Doctor given 10-month suspension for ‘cavalier’ issuing of prescriptions to overseas patients

By Ben Lynch, Local Democracy Reporter

A Westminster doctor involved in a scheme which saw almost 300 prescriptions inappropriately issued to overseas patients has been suspended for 10 months.

Professor Sundara Lingam facilitated the issuing of medication for conditions as serious as cancer and HIV for patients, some of whom it later turned out did not exist.

The Medical Practitioner’s Tribunal Service, which issued its judgement following a hearing, held earlier this year, found his actions posed a serious risk of harm to patients, and that multiple red flags had been ‘wilfully’ ignored.

Professor Lingam had previously gone before the tribunal in October 2022, in which he admitted signing off on the requested prescriptions between January 2013 and March 2014.

A number of conditions were imposed upon his practice for 24 months. However, in April 2023, the Professional Standards Authority appealed to the High Court contesting the decision. The High Court quashed the sanction and ordered it be reviewed, due to “inadequate and unclear reasoning”.

As was found in the original tribunal, and which was admitted by Professor Lingam, he had transcribed, signed and issued 299 prescriptions for a company called Kool Pharma to patients based overseas.

Professor Lingam claimed he believed he was partaking in humanitarian work, with the medication being sent to people living in ‘developing’ countries.

However, the tribunal found that he failed to adequately investigate where the prescriptions were going, with no information on patients’ medical history or proof of identity.

Some recipients were also based in ‘more economically developed countries’ where they could expect to receive the medication themselves, and others were later found to not even exist.

Professor Lingam had acknowledged he had acted in an ‘irresponsible and unsafe manner’, and that his actions could have led to patient harm or death.

However, concern was raised at the lack of action taken to improve his understanding of the misconduct, and that the Professor “did not fully appear to understand why his actions were wrong”.

At the remittal tribunal, Mr Saul Brody, on behalf of the General Medical Council (GMC), submitted that a suspension would be a more appropriate sanction for Professor Lingam.

He argued the Professor adopted a ‘cavalier attitude’ to prescribing, and had failed to fully acknowledge the gravity of his actions.

He added the number of prescriptions issued was high, and that a suspension would “act as a deterrent and would send a signal to the doctor, the profession and the public about what is regarded as behaviour unbefitting of a doctor”.

Professor Lingam countered saying he had taken action such as attending online courses and discussing what had happened with his appraiser, and that a suspension would be ‘very shameful’ to himself and his family.

He also presented evidence indicating his commitment to the profession, including helping overseas students get into British medicine and through his teaching and attending conferences.

The tribunal’s report details how there remained issues with the Professor’s understanding of his misconduct, “including a lack of understanding of the fundamental principles of prescribing, a resolute refusal to accept that the recipients of the medication he prescribed were his patients, and a lack of understanding of the unwarranted risk of serious harm and death to the patients for whom he prescribed”.

A number of mitigating factors were considered, including Professor Lingam’s extensive contribution to the wider medical profession and that he stopped remote prescribing for Kool Pharma as soon as he was made aware by the Medicines and Healthcare products Regulatory Agency that there was an issue.

The seriousness of his actions and length of time the prescriptions were being issued however were among the factors resulting in the heavier sanction.

The 10-month suspension was deemed appropriate to ‘mark the seriousness’ of Professor Linam’s misconduct, and meet the public interest. The tribunal concluded: “his behaviour was wholly unacceptable in a registered medical practitioner.”

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