General Medical Council v Hiew

An interim order restricting a registered medical practitioner should remain in force only while material establishes a real and continuing concern requiring protection of patients or the public. Extension beyond the ordinary period is exceptional, particularly where the practitioner has already been unable to practise for a substantial time. Allegations of dishonesty or criminal conduct should not be pursued without evidence capable of justifying them. Restrictions on practice must address an evidenced risk and should not be maintained merely because a theoretical risk remains. A fresh interim order may be considered if genuinely new material later establishes the necessary concern.

The General Medical Council applied for a further extension of an interim order concerning Dr Stephen Hiew. The order had initially suspended his registration and was later replaced by conditions restricting his practice. The proceedings followed an earlier six-month extension ordered by Bean J, whose decision had been appealed to the Court of Appeal.

The GMC relied on allegations concerning dishonesty, falsified records, practice-management failures and risks to patients. The criminal investigation against Dr Hiew had resulted in a decision by the Crown Prosecution Service to take no further action, and the GMC had not yet obtained the underlying material. The central issue was whether the existing evidence justified continuing conditions on his registration.

1. The application for a further extension of the interim conditions was refused. The application was dismissed with costs of £2,975.10 including VAT.

2. Interim orders are intended to hold the position pending substantive proceedings. Although they may be extended beyond the initial period, that is exceptional. The prolonged inability of a practitioner to practise, and the uncertainty about his professional future, are important considerations.

3. The allegations of dishonesty and falsification had originally justified consideration of suspension while the police investigation was unresolved. After the CPS decided not to prosecute Dr Hiew, however, the GMC lacked material capable of justifying those allegations. It was wrong to formulate draft allegations of criminal conduct without evidence supporting them.

4. The material before the court did not show that Dr Hiew, as a medical practitioner, posed a present danger to patients. Concerns about deficiencies in the practice and the handling of records could justify restrictions on managerial or sole-practitioner work only if supported by a real evidential risk. The possibility that he might establish a private practice was theoretical. Disclosure obligations, employer supervision and the involvement of a Primary Care Trust substantially reduced that concern.

5. The Interim Orders Panel could reconsider the matter afresh if new material from the CPS established a real need for an interim order. The present order did not prevent such reconsideration, but a fresh order should be based on new evidence and followed, where possible, by properly formulated charges and a prompt hearing.

• High Court (Administrative Court): Bean J extended the suspension for six months on 17 October 2006. That decision was appealed to the Court of Appeal, where judgment was pending. The present court refused the GMC’s application for a further extension of the conditions.