Mr Muhammad Karmani v Spire Healthcare Limited — 2025

Mr Karmani was a consultant orthopaedic spinal surgeon with practising privileges at the respondent's Montefiore hospital until those privileges were permanently withdrawn on 28 October 2022. The tribunal recorded that the claim included direct race discrimination, harassment related to race, and protected disclosure detriment; the harassment complaint was withdrawn. The remaining complaints concerned alleged detriments linked to concerns about NICE guidance, MDT approval, patient safety matters, and the respondent's MED06 professional review processes.

On protected disclosures, the tribunal found that alleged disclosures 4 and 5 were qualifying and protected disclosures. They concerned statements in May and June 2021 that Mr Cass was carrying out instrumented or spinal surgery for back pain against NICE guidance and was not following NICE guidance. Alleged disclosures 1 to 3 and 6 were not qualifying disclosures. The tribunal found that several alleged acts amounted to detriments, including aspects of the handling of patient KW and MB matters, suspension and withdrawal of practising privileges, procedural failures in the MED06 process, and parts of the appeal handling. However, it accepted the respondent's explanations for those detriments and found that none was done on the ground that Mr Karmani had made protected disclosures.

On direct race discrimination, the tribunal identified the relevant comparator as a white consultant orthopaedic spinal surgeon who had been through a PRC. It found that Mr Karmani had proved some detriments, but that the proved detriments did not amount to less favourable treatment because of race. The tribunal considered comparisons with Mr Cass, including clinical incidents, MDT compliance, the MED06 process, Equality Act questions, and disclosure issues, but found material differences between their circumstances. It held that the burden of proof did not shift, and in the alternative found that race was in no sense whatsoever a significant or material influence on the treatment complained of.

The tribunal made detailed findings about the 2019 PRC concerning patient CD and the 2022 PRC concerning patients KW and MB. It found that the withdrawal of practising privileges was a severe sanction and that the respondent was unwilling, where relevant, to give Mr Karmani the benefit of the doubt, but concluded that the sanction was not unfair or disproportionate in context, particularly because of the earlier 2019 PRC and its recommendations. No remedy was awarded because the direct race discrimination and protected disclosure detriment complaints were dismissed.