The Supreme Court has dismissed a surgeon’s appeal over the Medical Council of Ireland’s refusal to enter him on the specialist register, finding no error in the High Court judgment and rejecting arguments that had not been made there.
The judgment, delivered by Ms Justice O’Malley on 7 March 2016, concerned a judicial review challenge to the Council’s refusal of the appellant’s application for specialist registration in orthopaedic surgery. The appeal did not reopen the merits of the Council’s assessment of his training and experience.
The surgeon first applied in 2003 relying on a Swedish specialist certificate. The Swedish authority later informed the Council that it had decided to remove him from its specialist register, stating that he had misled it about his qualifications. The Supreme Court said the reason for the Swedish authority’s change of position was not entirely clear.
The Council then considered the application on the basis of the surgeon’s Montserrat registration and his training and experience. An Irish surgical training committee advised that his training was not similar or equivalent in duration or quality to structured higher surgical training and recommended two further years of training. The Council refused registration in November 2004. An internal appeal board later recommended refusal at that time, with registration in the United Kingdom or two further years of training in Ireland as possible routes. The Council accepted that recommendation in December 2005.
In the judicial review proceedings, the surgeon argued that his Montserrat certificate entitled him to automatic recognition and challenged the assessment process. The High Court refused relief in January 2009. It held that the relevant EU provisions applied to member states, not Montserrat, and that the Council could assess his qualifications and seek advice from the training committee.
On appeal, the surgeon advanced arguments about the Swedish certificate, the Council’s inquiries into it, the legality of the internal appeal process and delay. The Supreme Court noted that these claims had not been pleaded, supported by evidence, argued in the High Court or included in the grounds of appeal in the required way. It said a judicial review applicant is confined to the grounds permitted by the court and cannot add grounds without leave.
The Court also noted that no argument was made on appeal that the High Court had erred in its ruling on the Montserrat registration. As the surgeon had not challenged the High Court’s primary rulings and no error appeared on the face of its judgment, the Supreme Court dismissed the appeal. The order did not grant registration or determine the merits of the newly advanced claims.