GMC v Sathyanath: High Court quashes tribunal decision in GP intimate examination case

The High Court has allowed an appeal by the General Medical Council against a tribunal's finding that a GP's fitness to practise was not impaired, holding that the tribunal asked the wrong question when assessing whether his conduct during an intimate examination was clinically indicated.

In General Medical Council v Sathyanath [2026] EWHC 2479 (Admin), Mr Justice Morris quashed the June 2025 decision of the Medical Practitioners Tribunal and remitted the case to a differently constituted panel. The GMC appealed under section 40A of the Medical Act 1983.

The tribunal had found that Dr Chitlapalli Sathyanath, during a 2022 consultation, placed his hand inside a patient's underwear and brushed it over her pubic bone region. He admitted failing to offer a chaperone or obtain consent. The tribunal nonetheless found that the conduct was clinically indicated and not sexually motivated. It found serious misconduct but no impairment, and issued a warning.

The appeal proceeds by way of review. Clinical indication and impairment are evaluative judgements, on which the court defers to a specialist tribunal unless there is an error of principle, including an identifiable flaw in reasoning, or a conclusion outside reasonable bounds. Sexual motivation, in the judge's view, is a finding of secondary or inferential fact, despite an observation in GMC v Haris that could be read the other way, so the court is more ready to interfere with it.

On clinical indication, the tribunal had concluded that "the examination" was clinically indicated. Morris J held that allegation 3(a) required it to consider the specific conduct in allegations 1(a) and (b), or at least those elements taken together. It was undisputed that a groin examination was indicated, but that was not the question posed, and the charges were not ambiguous.

The tribunal also omitted key evidence from the GMC's expert, who said that touching the pubic area was inappropriate and that a competent GP would withdraw the hand between examining each side. It overlooked the doctor's own evidence that there was no clinical reason for touching of the kind it found had occurred. The judge substituted a finding that allegation 3(a) was proved in relation to allegations 1(a) and (b).

That error was material to sexual motivation, which the tribunal approached on the footing that the conduct was clinically indicated. Its acceptance that the brushing was inadvertent was a second problem, since the doctor had denied any brushing at all. It also failed to weigh relevant matters, including the nature of the touching, its occurrence before any groin examination, the patient's own view, its absence from the clinical notes and the fact that only the groin was examined. The GMC did not ask the court to find sexual motivation itself, so the issue returns to a fresh tribunal.

The third ground, on impairment, did not arise, but Morris J said he would have rejected it. Although the GMC's criticisms had some force, the tribunal was entitled to weigh positive evidence from colleagues and give a good character direction.

The judge provisionally proposed quashing the decision not to make a direction and the finding of no impairment, and remitting allegation 3(b), misconduct and impairment. He will hear the parties on the precise terms of the order.

Peter Mant KC appeared for the GMC. Nadia Motraghi KC and Tara O'Halloran, instructed by the Medical Protection Society, appeared for Dr Sathyanath.