Medical Council v Thomas Kwan: High Court Confirms Cancellation of Doctor’s Registration

In its recent judgment of Medical Council v Thomas Kwan, the High Court has confirmed the decision of the Medical Council under section 71 of the Medical Practitioners Act 2007 (“the Act”) to cancel the registration of a Respondent doctor who was found guilty of attempted murder in the UK. Eamon Harrington, Partner, and Ana Harrington, Trainee, review the judgment and its implications for professional regulation and public trust in the medical profession.

Background

The facts in this case were highly unusual. The Respondent, feeling that he had not received his proper share of his inheritance from his late father, and believing that he would likewise not receive his fair share of his inheritance from his mother due to her relationship with a new partner, resolved to kill the new partner.

It was, evidently, a plan some time in the making. In early 2023 he set up a shell company, which he used to obtain ingredients and materials needed to manufacture ricin, a highly toxic poison. Searches on his phone revealed multiple internet searches involving ricin in January 2024, and books were found in his home detailing the use of various poisons to kill humans. Additionally, his home and garage were found to contain liquid mercury, arsenic, thallium and sulfuric acid.

By November 2023 the plan was ‘well underway’. A fraudulent letter was sent to his mother’s partner, purporting to be from the NHS and advising of a future home visit from a community nurse to administer seasonal vaccines. A further letter was sent in January 2024. These letters were convincing, including as they did NHS logos, hyperlinks, and even QR codes. Other unsent letters were found at the Respondent’s home, suggesting alternative plans he had considered, such as a letter claiming to be from the Northern England Men’s Sporting Association and offering free drinks and ready meals.

On 21 January 2024, two days before the attempted murder, and using an unregistered SIM card to mask his mobile number, he texted the victim a reminder about the upcoming community nurse visit. The next day he drove (using false licence plates) to a hotel in the area, checking in under an assumed name. On 23 January, wearing a long coat, cap, blue surgical mask and sunglasses, he drove to his mother’s house and was let in by his mother’s partner, who did not recognise him due to his disguise and affected Asian accent. He completed a medical questionnaire with the partner and took his blood pressure, as well as his unsuspecting mother’s blood pressure at her request. Finally, he administered the poisonous injection to his mother’s partner claiming that it was a Covid-19 booster. When the victim complained of stinging pain, the Respondent informed him that this was likely an allergic reaction and seemed to hurry from the house. It was only when the perpetrator’s mother commented that the community nurse was the same height as her son that the victim realised something was wrong, but by then the perpetrator had already left the area.

The victim attended the local hospital where he stayed for some weeks and, although he did survive, he was left with lasting physical and psychological injuries.

The General Medical Council in the UK informed the Irish Medical Council in March 2024 that the doctor’s registration had been suspended in the UK, and in November 2024 he was sentenced to 31 years and 5 months’ imprisonment in the UK for attempted murder and administration of poison with the intent to endanger life or to inflict grievous bodily harm.

Irish Medical Council

Although practicing in the UK at the time of the incident, the Respondent had also been registered with the IMC in Ireland as of January 2022. The IMC held a Preliminary Proceedings Committee which referred the matter to the Council itself under section 57(5) of the Act. The Council then met in June 2025, having previously invited the doctor’s involvement and been informed that he had no interest in participating in this meeting. The Council decided to impose the sanction of cancellation on the doctor, being of the view that the criteria in section 57(6) of the Act were satisfied. It noted that the doctor’s conviction in the UK was for crimes which would be triable on indictment in Ireland, but also that the nature of the offences was most serious, particularly having regard to a number of facts:

• The doctor used his status as a medical professional to plan and execute the crime;
• The crime was carried out with forethought;
• The crime was carried out for financial gain;
• The perpetrator left his victim while knowing he was suffering a reaction to the poison;
• The crime used trickery and abused the vulnerability of the victim during a pandemic; and
• Permanent harm was caused to the victim.

In the circumstances, the Council felt that the Respondent was not a fit and proper person to continue to practise medicine, and that it was in the public interest that his registration be cancelled. While it was the case that his registration had been suspended in the UK, and he was serving a long prison term, it was felt that cancelling his registration would prevent any further abuse of his position as a registered medical professional and potential deception. Additionally, this was a matter which affected the reputation of the profession, which might be damaged if this doctor’s registration were not cancelled. The seriousness of the sanction would, it was hoped, highlight the seriousness of the conduct.

The Respondent was notified of the IMC’s decision in July 2025 and of his right to appeal or to write to the Court, but did not do so.

Judgment

The Court acknowledged that, under section 76(3) of the Act, the statutory test for it to confirm the IMC’s decision was that it should do so unless there was ‘good reason’ not to.  It found that the Council had complied with all of the statutory requirements, and in the absence of breach of fair procedures or a manifestly unreasonable decision, it would confirm the Council’s sanction. Indeed, the Court was at pains to note that any decision other than cancellation of registration would be manifestly unreasonable.

Given that the Respondent was in prison and likely to remain there for a long time, the IMC did not seek its costs and no order as to costs was made.