Public Minutes of the Investigation Committee

Public Minutes of the Investigation Committee Date of hearing: Name of Doctor Mr Vinay Aggarwal Doctor s UID 7303856 Committee Members Mr Pradeep Agarwal (Lay Chair) Professor Jennifer Adgey (Medical) Mr Geoff Baines (Lay) Legal Assessor Panel Secretary Mr Bernard Phillips Mr Declan Leahy Attendance and Representation GMC Representative Doctor s attendance Doctor s representative Mr Nigel Grundy Mr Aggarwal was neither in attendance not was he represented. Outcome Warning

Determination Mr Grundy, Preliminary matters Proof of service 1 Mr Aggarwal was not present at today s hearing, nor was he represented. You, on behalf of the GMC submitted that he had been appropriately served with notice of the hearing in accordance with Rule 11(5) and Rule 40 of the GMC (Fitness to Practise) Rules 2004. 2 The Committee is satisfied that Mr Aggarwal was properly served with notice of today s hearing. Not only was he sent the information in compliance with the rules, but his recent emails showed that he had received the information. Proceeding in the absence of Mr Aggarwal 3 In an email dated 26 October 2017 Mr Aggarwal contacted the GMC to request a postponement to the Investigation Committee hearing. He stated that he had received both the email and the documents you sent by post albeit only recently. He requested that the hearing be postponed for a month so he can have enough time to file [his] response & also secure visa to attend the hearing. This was rejected by a Chair of the Investigation Committee. 4 In an email dated 30 October 2017, Mr Aggarwal renewed his request for the Committee to postpone the hearing, stating that he would like one month to organise a visa in order to attend the hearing, and to give him adequate time to file his response. 5 You, on behalf of the GMC, submitted that the Committee should proceed in Mr Aggarwal s absence. You submitted that he had already provided two detailed written responses to the allegations and that he already had ample time to consider the matter and provide additional responses. You submitted that he had already seen the evidence prior to the notice of hearing, as it had been sent to him on 21 April 2017 and that he has had plenty of time available to him to organise a visa, as he was informed of the hearing on 18 September 2017. 6 The Committee is not convinced that if the matter were adjourned that Mr Aggarwal would attend a future listing in view of the lateness of his application for postponement, and the uncertainty as to whether or not he will obtain a visa in good time. The Committee determined that he has had ample notice of the hearing and

time to arrange travel and visas. The Committee is satisfied that there is no risk of its reaching the wrong conclusion on the merits, as he has already provided detailed written responses to the allegations. The Committee also took into account that it is in the public interest that the hearing should take place within a reasonable time from the events to which it relates. 7 The Committee therefore determined that the hearing shall proceed in Mr Aggarwal s absence in accordance with Rule 31 of the GMC (Fitness to Practise) Rules 2004. Background 8 On 22 September 2016, GMC were contacted by Kettering General Hospital NHS Foundation Trust ( KGH ) and informed them that Mr Aggarwal had been excluded for two weeks on 5 August 2016, pending an investigation. KGH stated that this was done on the basis that [they] were assured that [Mr Aggarwal] would not be undertaking any work in any organisation until this matter was concluded and that his proposed transfer to Leicester Royal Infirmary would be delayed. 9 On 4 October 2016 the GMC were informed by University Hospitals of Leicester NHS Foundation Trust ( UHL ) that Mr Aggarwal had been working at Leicester Royal Infirmary from 10-17 August 2016. UHL stated that they were informed of his suspension from KGH on 11 August 2016 and that they were also informed that he was due to finish at KGH on 7 September 2016. UHL stated that they met him on 17 August 2016 where he confirmed that he had not disclosed the exclusion or investigation by KGH to anyone within UHL. They stated that this constituted a failure to satisfactorily clear employment history checks and resulted in his offer of employment being withdrawn by UHL. 10 UHL provided the GMC with a copy of a letter sent to Mr Aggarwal on 22 August 2016, which had a summary of a meeting he had with them on 17 August 2016. It records that he stated that he had been advised by KGH that they would be informing UHL about the investigation and therefore [he] had not disclosed this yourself. 11 The GMC contacted Mr Aggarwal on the 26 October 2016 to let him know that they had opened an investigation into his fitness to practise. 12 On 11 December 2016 Mr Aggarwal wrote an email to the GMC providing comments on the investigation. In this email he confirmed that he had been excluded from KGH on 5 August 2016 and that he joined UHL on 10 August 2016. He stated that he thought he was excluded, not suspended, but that in a meeting on 17 August 2016 with KGH he was informed that they were the same. He stated that GMC guidelines does not mention anything about exclusion, but only mentions suspension. He stated that he believed that the referral from UHL was intended to cause harm by interfering with his visa and that he does not believe their referral was in good faith. 2

13 The GMC obtained a witness statement from Mrs Debra Davies, the CMG HR Lead at UHL dated 6 March 2017. In this witness statement she confirmed that on 16 June 2016 Mr Aggarwal filled out an declaration form for work at UHL where he truthfully confirmed that there was no prohibition, limitation or restriction on him. However the form also contained a clause which set out that he should have notified UHL of any changes to these answers, which she confirmed that he did not do. 14 The GMC wrote to Mr Aggarwal on 21 April 2017 to inform him that they had completed their investigation into his fitness to practise. They provided him with the evidence they had obtained and invited him to provide his comments. 15 On 28 May 2017 Mr Aggarwal responded to the GMC. He stated that there was no onus on him to inform UHL about exclusion, and that this obligation would only exist if there was an investigation being conducted by a licensing or regulatory body by reference to only one question on the declaration form. He stated that he had started employment at UHL in order to stick to the requirements of his visa, as he had 60 days from certificate of sponsorship (from 7 June 2016) to commence employment, otherwise he would have been in the country illegally. 16 The GMC wrote to Mr Aggarwal on 22 June 2017, to inform him that based on the information available to them, the Case Examiners felt that this was a case that could be concluded with a warning. The GMC invited him to provide a response. 17 On the 3 September Mr Aggarwal emailed the GMC and stated that [he does] not concur with the decision of the case examiners regarding [a] warning & hence [is] NOT inclined to accept any sort of warning. 18 On 18 September 2017 the GMC wrote to inform Mr Aggarwal that he had been referred to the Investigation Committee for an oral hearing. GMC Submissions 19 You explained the facts set out above in detail and went on to submit that it was appropriate to issue a warning in this case. You submitted that it was clear that Mr Aggarwal was excluded on 5 August 2016, and that exclusion should be seen to be the same as suspension. You submitted that a member of the public would expect a doctor who has been suspended to inform their other employers and that there was a duty for Mr Aggarwal to do so in this case. He submitted that it is clear from the evidence, and by Mr Aggarwal s own admission, that he did not do so. He submitted that this was a significant departure from paragraph 76 of Good medical practice (2013). 20 You submitted that in Mr Aggarwal s responses to the GMC, he has not appeared to appreciate the seriousness of his actions or of his obligation under paragraph 76 of Good medical practice (2013). You stated that he has shown no insight, and has adopted an approach of deflection and aggression. You noted that it was an 3

isolated matter but submitted that central to the purpose of a warning is to reduce the risk of repetition and to maintain proper professional standards. Finding of Facts Committee Determination 3 Following the commencement of your employment with the University Hospitals of Leicester NHS Trust Foundation ( UHL ), you failed to inform UHL that you: a had been suspended from KGH for two weeks from 5 August 2017; b were the subject of an investigation being carried out by KGH. Found proved. The Committee determined that it is clear that Mr Aggarwal did not inform anyone at UHL that he had been suspended by KGH on 5 August 2016. The Committee noted that in a meeting on 17 August 2016 between Mr Aggarwal and management at UHL he admitted that he had not informed anyone at UHL of the suspension. The Committee determined that suspension and exclusion can reasonably be considered to be the same thing, as was admitted by Mr Aggarwal in an email to the GMC dated 11 December 2016. 5 Your conduct as described in paragraphs 3 above was: a misleading; Found proved. The Committee determined that Mr Aggarwal s conduct was clearly objectively misleading. It considered that he had misled UHL by not informing them of his suspension, when he had a duty to do so. The obligation to disclose these matters arises from the duties set out in Good medical practice (2013) paragraph 76, regardless of how the questions were phrased in his declaration form to UHL. The Committee noted that the declaration form he submitted to UHL dated 16 June 2016 asked him whether or not he was subject to any prohibition or limitation and required him to inform them if his answers or circumstances changed at any point. He did not so when there was a continuing obligation on him to. b dishonest. Found proved. In determining whether this conduct was dishonest the Committee applied the standards of ordinary, decent people. Applying those standards, the Committee concluded that a number of features rendered Mr Aggarwal s conduct dishonest. The declaration form itself (dated 16 June 2016) stated that any changes to the answers needed to be notified to his employers. It was not his case that he had acted either carelessly or under stress. He sought to draw a distinction between suspension and exclusion, which he accepted was a distinction without a difference. He sought also to justify his failure to notify UHL on the basis that one of the questions on the declaration form referred only to an investigation by a licensing or a regulatory body. There were, however, other questions which required him to disclose the actions taken by his former employer. When he was interviewed by the HR department at UHL in a meeting on 17 August 2016 he did not suggest that his failure to notify them of his suspension was 4

inadvertent or careless, but confirmed that it was deliberate, as he took the view that KGH would notify them, and that it was not for him to do so. However he also admitted that his former employers (KGH) did not know that he was due to start his employment with UHL on 10 August 2016. The Committee therefore considered that his failure to disclose was deliberate and dishonest by objective standards. Consideration of a warning 21 At today s hearing the Investigation Committee carefully considered all the material before it including the submissions made by Mr Aggarwal in writing, and those made by you, on behalf of the GMC. It has accepted the advice of the Legal Assessor. 22 The Committee is aware that it must have in mind the GMC s role of protecting the public, which includes: c Protecting, promoting and maintaining the health, safety and well-being of the public; d Promoting and maintaining public confidence in the medical profession, and; e Promoting and maintaining proper professional standards and conduct for members of that profession. 23 The Committee determined that Mr Aggarwal s conduct constituted a significant departure from Good medical practice (2013), specifically paragraph 76. It considered that his dishonest and misleading actions were serious, in that UHL were not provided with the information they needed to make appropriate employment decisions and that he did not comply with a clear duty upon him to inform UHL of his suspension and the investigation being carried out by KGH. The Committee determined that it would be appropriate to issue Mr Aggarwal with a warning in this case, as his conduct approaches, but falls just short of a realistic prospect of a finding of impaired fitness to practise, and that if this conduct was repeated, it would likely result in a finding of impaired fitness to practise. 24 The Committee noted that this was an isolated incident and that Mr Aggarwal has a previous good history. However it determined that despite this, it would be proportionate to issue him with a warning due to the severity of his actions. It considered that he has not provided any evidence of insight into his behaviour or an apology and it noted that at multiple points in the process he has attempted to deflect responsibility onto others. As such the Committee determined that there is a risk of Mr Aggarwal repeating these actions. 25 The Committee therefore directs that the following warning should be imposed upon Mr Aggarwal s registration: On 5 August 2016 you were excluded by your employing trust following an allegation of misconduct (of which you were later cleared). You started 5

work at another trust on 10 August. You failed to inform the second trust of the investigation or your exclusion. This conduct does not meet with the standards required of a doctor. It risks bringing the profession into disrepute and it must not be repeated. The required standards are set out in Good medical practice (2013) and associated guidance. In this case, paragraphs 65 and 76 of Good medical practice are particularly relevant. 65. You must make sure that your conduct justifies your patients trust in you and the public s trust in the profession. 76. If you are suspended by an organisation from a medical post, or have restrictions placed on your practice, you must, without delay, inform any other organisations you carry out medical work for and any patients you see independently. Whilst this failing in itself is not so serious as to require any restriction on your registration, it is necessary in response to issue this formal warning. This warning will be published on the List of Registered Medical Practitioners (LRMP) for a period of five years and will be disclosed to any person enquiring about your fitness to practise history. After five years, the warning will cease to be published on LRMP however it will be kept on record and disclosed to employers on request. 26 Mr Aggarwal will be informed of this decision in writing in the next two working days. This ends the determination of the Investigation Committee in this case. Signed... Dated Mr Pradeep Agarwal Investigation Committee Chair 6