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

An interim order imposing conditions on medical practice may be extended without notice where urgent expiry makes immediate protection necessary and the evidence justifies continuation. The court should safeguard the affected practitioner’s position by granting liberty to apply for variation or discharge on appropriate notice. In deciding whether conditions should remain, the court balances public protection and the public interest against the consequences for the practitioner, particularly where cogent evidence indicates impaired fitness to practise, risk to patients and remediable professional deficiencies.

The General Medical Council applied for a further one-year extension of interim conditions imposed on Mr Syed’s medical practice. The conditions had been in force for approximately five years and were due to expire imminently.

Mr Syed had not been notified of the precise hearing date and time, did not attend, and was not represented. The application arose from concerns about serious deficiencies in his competence as a neurological surgeon. A performance assessment had identified serious deficiencies capable of remedy by training, while limiting his professional practice. The matter had been referred for consideration of his fitness to practise.

The central issues were whether the order should be extended urgently without notice and whether continuation of the conditions was justified pending final determination of fitness to practise.

1. Extension without notice. The court extended the interim order of conditions until 27 May 2006, although the defendant had not been notified of the precise hearing date and was absent. The imminent expiry of the existing order created sufficient urgency for an immediate order.
2. Protection of the defendant’s position. Because the hearing was, in reality, without notice, the order included an express provision granting Mr Syed liberty to apply to the court, on one week’s notice to the GMC, for variation or discharge.
3. Justification for continuation. The court accepted that the Interim Orders Panel had reached its conclusion on 3 March 2005 on proper and cogent evidence. That evidence supported findings of impaired fitness to practise, a possible risk to patients, serious shortcomings in professional performance, and a need to maintain restrictions until fitness to practise was finally determined.
4. Proportionality. The continuation of conditions was justified by balancing the protection of members of the public and the public interest against the consequences for Mr Syed. The conditions remained necessary while the fitness-to-practise process continued.
5. Order. The application was granted in the terms sought. The conditions were continued until 27 May 2006, subject to the defendant’s liberty to apply for variation or discharge.

First-instance decision. The judgment records earlier consensual renewals of the interim conditions in the High Court, but no appeal from a lower court decision.