Psychiatrist is suspended for another 12 months after showing no reflection or remediation

A consultant psychiatrist who was suspended two years ago for refusing to examine or admit a mentally ill patient has been given another 12 months’ suspension after he told a panel of the Medical Practitioners Tribunal Service that he had acted correctly and would do the same again.

Sharaf Abd El Monem Salem was suspended for 12 months in December 2011 for multiple breaches of good practice in the case of “Patient A,” who was brought by a community mental health team to Bartholomew House, Goole, East Yorkshire, where Salem was the consultant responsible for managing inpatients. That suspension did not take effect until 2013 pending his unsuccessful appeal to the High Court.

The 2011 hearing found that Salem, who knew Patient A from previous encounters, refused to admit or examine her and refused to listen to the community mental health nurse’s description of the patient’s presentation or the team’s reasons for seeking to admit her. Salem argued that Humber Mental Health Teaching NHS Trust’s gatekeeping policy on admitting mentally ill patients had not been followed, because he had not been informed of the plan to admit Patient A. But the panel found that the community mental health team had met its requirements by attempting to reach Salem at his office.

Salem was also found to have failed to help or advise a first year general practice trainee who took on the case of Patient A, telling her, “just do what you want.” When the patient absconded from Bartholomew House through the kitchen, only to return shortly thereafter, Salem told the general practitioner: “You don’t know this patient, she’s crazy, you should have let her run away,” the panel heard.

Salem did not attend the 2011 hearing which suspended him, but was present at the review hearing in Manchester. Such hearings are routine as suspensions draw to an end and seek to establish that suspended physicians have kept up their medical knowledge, shown insight into their previous failures, and met any requirements imposed by the original tribunal.

The panel’s chairwoman, Susan O’Connell, told Salem, “You have not provided written evidence of retraining, reflection, or remediation . . . You have made no progress since your original fitness to practise hearing towards remedying your misconduct. The panel is concerned that in your oral evidence, you admitted that ‘I will do this act again today if this happens.’ In view of this, the panel is concerned that your misconduct might be repeated.”

A further 12 months’ suspension, she said, “will give you sufficient time to develop and demonstrate insight and a further opportunity to undertake the corrective actions recommended.”

At the next review hearing, suggested O’Connell, Salem should produce testimonials from colleagues, evidence of steps taken to keep abreast of his field and to improve anger management and communication, evidence of insight into his breaches of good practice and “evidence that demonstrates an understanding of the regulatory process and the purpose of the sanction imposed.”