he was due to arrive in Kilimanjaro in the early hours of 25 April 2018, and his evidence that he left on 26 May 2018 was not contradicted. As a matter of fact, these dates did not amount to 6 weeks. The Tribunal therefore found that Dr Aziz had not attended

KCMC for a period of 6 weeks, and that the dates on the report were untrue. 28. The Tribunal then considered whether Dr Aziz knew that the report contained information which was untrue in this respect. In reaching its decision on this issue, it carefully

considered the evidence before it about Dr Aziz’s experience at KCMC and the circumstances in which the placement report was completed.

29. Dr Aziz told the Tribunal that his placement at KCMC had not been well organised. He explained that this was the first time he had been away from home/abroad for a long period, and that his accommodation had been unsanitary and insect ridden. His evidence about this

was supported in the WhatsApp messages that he sent to his mother during the placement and the photographs he took at the time. Dr Aziz explained to the Tribunal that, at one point, a member of staff had moved his belongings into a different room without his permission. Dr

Aziz drafted an email (which the Tribunal has seen) intending to raise his concerns with UCL; however he decided not to send this at the time because he didn’t wish to cause any difficulties.

30. Dr Aziz also explained that the placement was not like a clinical placement in the UK. He said it was more of an ‘observership’ and that he had done no clinical work which required any supervision. In this respect, the Tribunal noted the wording of the (untitled and

undated) placement information letter which made it clear that placement students were prohibited by law from providing direct patient care. It stated:

‘…Doctors/ students who are not registered with the Medical Council of Tanganyika are prohibited by law from providing direct patient care’.

31. Dr Aziz’s evidence was that he was anxious to leave KCMC. He also formed the view, having not done any work which required supervision, that the placement report was not important, but was more of a record to confirm that he had attended the placement. He said

he was unable to find a doctor to complete the report and asked Ms A to do so because she was someone who could confirm his attendance. Having filled in his name and the dates at the top of the report, he then gave it to Ms A to complete the rest. Dr Aziz said that he did not tell her what to write on the report and did not look to see what she was writing when

she completed it. Once she had finished, Dr Aziz says he took a photograph of the report with his phone, threw away the original, and later emailed the report to UCL as an attachment without looking at it.

32. Ms A gave evidence to the Tribunal about the completion of the report. She said she had written the dates on the bottom of the report and had copied these from the dates she

had seen at the top. She had also completed the ‘comments of the supervising member of



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staff’ section and had graded Dr Aziz with a ‘B’. She was unable to recall other details about the completion of the report but told the Tribunal that at no time had Dr Aziz told her what

to write on the report. The Tribunal found Ms A’s evidence to be credible, consistent, and reliable, and it fully corroborated Dr Aziz’s evidence about the completion of the report.

33. In the light of the evidence before it, the Tribunal accepted Dr Aziz’s evidence that he was anxious to leave and did not think that the report was an important document. Given the prevailing circumstances, it found Dr Aziz’s belief that the report was not an important document to be his genuinely held belief at the time, and one which it was reasonable for

him to have held. It accepted that Dr Aziz did not complete the majority of the report, did not look at it carefully during its completion or afterwards, and did not know it contained untrue information about the dates of the placement.

34. The Tribunal therefore found paragraph 2(a) of the Allegation not proved.

b. left the Placement early without seeking confirmation that this was approved; Found not proved

35. Dr Aziz accepts that he left the placement earlier than agreed in advance. The Tribunal had regard to Dr Aziz’s pre-elective approval form, where the dates of his placement

are given by him as ‘23/04/2018’ to ‘01/06/2018’. On Dr Aziz’s own evidence, he lef t the placement on 26 May 2018. In the light of this, the Tribunal was satisfied that Dr Aziz left the placement earlier than planned.

36. Dr Aziz’s evidence is that he did, however, seek approval to leave the placement early. In his witness statement Dr Aziz stated:

‘To leave KCMC I had to check out and get my deposit back. Even though I had completed the timetable given to me by the paediatric department I went to the

elective office and asked if I could leave on the Saturday 26 May 2018. The Elective Administrator, Ms F [Ms F, Elective Administrator at KCMC], said that it was OK and that I would have to return on Friday to complete the check out. I completed my

check out on Friday 25 May 2018 as Ms F did not work on Saturdays. I received my cash deposit back from Ms F and was given verbal instructions with regards to leaving the following day. She was fully aware of my departure and when it was.’

The Tribunal found Dr Aziz’s evidence on this issue to be credible. Further, the GMC has not adduced any evidence to contradict his account. It was open to the GMC to call Ms F as

witness, however, they did not do so. The Allegation also did not specify from whom Dr Aziz should have sought approval. Having accepted Dr Aziz’s evidence, the Tribunal decided that although he left the placement early, he did seek confirmation that to do so was approved.

The Tribunal therefore found paragraph 2(b) of the Allegation not proved.

c. not completed the Placement. Found not proved



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37. Dr C’s evidence was that he had only seen Dr Aziz on two occasions during his placement. He said he had asked another student if they knew where Dr Aziz was, and was

told that he had gone ‘on safari’. The Tribunal had no reason to doubt Dr C’s assertion that he had only seen Dr Aziz on two occasions. However, as a matter of common sense, the fact that Dr C had only seen Dr Aziz on two occasions did not mean that he (Dr Aziz) had not been

present at other times. Dr C also confirmed that no register had been taken of student attendance. 38. In contrast with the evidence of Dr C, Dr Aziz told the Tribunal that he had attended

KCMC regularly and denied that he had left to go on safari. Dr Aziz said that he had been ill for two days during the placement, but apart from this illness, had attended ward rounds and some morning reports. He also said that he attended the hospital on some weekends and

bank holidays, because there were fewer students at the ward rounds and this was a better learning experience than weekdays. The Tribunal received evidence confirming that there had been two bank holidays during Dr Aziz’s time at KCMC (26 April 2018 and 1 May 2018).

39. Dr Aziz calculated that he probably attended KCMC on 25 days. He reached this conclusion having assessed the content of the WhatsApp messages sent to his mother. The

Tribunal has seen these messages and accepted that Dr Aziz corresponded daily with his mother throughout his time at KCMC, sometimes multiple times per day. His messages mostly reported his concerns about accommodation, food, and made some references to his

attendance at KCMC. In addition, there was evidence from other independent sources which corroborated Dr Aziz’s evidence about his attendance at KCMC. This was as follows:

• Ms A and Ms D both confirmed that they had seen Dr Aziz regularly at KCMC during

ward rounds, morning reports, weekends, and bank holidays. Ms A stated in her evidence that Dr Aziz attended more than the other medical students. The Tribunal found both of these nurses to be credible, consistent, and reliable witnesses. They had no prior knowledge of Dr Aziz, yet both were willing to provide witness

statements and give evidence in these proceedings. Ms A, in particular, had interrupted her holiday in Columbia to give evidence in support of Dr Aziz.

• Dr E made a witness statement in which she also confirmed that Dr Aziz had been a regular attender at KCMC. The Tribunal reminded itself that her evidence was hearsay, had not been given under oath, and had not been tested in cross-examination. However, there was no information before the Tribunal to suggest that

Dr E might be an unreliable witness. It was also apparent from email correspondence between Dr E and Dr Aziz’s solicitor, that although Dr E had decided not to give evidence, she was nevertheless ‘comfortable’ with her witness statement. The

Tribunal therefore concluded that it could attach some weight to her written evidence.

• The Tribunal had also been provided with WhatsApp messages between Dr Aziz and two other doctors who were present at KCMC. One of these doctors (Dr SG) said in the messages that, as far as he could remember, Dr Aziz used to attend ward rounds



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and that he, ‘attended so many times’. The other doctor (Dr AH) said that she and Dr Aziz, ‘passed ward rounds together in room 3’. She also said that she remembered Dr

Aziz participating actively in discussions. The Tribunal was mindful that it had not heard from these witnesses and that their evidence had not been presented in the form of signed witness statements. However, the WhatsApp messages were entirely

contemporaneous and the Tribunal had heard no evidence which would give rise to doubts about the reliability of these doctors. It therefore attached some weight to the content of these messages.

40. In the light of the above, the Tribunal accepted Dr Aziz’s evidence that he had

attended the placement for around 25 days. The evidence that he had been on safari was hearsay and uncorroborated. It seemed likely to the Tribunal that, if Dr Aziz had left KCMC to go on safari, he would have shared this information in the regular WhatsApp correspondence

with his mother. 41. In deciding whether Dr Aziz ‘completed’ his elective p lacement, the Tribunal also

considered Dr B’s evidence. He told the Tribunal that the expectation was that students would attend their placement on weekdays for 6 weeks. He said that illness would be allowed for unless it reached a substantial proportion of the placement, and that students are more

likely to become unwell whilst overseas. Dr B confirmed that the attendance requirement at UCL is a minimum of 80%. He also accepted, when questioned by Mr Haycroft, that:

• 6 weeks of weekdays amounts to 30 days, and that;

• 80% of 30 days would amount to 24 days.

42. The Tribunal also took into account that the rota Dr C gave Dr Aziz covered a four week period from 27 April 2018 to 23 May 2018. Further, the Application Information from

KCMC sent to Dr Aziz in advance set out:

‘We accept medical students….to come for their attachments for not more than 3

months and also not less than 4 weeks.’

This suggests that a 4 week placement was an acceptable period from KCMC’s perspective.

43. Having taken account of the matters set out above, the Tribunal was satisfied that, although Dr Aziz left KCMC earlier than the original planned date, he had nevertheless completed his placement. It therefore found paragraph 2(c) of the Allegation not proved.

Paragraph Three You asked Ms A to complete and sign the ‘Elective Supervisor’ and ‘Supervising Member of Staff’ section of the Report. Admitted and found proved

Paragraph Four You knew that Ms A was not:



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a. your elective supervisor and/or supervising member of staff; Admitted and found proved

b. authorised to sign the Report. Found not proved

44. Dr C’s evidence was that Dr Aziz was required to return to him at the end of the placement to have the report signed off. He wrote in his witness statement of 7 December

2018 that:

‘On 2 May 2018, I first met Dr Aziz during an introductory session. During the introductory session, I would normally welcome the elective students and provide

them with a summary of what happens in the paediatric department…’ In oral evidence, Dr C confirmed that he would typically have explained during such a session

that the report forms would need to be handed to (and signed by) him. The Tribunal noted, however, that Dr C’s evidence on this point was based on his usual practice, as opposed to his particular recollection of his interaction with Dr Aziz. Given this, the Tribunal could not be

satisfied from Dr C’s evidence that he definitely identified himself as Dr Aziz’s supervisor during this meeting, nor that he definitely told Dr Aziz that the report form was to be completed by him.

45. The Tribunal paid careful attention to the documentation surrounding Dr Aziz’s placement. It was apparent that, at no place within any of this documentation, was the name

of Dr Aziz’s supervisor confirmed. Further, it was evident from the placement documentation, that Dr Aziz’s elective was approved by UCL without him having a named supervisor in place. 46. Dr Aziz’s evidence was that, as his placement had been approved without a

supervisor, he therefore (wrongly) assumed that a supervisor was not vital. He explained that he was never to his knowledge appointed a supervisor during his time at KCMC and said that – in any event – the non-clinical work he was undertaking did not require any level of

supervision. 47. Dr Aziz explained, when questioned, that he wanted the report form to be signed by

someone with whom he had worked regularly, and thought it was most important that it was signed by someone who could verify his attendance. He stated that if the placement had involved any teaching he would have asked a local staff member of staff to sign it. He said in

his witness statement that he was aware of a previous British medical student who had their form signed by an overseas visitor, stating:

‘…I was also aware that the British medical student who attended their elective at

KCMC in the paediatric department prior to me named [XXX] had gotten a Dutch visitor to sign her elective form. I therefore wrongly assumed this was normal practice.’



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48. In cross-examination Dr Aziz told the Tribunal that he knew Ms A was not the most appropriate person to sign the report form, but added that he thought it was acceptable to

get somebody who was in the same department at the time to sign it. He confirmed that he did not regard himself as having a supervisor given that no supervisor had been formally assigned, adding that Dr C had not identified himself as his supervisor during their meeting

on 2 May 2018. 49. The Tribunal decided, having considered the evidence as a whole, that it accepted Dr Aziz’s evidence that no named supervisor had been allocated to him. The Tribunal was also

satisfied from Dr Aziz’s evidence that he believed, in the circumstances set out above, that Ms A was a suitable and appropriate person to sign the report form. Given the documentation which confirmed that no named supervisor had been allocated; Dr Aziz’s

awareness of a previous British student who had had their report form signed in a similar way; and his belief that the placement was more of an ‘observership’, the Tribunal was also satisfied that this belief was both reasonable and genuinely held in all the circumstances.

50. The Tribunal heard lengthy evidence and submissions about a letter dated 27 April 2018 addressed to ‘The Head, Department of Paediatric KCMC – Moshi’ entitled: ‘RE:

PLACEMENT OF ELECTIVE STUDENT Mr. Hassan Azizi [sic]’. 51. Dr C’s evidence is that Dr Aziz gave him this letter by hand on 2 May 2018. Dr Aziz

disputed this, saying that he had never seen this particular document until it was disclosed as part of these proceedings. Dr Aziz confirmed that he met with Dr C on 2 May 2018 and gave him a document, but stated that this was a different document concerning his placement. The Tribunal decided that it was not necessary to resolve this dispute because, in any event,

this particular document did not specifically name Dr C as Dr Aziz’s supervisor, nor did it mention that Dr Aziz will be under the supervision of any particular named person. In the Tribunal’s view, this letter served only to corroborate Dr Aziz’s evidence that he was never

allocated a named supervisor. 52. Bearing all of the above in mind, the Tribunal found this paragraph of the Allegation

not proved.

Paragraph Five Your action, as referenced at paragraph:

a. 1 was dishonest by reason of paragraph 2; Found not proved

53. Given the Tribunal found Paragraph 2 of the Allegation not proved in its entirety, this paragraph of the Allegation falls.

b. 3 was dishonest by reason of paragraph 4. Found not proved

54. Dr Aziz has admitted that he knew Ms A was not his elective supervisor and/or a

supervising member of staff. The Tribunal therefore asked itself whether, in accordance with



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the test set out in Ivey, his actions in asking her to complete and sign the report form were dishonest by the standards of ordinary decent people. In reaching this decision, the Tribunal

was required to take into account its findings about the actual state of Dr Aziz’s knowledge or belief as to the facts.

55. The Tribunal has already set out that it was satisfied that Dr Aziz’s genuinely held belief was that the form was not an important part of his placement, and that he thought its purpose was merely to confirm attendance, given that he had undertaken no supervised work. In his witness statement he set out that:

‘… At the time I did not treat the form as a formal or important document beyond confirming I had been on the placement…’

Further, Dr Aziz said in his witness statement, and the Tribunal accepted, that:

‘…when I arrived on the ward there were no available doctors that I had worked with regularly before. As such, I thought the most important thing was to have someone sign the form who was able to verify that I had in fact attended the elective.’

56. Dr Aziz’s evidence was that he did not intend to mislead UCL when he asked Ms A to sign the placement report. In the light of the factors set out in paragraph 55 above, the

Tribunal accepted that he did not intend to mislead UCL. 57. Bearing the above in mind, the Tribunal determined that an ordinary and decent person would not consider Dr Aziz’s actions, in asking Ms A to complete and sign the form,

despite knowing that she was not his elective supervisor, to be dishonest. He had been unable to find a doctor who could attest to his attendance and had done his best to find someone to sign the form who genuinely knew about his presence at the placement. Ms A

had signed her own name on the form and there was no evidence that Dr Aziz had told her to do otherwise.

58. The Tribunal was aware of the requirement for cogent evidence to support a finding of dishonesty, and it was not satisfied that there was such evidence. It therefore foun d this paragraph of the Allegation not proved.

Paragraph Six On or around 1 August 2018, during a conversation with Dr B, when questioned about

the information in the Report, you said that Ms A was a ‘visiting overseas doctor’ and/or ‘had been in the faculty whilst you had undertaken your placement’, or words to that effect. Found not proved

59. The Tribunal first considered whether, on the evidence before it, it was more likely than not that Dr Aziz told Dr B that Ms A was a ‘visiting overseas doctor’, or words to that effect.



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60. In Dr B’s witness statement, he said that Dr Aziz told him, during their conversation on 1 August 2018, that Ms A was a ‘visiting overseas doctor who had now left the institution’. Dr

B repeated this in his telephone note which he accepted making some 24 hours after the telephone conversation in question. Dr B also accepted that the exchange had been heated, difficult, and lengthy and that, at times, he had to shout to make himself heard. In the

Tribunal’s view, this was likely to have impacted upon the accuracy of his recollection of what was said. During cross-examination, Dr B fairly conceded that Dr Aziz might not have used the word ‘doctor’.

61. Dr Aziz’s own evidence is that he described Ms A as a ‘visiting healthcare professional’, or words to that effect. The Tribunal noted that Dr Aziz does not refer to Ms A as a doctor in any of his correspondence with Dr B, Dr C, or with the GMC, referring to her

alternatively as a ‘nurse’ or an ‘overseas healthcare professional’. The Tribunal determined that this, to some extent, corroborated his evidence that he did not refer to her as a doctor on 1 August 2018.

62. Having considered the evidence as set out above, the Tribunal was not satisfied, on the balance of probabilities, that Dr Aziz described Ms B as a ‘visiting overseas doctor’.

Accordingly, it found this aspect of the Allegation not proved. 63. The Tribunal next considered whether Dr Aziz described Ms A as someone who ‘had

been in the faculty’ whilst he had undertaken his placement. It carefully considered Dr B’s statement and the content of his telephone note, but could find no reference from Dr B to Dr Aziz having described Ms A in this way, or having used words to that effect during their conversation on 1 August 2018. The Tribunal therefore found this aspect of the Allegation

also not proved.

Paragraph Seven You knew that the information you gave Dr B on 1 August 2018 was untrue. Found not proved

64. Given the Tribunal’s findings set out above, this paragraph of the Allegation falls.

Paragraph Eight Your action, as referenced at paragraph 6 was dishonest by reason of paragraph 7. Found not proved

65. Given the Tribunal has found paragraph 6 of the Allegation not proved, this paragraph

of the Allegation falls. Determination on Impairment - 25/08/2020

1. The Tribunal now has to decide in accordance with Rule 17(2)(l) of the Rules whether, on the basis of the facts found proved, Dr Aziz’s fitness to practise is impaired by reason of misconduct.



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The Evidence

2. The Tribunal has taken into account all the evidence received during the facts stage of the hearing, both oral and documentary. In addition, Dr Aziz provided oral evidence at Stage 2. The

Tribunal also received a Stage 2 Defence Bundle. This included:

• A reflective statement, dated 14 August 2020;

• List of jobs Dr Aziz has applied for whilst suspended;

• Testimonial letters and emails;

• Continuous Professional Development (‘CPD’) certificates. Summary of submissions on behalf of the GMC

3. Ms Dudley-Jones referred the Tribunal to the relevant legal principles to consider when determining misconduct and impairment. She also referred the Tribunal to ‘Achieving good medical practice: guidance for medical students (1 September 2016) (‘AGMP’) and to Good Medical Practice (2013) (‘GMP’).

4. Ms Dudley-Jones submitted that Dr Aziz’s actions were serious and that he was reckless in allowing someone who was not his medical supervisor to sign the Report. She also

submitted that whilst the Tribunal did not find that Dr Aziz intended to mislead UCL, his conduct did mislead UCL.

5. Ms Dudley-Jones submitted that this was an act of serious misconduct and that a finding of impairment was necessary to uphold public confidence in the profession.

Summary of submissions on behalf of Dr Aziz 6. Mr Haycroft provided the Tribunal with written submissions in which he referred the

Tribunal to the relevant legal principles to consider when determining misconduct and impairment. He submitted that the only facts to be considered are those found proven, namely all those admitted which were paragraphs 1, 3 and 4 of the Allegation. These stated:

1. In or around June 2018, whilst studying at University College of London Medical School, you submitted an elective placement report (‘the Report’) stating that you had completed the mandatory 6 week elective placement (‘the Placement’) at Kilimanjaro

Christian Medical Centre (‘KCMC’) between 23 April 2018 to 15 June 2018. 3. You asked Ms A to complete and sign the ‘Elective Supervisor’ and 'Supervising

Member of Staff’ section of the Form. 4. You knew that Ms A was not:

a. your elective supervisor and/or supervising member of staff;



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7. Mr Haycroft submitted that paragraphs 1 and 3 were statements of fact only which did not

connote any wrongdoing. He submitted that paragraph 4 is a statement of Dr Aziz’s state of mind about the placement, but that in all the circumstances this does not amount to misconduct.

8. Mr Haycroft submitted that even if the Tribunal found misconduct, Dr Aziz’s fitness to practise was not impaired given that this was an isolated incident which has now been remedied through reflection and training and is highly unlikely to be repeated.

The Relevant Legal Principles 9. The Tribunal reminded itself that at this stage of the proceedings, there is no burden or

standard of proof and the decision on impairment is a matter for the Tribunal’s judgement alone. 10. The Tribunal must consider whether or not the facts admitted and found proved amount to

misconduct and whether any misconduct was serious. If so, it should consider whether Dr Aziz’s fitness to practise is impaired by reason of that serious misconduct.

11. The Tribunal must determine whether Dr Aziz’s fitness to practise is impaired today, taking into account Dr Aziz’s conduct at the time of the events and any relevant factors since then, such as whether the matters are remediable, have been remedied and any likelihood of repetition.

12. When considering impairment the Tribunal must have particular regard to the statutory overarching objective which is,

a. To protect, promote and maintain the health, safety and wellbeing of the public;

b. To promote and maintain public confidence in the medical profession; and

c. To promote and maintain proper professional standards and conduct for

members of the profession. The Tribunal’s Determination on Impairment

Misconduct 13. The Tribunal first considered whether the facts found proved amounted to

misconduct which was serious. In so doing, it considered whether Dr Aziz had breached any of the relevant standards.

14. The Tribunal noted that in his reflective statement, Dr Aziz had made reference to having breached GMP. Ms Dudley-Jones also invited the Tribunal to find that Dr Aziz had breached GMP. The Tribunal were mindful that Dr Aziz’s placement was part of his

undergraduate training to become a doctor and that he had not yet qualified at the time of



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the events being considered by this Tribunal. It concluded that the standards set out in GMP did not therefore apply to him. It had regard to the standards set out in AGMP, which were

the standards applicable to Dr Aziz as a medical student at the time. It had particular regard to the following paragraphs, which state:

“Being professional on placements – practical steps

• Make sure you know who is responsible for directly supervising you on your placement and who has the overall responsibility for medical students where you

are working. This will help you understand where to go if you need help and if you have any concerns you need to raise.”

“Record your work clearly, accurately and legibly

15 You should make sure all the documentation you submit to your medical school is written in a professional way. This includes the findings of activities,

such as audit or research you carry out as part of your studies.”

15. In exercising its judgment on the issue of misconduct, the Tribunal considered Dr

Aziz’s actions in the context in which they occurred. The Tribunal had found Dr Aziz to be a credible witness. It had accepted his evidence that the elective placement had involved no clinical work. He did not have a named supervisor and had been unable to find another local

Doctor to sign the placement form. Consequently, he asked Ms A to sign it because he knew she could attest to his attendance during the placement. He was aware of another British student whose placement had been signed off in a similar way and thought Ms A would be a

suitable person to complete and sign the Report even though she was not his supervisor. Having undertaken no clinical work during the placement, Dr Aziz formed the view that the placement Report was not an important document, a view which the Tribunal had found was both reasonable and genuinely held in the circumstances.

16. However, Dr Aziz should have ensured that the Report did not contain information which he knew was inaccurate. As a matter of common sense, UCL would inevitably rely on

the content of the Report even though it had not been his intention to mislead them. 17. In the Tribunal’s judgment, Dr Aziz’s actions were foolish and naïve. He believed that

the placement Report was not an important document, but this did not relieve him of his responsibility to exercise proper care when completing it and sending it to UCL. It should have been obvious to Dr Aziz that any document required by his academic institution

necessitated careful and accurate completion. His decisions to name Ms A as his supervisor on his placement Report, and to send that Report to UCL were poor decisions to which he gave little thought. These decisions were based on his erroneous belief that the Report was

not an important document because he had not been allocated a supervisor, and had undertaken no clinical work.



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18. The Tribunal found that Dr Aziz’s actions fell below the standards expected of him as a medical student in paragraph 15 AGMP. However, the Tribunal decided that his conduct was

careless and negligent but did not constitute a serious or significant departure from the expected standards. It was not satisfied that fellow practitioners would regard his conduct as “deplorable” in the circumstances which prevailed at that time.

19. The Tribunal had regard to the case of R (on the application of Calhaem) v General Medical Council 2007 EWHC 2606 (Admin), (“Calhaem”), in which Jackson J stated,

“(1) Mere negligence does not constitute "misconduct" within the meaning of section 35C(2)(a) of the Medical Act 1983. Nevertheless, and depending upon the circumstances, negligent acts or omissions which are particularly serious may amount

to "misconduct". (2) A single negligent act or omission is less likely to cross the threshold of

"misconduct" than multiple acts or omissions. Nevertheless, and depending upon the circumstances, a single negligent act or omission, if particularly grave, could be characterised as "misconduct".

20. Having decided that Dr Aziz’s conduct was negligent but not a serious departure from the standards expected of him, the Tribunal concluded that the facts found proved did not

amount to misconduct, in accordance with the principles set out by Jackson J in the case of Calhaem. 21. In the light of this finding, the Tribunal concluded that Dr Aziz’s fitness to practise is

not impaired by reason of his misconduct. Determination on Warning - 25/08/2020

1. Having determined that Dr Aziz’s fitness to practise is not impaired, the Tribunal considered whether, in accordance with s35D(3) of the 1983 Act, a warning should be issued.

Submissions

2. Ms Dudley-Jones made no application for a warning. 3. Mr Haycroft made no submission on whether a warning should be issued.

The Relevant Legal Principles 4. When considering whether to issue a warning, the Tribunal must again have particular

regard to the statutory overarching objective: d. To protect, promote and maintain the health, safety and wellbeing of the public;



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e. To promote and maintain public confidence in the medical profession; and

f. To promote and maintain proper professional standards and conduct for members of the profession.

5. The Tribunal must apply the principle of proportionality; balancing the doctor’s interests with the public interest. 6. The decision of whether to issue a warning is a matter for the Tribunal’s judgment

alone. Written reasons must be given for the Tribunal’s decision. The Tribunal’s Determination on Warning

7. The Tribunal bore in mind the circumstances of this case. It had regard to the statutory overarching objective, as well as to the principle of proportionality, weighing the interests of the

public with Dr Aziz’s interests. 8. The Tribunal had regard to the relevant paragraphs of the Guidance on Warnings (February

2018) (‘GoW’). It had particular reference to paragraphs 13, 14 and 16, which state:

“13 Although warnings do not restrict a doctor’s practice, they should nonetheless

be viewed as a serious response, appropriate for those concerns that fall just below the threshold for a finding of impaired fitness to practise. 14 Warnings should be viewed as a deterrent. They are intended to remind the

doctor that their conduct or behaviour fell significantly below the standard expected and that a repetition is likely to result in a finding of impaired fitness to practise. Warnings may also have the effect of highlighting to the wider profession that certain

conduct or behaviour is unacceptable. …

16 A warning will be appropriate if there is evidence to suggest that the practitioner’s behaviour or performance has fallen below the standard expected to a

degree warranting a formal response by the GMC or by a MPTS tribunal. A warning will therefore be appropriate in the following circumstances:

• there has been a significant departure from Good medical practice…”

9. The Tribunal found that there had not been a significant departure from AGMP and it did not make a finding of misconduct. In these circumstances it decided that it would not be

appropriate to issue a warning. To do so would be contrary to the GoW.



MPT : Dr AZIZ

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Confirmed Date 25 August 2020 Mrs Fiona Barnett, Chair



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ANNEX A – 24/08/2020

Application to hear evidence by telephone link

96. Mr Haycroft made an application to hear the evidence of Ms A and Ms Dby telephone

link, in accordance with Rules 34(13) and 34(14) of the General Medical Council (Fitness to Practise) Rules 2004, as amended, (‘The Rules’). These paragraphs state:

‘(13) A party may, at any time during a hearing, make an application to the Committee or Tribunal for the oral evidence of a witness to be given by means of a video link or a telephone link.

(14) When considering whether to grant an application by a party under paragraph (13), the Committee or Tribunal must—

(a) give the other party an opportunity to make representations;

(b) have regard to— (i) any agreement between the parties, or (ii) in the case of a Tribunal hearing, any relevant direction given by a Case Manager; and

(c) only grant the application if the Committee or Tribunal consider that it is in the interests of justice to do so.’

Submissions on behalf of Dr Aziz

97. Mr Haycroft submitted that on 18 October 2019 an application was made to the MPTS Case Manager for these witnesses to give their evidence by telephone as they live in Sweden and would not be able to travel to the UK to give evidence. In addition, they did not

have access to video conference facilities in a private room at their place of work. On the same day the GMC indicated that it did not oppose the application and the MPTS Case Manager granted the application.

98. This hearing adjourned part heard in October 2019. Ms A is now on holiday in Colombia and Ms D is at work in Sweden. They have both agreed to give evidence by telephone but at the GMC’s request have been asked to try and engage Skype for Business.

They have however been unable to download the application successfully. Mr Haycroft submitted that it would be in the interests of justice for the application to be granted bearing in mind the circumstances of this case and the previous MPTS Case Manager’s decision.

99. Ms Dudley-Jones on behalf of the GMC did not oppose the application but submitted that it would have been desirable to hear the witnesses via Skype for Business.



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100. In making its decision the Tribunal had regard to paragraph 34(13) and 34(14) of the Rules. It took into consideration that both witnesses are currently abroad without access to

video link facilities. It noted that the application has not been opposed by the GMC and that in October 2019 the MPTS Case Manager had granted an application for both witnesses to give telephone evidence. The Tribunal therefore concluded that it would be in the interests

of justice to allow both witnesses to give their evidence via telephone link, and it granted the application. ANNEX B – 24/08/2020

Application to admit hearsay evidence

101. Mr Haycroft made an application to adduce Dr E’s witness statement and associated exhibits as hearsay evidence, pursuant to Rule 34(1) of the General Medical Council (Fitness

to Practise) Rules 2004, as amended. Rule 34 (1) states that:

‘… a Tribunal may admit any evidence they consider fair and relevant to the case

before them, whether or not such evidence would be admissible in a court of law.’ Submissions on behalf of Dr Aziz

102. Mr Haycroft reminded the Tribunal that Dr E was due to give evidence at Dr Aziz’s hearing in October 2019 by telephone, but that the hearing was adjourned part heard. He told the Tribunal that Dr E is no longer willing to provide oral evidence although she stands by

what she has said in her witness statement. He referred the Tribunal to the correspondence between Dr E and Dr Aziz’s solicitor.

103. Mr Haycroft provided written submissions to the Tribunal. He submitted that Dr E’s evidence is relevant as it goes to the issue of Dr Aziz’s attendance at KCMC and that it is fair to admit her statement as hearsay, given:

- It is already in the bundle and the MPT have read it;

- The defence have no control over the witness;

- The witness cannot be summonsed;

- She would have given evidence in October by telephone/video but for the delays caused by no fault of Dr Aziz and indeed the delays seem to be part of the reason she is now unwilling to attend;

- It is agreed now she was present at KCMC for part of the time Dr Aziz was there and neither KCMC nor the GMC have sought to make any enquires of her.

104. Mr Haycroft submitted that if this type of application were to be refused, then few

hearsay applications would be granted. In these circumstances, Mr Haycroft invited the Tribunal to receive Dr E’s witness statement as hearsay. He also set out in his written



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submissions factors which the Tribunal should consider in deciding what weight to attribute to hearsay evidence.

Submissions on behalf of the GMC

105. Ms Dudley-Jones opposed Mr Haycroft’s application. She agreed that the witness statement of Dr E is relevant as it attests to his attendance at KCMC from approximately 25 April to 14 May 2018.

106. However, she submitted that it would not be fair for it to be admitted as hearsay evidence. She submitted that there are two other witnesses who are due to give evidence this afternoon, Ms A and Ms S, who can give evidence attesting to Dr Aziz’s attendance over

this period of time. Ms Dudley-Jones submitted that it would be unfair to admit the evidence for a number of reasons:

- At the time that the statement was added to the agreed bundle it was understood that Dr E was going to attend the hearing and that she would be cross examined;

- Ms Dudley-Jones said she had not objected to a particular line of questioning during the cross examination of Dr C on the understanding that Mr Haycroft would deal with this issue during the evidence of Dr E;

- Dr E’s email dated 4 January 2020 confirmed that she is unwilling to give evidence and attest to the truth of her witness statement. She had given no reason for this;

- The GMC cannot now cross examine Dr E as to the truth of her witness statement and cannot test her evidence.

107. Ms Dudley-Jones said that if the Tribunal was minded not to accept the witness statement, then she would ask that it takes the witness statement, exhibits and related documents from the bundle and put them out of its mind. She said that the test for the

admissibility of this evidence is not met in this case, and it would be unfair for the Tribunal to admit it.

Further submissions on behalf of Dr Aziz 108. In response to Ms Dudley-Jones’s submissions, Mr Haycroft responded that Dr E’s evidence was crucial, that she was going to be called in October 2019 but that the

opportunity to call her then was lost. He submitted that it was wholly wrong to say that Dr E was unwilling to confirm the truth of her witness statement and that she had not retracted her statement. Mr Haycroft said that there is a fair inference that can be drawn from Dr E’s

email that she confirms her statement. He said it should be admitted, with the Tribunal later deciding what weight to attribute to it. He submitted that it is also clear from the communications received from Dr E that she bears no ill will to Dr Aziz. He submitted that it is

fair to admit ‘this part of the jigsaw puzzle’, that this Tribunal have a duty of enquiry and it would be fair to admit this evidence without hearing from Dr E.



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Legal Advice

109. In reaching its decision the Tribunal had regard to the advice of the Legally Qualified Chair. She referred it to Rule 34(1) and advised that this provides no further guidance as to when it may be ‘fair’ to admit evidence and how the Tribunal should make this assessment.

She advised that the relevance of the evidence is not in issue. The issue is one of fairness and in assessing this, the Tribunal should consider not only whether there is prejudice to Dr Aziz if Dr E’s evidence is not admitted, but also whether there is prejudice to the GMC if it is.

110. She advised that the reason for Dr E’s non-attendance was a factor to be taken into consideration. However, even if there was no good reason for her non-attendance, this did not necessarily mean that her evidence must be excluded. She advised that other factors

which the Tribunal could consider are: how much probative value the statement has, what other evidence can be given on the matter, how important the evidence is in the context of the case as a whole, how reliable the maker of the statement appears to be, and the difficulty

facing the party challenging it. She advised the Tribunal that it must consider and weigh up the competing arguments to determine whether it is fair and relevant to admit the evidence.

The Tribunal’s Decision 111. The Tribunal first considered whether the evidence was relevant. It noted that it is not

disputed by the parties that this evidence is relevant to the issue of Dr Aziz’s attendance at KCMC during the time in question. The Tribunal was of the view that this will be pertinent to the decisions on facts that the Tribunal will have to make in due course. Accordingly, the Tribunal determined that this evidence is relevant.

112. The Tribunal next considered whether it would be fair to admit this evidence. It was mindful that Dr E is now unwilling to participate in this hearing but it has received no

explanation why this is now the case. It had regard to Dr E’s email dated 4 January 2020 in which she stated:

‘Unfortunately, I am no longer able to provide video evidence in February. I have already provided the statement on the matter in the area in which I am comfortable speaking

I do wish …Dr.Aziz the best with future proceedings.’

113. The Tribunal acknowledged that if it admits Dr E’s evidence, this would cause unfairness to the GMC who would be unable to cross examine her and test the truth of the

statement provided. 114. However, the Tribunal also acknowledged that if the evidence was not admitted, it

would cause unfairness to Dr Aziz for the following reasons:

- Dr E had been prepared to give her evidence in October 2019 and, whilst no reason has been given for her unwillingness to attend this reconvened hearing, it was



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reasonable to infer that the delay may be a part of her change in position. This was no fault of Dr Aziz;

- Having carefully considered her email of 4 January 2020, it was reasonable to infer that she was ‘comfortable’ with the content of her witness statement. There was no suggestion that she wished to retract what she had said which is, on the face of it, supportive of Dr Aziz. Excluding her evidence would lead to a loss of evidence which

could assist his case. 115. After taking the all of the above into consideration, the Tribunal has decided to grant

Mr Haycroft’s application for the witness statement to be admitted into evidence. It considered that the unfairness to Dr Aziz in not admitting the evidence outweighs the unfairness to the GMC of allowing it. The Tribunal can later, when deciding on the facts, decide what weight, in any, it should attach to this evidence.

116. The Tribunal has however decided that the transcript of WhatsApp messages between Dr E and Dr Aziz’s legal representatives between 14 October 2019 and 30 December

2019 should not be admitted into evidence. The messages relate to matters which were not addressed by Dr E in the original witness statement. The information contained in these messages has not been incorporated in a signed witness statement. It noted that Dr Aziz’s

legal representatives had invited Dr E to provide a supplementary witness statement relating to these matters but she declined to attend shortly after that, and there is no confirmation that she would be in agreement for that information to be used in these proceedings. The

Tribunal concluded that it would cause unfairness to the GMC if these messages were admitted into evidence in the circumstances. The Tribunal will remove these documents from the evidence bundle and put out of its mind anything which was stated in these communications.

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