The Court of Appeal allowed RAS Medical Limited’s appeal after finding that the Royal College of Surgeons in Ireland (RCSI) had handled its application for continuing professional development (CPD) accreditation in a seriously flawed and unfair way. The court did not decide that the course had to be accredited.
RAS Medical, which operates Park West Clinic, had applied for accreditation for a one-day cosmetic surgery course scheduled for 27 July 2013. The programme was to include three live surgeries. Its medical director, Dr Ahmed Salman, submitted the application on 20 June 2013 under RCSI’s published guidelines. A similar event had received approval in 2011.
The RCSI committee initially sought more information, including the name of a specialist plastic surgeon who supported the course. After RAS Medical supplied details of its speakers, the RCSI told it on 9 July that the course could not be accredited because the chief organiser was not on the Medical Council’s Specialist Register in Plastic Surgery. A new version of the guidelines, published on 15 July, added a requirement that the clinical lead or chief organiser be on the Medical Council’s Specialist Division register.
The Court of Appeal considered internal RCSI emails and committee records disclosed during the case. It concluded that the committee had decided to require a specialist sponsor and amend the guidelines in response to RAS Medical’s application. The court rejected the view that “supports the event”, “chief organiser” and “clinical lead” were interchangeable descriptions, finding that the internal exchanges showed the terms had been deliberately changed.
The court said patient safety was a legitimate concern and the committee could have sought assurances about the proposed surgery or the participants’ expertise. But it found that the committee had not followed that course. The decision to refuse had been made before RAS Medical’s response about Dr Jawad’s registration, and the committee did not rely on that response as its reason for refusal. The court therefore did not determine whether the applicant had failed in its duty of full disclosure.
The High Court had refused judicial review, accepting the RCSI’s position that its guidelines allowed the committee to require a specialist and that an internal appeal was available. The Court of Appeal said the disclosed material showed the application was not considered under the existing guidelines and that the internal appeal was of limited value because it went to the same committee and no meeting was scheduled before the course date.
The court held that RCSI was not obliged to approve the course simply because the application complied with the guidelines. It was required to consider it fairly. The appeal was allowed, overturning the High Court’s rejection of the judicial review application. The judgment did not order accreditation or settle whether the course should have been approved on its merits.