A HEREFORDSHIRE surgeon who burned his initials on to the livers of two unconscious patients could be facing a longer ban after the General Medical Council (GMC) complained that a five-month suspension was "insufficient", a High Court judge has said.

Mrs Justice Collins Rice ordered a fresh Medical Practitioners Tribunal hearing into the case of Simon Bramhall, who worked at the Wye Valley NHS Trust for a time, after considering a GMC appeal.

The judge, based in London, said a tribunal that considered the case last year did not "put its finger on precisely what was and was not wrong" with Mr Bramhall's conduct.

Bramhall, who is in his 50s and was a transplant surgeon at University Hospitals Birmingham NHS Foundation Trust, was given a community order and fined £10,000 by a judge at Birmingham Crown Court in January 2018 after he admitted two counts of assault by beating.

He told police he used an argon beam machine to initial the organs to relieve operating theatre tensions following difficult and long transplant operations in 2013.

Mrs Justice Collins Rice was told that, in December 2020, a Medical Practitioners Tribunal imposed a five-month suspension on Bramhall's medical registration.

Lawyers representing the GMC said the sanction was "insufficient to maintain public confidence" in the profession.

The judge, who published a ruling online on Tuesday after considering arguments at a High Court hearing earlier this month, allowed the GMC's appeal.

She said the case must be reconsidered by a new tribunal.

"The Medical Practitioners Tribunal did not put its finger on precisely what was and was not wrong with Mr Bramhall's conduct and sanction accordingly," she said.

"It did not do full justice to this unique case.

"I allow this appeal on that basis.

"I am satisfied that the right way forward is to quash the sanctions determination and remit the case for a fresh determination by a differently constituted tribunal."

Mrs Justice Collins Rice heard the offences came to light when one patient had further liver surgery performed by another surgeon.

That surgeon saw and photographed "the marks" and reported the matter to the trust's medical director.

The judge said Bramhall, who lived in Church Lane, Tarrington, in 2017, had admitted responsibility.

She said the facts of the case were "highly unusual" and there was a "profound ambivalence to be confronted" about how Bramhall and his actions should "properly be regarded by authorities responsible".

"On the one hand, what Mr Bramhall did was calculatedly harmless, since no physical damage beyond the 'transient and trifling' was done," she said.

"It was also calculatedly inconsequential: the patients were not to know.

"But on the other hand, this was a criminal, non-consensual physical interference.

"It had to be sentenced as one of the most serious forms of common assault because of the multiplicity of aggravating features.

"One of his victims was certainly traumatised, writing powerfully to the sentencing court of her experience of being physically 'violated' in a sense she compared to sexual abuse or rape."

She said Bramhall had denied "personal gratification" and accepted "arrogance" as one explanation.

He had also spoken of "tension", the effects of "pressure of work on his own judgment", and wishing to "relieve the intensity of the theatre atmosphere".