General Medical Council v Uruakpa

An interim order restricting a doctor’s registration may be extended only after balancing public protection, the public interest and the doctor’s interests, including the effect of delay on livelihood. The court must scrutinise the regulator’s explanation for delay and require full disclosure of the relevant background. Where serious allegations indicate a real risk to the public, an extension may remain justified despite poor case preparation and delay. The extension should last no longer than necessary for the fitness to practise hearing.

The General Medical Council applied under section 41A(6) and (7) of the Medical Act 1983 to extend interim conditions imposed on Dr Uruakpa’s registration. The conditions had required him to work under supervision and had already been extended by Collins J in earlier proceedings. The GMC sought a further six-month extension, relying principally on the time required to list a ten-day fitness to practise hearing. Dr Uruakpa opposed the application, relying on the GMC’s delay, poor preparation and the serious effect of the conditions on his ability to work.

The central issue was whether a further extension was necessary and proportionate in light of the competing public-protection and individual interests.

1. Extension granted in part. The interim conditions were extended from 28 July 2007 only until 15 November 2007, when the fitness to practise hearing was expected to conclude. The GMC’s application for a six-month extension was therefore substantially limited.
2. The court had to balance the protection of the public against the doctor’s interests and the requirement that fitness to practise matters be dealt with as speedily as reasonably possible. Interim conditions can seriously impair a doctor’s livelihood, particularly where the doctor works as a locum and cannot obtain employment without supervision.
3. The GMC’s handling of the case was unsatisfactory. The case had been prepared late, with inadequate particularisation, and the material placed before the Interim Orders Panel did not fully disclose the earlier proceedings or the change in the hearing estimate. A party seeking an extension affecting an individual so substantially must make full disclosure of the case’s circumstances and background.
4. The court nevertheless had to consider the seriousness of the allegations. If substantiated, the concerns about supervision, induction and insight raised a real question of risk to members of the public. The period from 20 February to 28 September 2006, during which consideration was given to a professional performance assessment, was discounted in assessing the delay. The inability to list a ten-day hearing before 5 November 2007 was an exceptional circumstance sufficient to justify a limited extension.
5. The application was granted to that extent. The GMC was ordered to pay 50 per cent of Dr Uruakpa’s costs, reflecting both its success in obtaining an extension and the unsatisfactory manner in which the application and underlying case had been handled.

The judgment records an earlier extension by Collins J in [2007] EWHC 1454 (Admin), which had warned that any further extension would require the most exceptional circumstances. The present court granted a shorter extension, ending on 15 November 2007.