General Medical Council, R (on the application of) v Mehrotra

The court has a discretion under Medical Act 1983, section 41A, whether to extend an interim conditional registration order. Although an undertaking will ordinarily be inappropriate because it removes the continuing statutory control and review mechanisms of the Interim Orders Committee and the court, it may be accepted in an individual case where the public remains protected and the circumstances are exceptional. Relevant considerations include the doctor’s previous unblemished record, the absence of any breach, the nature of the undertaking, the imminence of the substantive hearing and the interests of the doctor. Such a decision is fact-sensitive and should not be treated as a general precedent.

The General Medical Council applied under Medical Act 1983, section 41A(6) and (7), to extend for 12 months conditions imposed on Dr Mehrotra’s registration by the Interim Orders Committee. The conditions prohibited him from reporting on mammograms and required notification of the conditions and related GMC proceedings to relevant employers and agencies.

The substantive professional conduct proceedings had been delayed until January 2005. Dr Mehrotra offered undertakings in the same terms as the conditions and sought removal of the interim order. The central issue was whether the court should accept those undertakings in lieu of extending the order.

1. Application dismissed. The court accepted Dr Mehrotra’s undertakings and declined to extend the Interim Orders Committee’s order.
2. Under Medical Act 1983, section 41A(6) and (7), the court has a discretion to extend an interim order for up to 12 months. It is not bound to extend the order whenever conditions remain appropriate.
3. Ordinarily, an undertaking is unsuitable. It removes the direct control of the GMC and the court, prevents the statutory review and variation mechanisms from operating, and may deprive the GMC of the procedural benefit associated with a breach of conditions under Rule 33 of the Conduct Rules.
4. A deliberate breach of an undertaking given to protect the public would almost inevitably amount to serious professional misconduct, but the ordinary statutory safeguards should nevertheless remain in place in most cases.
5. This was the exceptional individual case. Dr Mehrotra had previously practised without complaint, had not breached the conditions, had already agreed not to report on mammograms, extended that commitment to the remaining conditions, and faced a substantive hearing fixed for the near future. The court was satisfied that the public would remain protected.
6. The decision was expressly confined to its own facts and was not to be treated as a general precedent. The defendant received the costs of attending the hearing, subject to detailed assessment if not agreed.