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

When an interim order imposed on a medical practitioner has severe practical and financial consequences, the court must balance protection of the public against the need for the underlying disciplinary process to progress promptly. An extension should last no longer than reasonably necessary to enable the matter to be determined properly. Where the case is sufficiently advanced, the court may grant a final extension and refuse any further extension save in exceptional circumstances. The fact that the practitioner could accept undertakings does not justify treating refusal of them as prejudicial where they do not materially alleviate the existing restrictions.

The General Medical Council applied under section 41A of the Medical Act 1983 to extend an interim order imposed on Dr Ian Duncan Crate by the Interim Orders Panel. The order substantially restricted his clinical and private practice and was due to expire on 31 July 2006.

The Council sought an extension of up to 12 months. Dr Crate accepted that some continuation was necessary but argued that the case should be progressed within four to six months. The central issues were the appropriate duration of the extension and the costs of the application.

1. Extension granted. The application under section 41A of the Medical Act 1983 succeeded, but the extension was limited to 5 April 2007. The court directed that this was a final extension and that no further extension should be considered except in the most exceptional circumstances.
2. The court recognised the Council’s duty to protect the public and the need to avoid rushing a substantial case before it had been adequately examined. Equally, restrictions which effectively prevented the practitioner from carrying out his normal clinical work imposed a crushing burden. The disciplinary process therefore had to be advanced with appropriate urgency.
3. The case examiner had apparently undertaken substantial consideration, including seeking detailed undertakings on a possible permanent basis. The appropriate practical question was how quickly the Council could assemble and list the anticipated five-day hearing. The court considered that the matter should be listed in the period then being used for comparable cases, with completion required by Easter 2007.
4. The practitioner was entitled to refuse the proposed undertakings. They did not materially alleviate the existing restrictions, and refusal could not prejudice his position where he wished to contest the substantive allegations before a Panel.
5. The court made no order as to costs. Although the Council obtained an extension, it did not obtain the 12-month period sought, and the court treated the costs question in light of the substance of the result and the circumstances in which the application had been brought.