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

In professional disciplinary proceedings, confidential documents may ordinarily be ordered to be produced where they are reasonably required for the inquiry. The court must protect patient confidentiality, including by requiring redaction sufficient to preserve anonymity. The presence of children and sensitive medical information does not itself justify withholding documents. Production should be ordered unless exceptional circumstances make it inappropriate. The fact that a related authority is under appeal does not prevent preparation of disciplinary proceedings. Unless a stay is sought and granted, proceedings should ordinarily continue.

The General Medical Council sought permission to issue a witness summons requiring Dr Donegan to produce correspondence with solicitors, preparatory notes and a reply concerning expert evidence she had given in family proceedings about childhood vaccination. Some documents had already been disclosed, and there was no dispute that a further report reply should be provided.

The remaining documents were confidential. The application raised the need for an order overriding that confidence and the possible effect of Meadows v General Medical Council [2006] EWHC 146, which was then under appeal. The issue was whether the GMC should be permitted to obtain the documents and proceed with preparation of the fitness-to-practise case.

1. The application was granted. The documents were to be produced, with confidential references capable of identifying the children redacted or blanked out. Dr Donegan was allowed 14 days to apply, and 28 days were allowed for production of the remaining documents.

2. In a professional conduct inquiry, the court may override confidentiality where the documents are reasonably required for the disciplinary process. The Court of Appeal decision in A Health Authority v X [2002] 2 All ER 780 made clear that such orders are ordinarily appropriate where patient anonymity is adequately protected. The same approach was reflected in A v General Medical Council [2004] EWHC 880.

3. The interests of children made confidentiality particularly sensitive, but there were no exceptional circumstances justifying refusal. Redaction provided sufficient protection. The fact that one child’s representative objected did not alter the result.

4. The possible effect of Meadows v General Medical Council [2006] EWHC 146 was not determined. The court noted that it might support a later application for a stay or discontinuance, subject to the outcome of the appeal, but no stay application was then before the court. Pending that application, the GMC was entitled to continue preparing the case.

5. There was no order as to costs.