George, R (on the application of) v GMC South Staffordshire Healthcare NHS Trust

An interim suspension order under Medical Act 1983, section 41A, is a protective measure based on a prima facie case, not a final determination of disputed facts. Earlier complaints may be considered as part of a pattern where the statutory rules permit it. A statutory application concerning an interim order is not formally an appeal, but it is an appeal-equivalent remedy; judicial review remains available only exceptionally where that remedy is inadequate in a way that causes injustice. Section 47(3) prevents an employer from dismissing a doctor solely because an interim suspension order prevents the doctor from performing the appointment.

Dr George, a paediatrician employed by South Staffordshire Healthcare NHS Trust, was suspended by the Trust and later made subject to an interim suspension order by the GMC’s Interim Orders Committee. The order followed allegations concerning professional performance and personal conduct, including matters dating back more than five years.

He sought relief under section 41A(10) of the Medical Act 1983, permission for judicial review of the Committee’s decision, and relief against the Trust’s proposal to consider dismissal because of the suspension. The central issues were the scope of the statutory remedy, the availability of judicial review, the fairness and adequacy of the Committee’s process, and the effect of section 47(3) on the employment.

1. GMC proceedings and interim order. The medical screener and the GMC were entitled to consider older matters under paragraph 4(1) of the applicable professional-performance rules where they had not previously been disposed of and could indicate a seriously deficient pattern of professional performance. The five-year limit in rule 5 did not prevent that use.
2. The Interim Orders Committee was not required to determine whether the allegations were proved. It had to decide whether there was cogent and credible prima facie material and whether an interim suspension or conditions were necessary for public protection, the public interest or the practitioner’s interests under section 41A(1). The Committee’s brief reasons adequately explained its conclusion and its 18-month order was within its powers, subject to statutory review.
3. Although section 41A(10) is not a formal appeal, it provides an appeal-equivalent statutory remedy. It permits the court to address an interim order, including an order made on review. The contrary observations in Donnelly v GMC were erroneous. The correct procedure is a claim under CPR Part 54, issued under CPR Part 8, as explained in Madan v GMC.
4. Judicial review was refused. The existence of the statutory remedy made judicial review exceptional. The reference in Sivasubramaniam v Wandsworth County Court to an alternative procedure being less satisfactory did not encompass ordinary differences in time limits or the scope of the statutory review, provided that resort to the statutory remedy caused no injustice.
5. Section 47(3) prevented the Trust from considering dismissal solely because the interim order suspended Dr George’s registration. Parliament intended to preserve the appointment while the temporary protective order operated. The claim against the Trust therefore succeeded.
6. The GMC was to arrange a speedy review by a freshly constituted panel in this case, with the suspension protected until the review or 30 July, whichever occurred first. Dr George was awarded his costs against the Trust and ordered to pay three quarters of the GMC’s costs. Permission to appeal was refused.

This was a first-instance judgment of the High Court (Administrative Court). The judgment does not state any prior appellate decision in this litigation.