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

On an application to extend an interim suspension of a medical practitioner, the court is the primary decision-maker. It may refuse an extension, grant the period sought, grant a shorter period, or terminate or shorten the existing order. The relevant criteria remain protection of the public, the public interest and the practitioner’s interests. The court considers the allegations, evidence, risk of harm, delay and prejudice, but does not determine the truth of the allegations or make primary findings of fact. The regulator bears the burden on the civil standard. Regulatory concerns may justify continuation despite serious delay and prejudice, but any further extension should be pursued with the utmost expedition and may require compelling justification.

The General Medical Council applied under section 41 A(7) of the Medical Act 1983 to extend an interim order suspending Dr Plavelil Abraham George from practice. The suspension had continued for about five years while performance and health concerns remained unresolved. Previous proceedings before the Fitness to Practise Panel had ended without determination because the panel found that it lacked jurisdiction over the matters referred.

The GMC sought a further 12-month extension. Dr George opposed any extension, or alternatively sought the shortest possible period, relying on the length of the suspension, his age and the prejudice caused. The central issue was whether the allegations and the need for further investigation justified prolonging the suspension, and, if so, for how long.

1. Extension granted. The interim order of suspension was extended for six months. The period was selected on the assumption that Dr George would co-operate and that the GMC could complete the necessary procedures within that time.
2. The court applied the principles stated by the Court of Appeal in General Medical Council v Hiew [2007] 1 WLR. The court is the primary decision-maker on an extension under section 41 A(7). It may refuse an extension, grant the period sought, grant a shorter period, or use section 41 A(10) to terminate or shorten the suspension. Parliament had not given the court power to make the original interim order.
3. The criteria are those applicable to the original order under section 41 A(1): protection of the public, the public interest and the practitioner’s own interests. The GMC bears the burden on the civil standard. Relevant considerations include the gravity of the allegations, the evidence, the risk of harm to patients, the reasons for delay and the prejudice caused by continuation.
4. The court must decide on the evidence filed for the application. It should give such weight as it considers appropriate to the views of the GMC and its panels. There is no threshold test and the court does not determine the truth of the allegations or make primary findings of fact. The question is whether the allegations, rather than their truth or falsity, justify prolonging the suspension.
5. Although the five-year suspension, Dr George’s age and the substantial delay caused serious prejudice, further investigation into his performance and health was necessary for patient and public protection. Those considerations outweighed the prejudice and the delay. Dr George was expected to co-operate with reasonable further requirements.
6. The GMC was required to proceed with the utmost expedition. Any later application for a further extension would require compelling justification. The court directed that the judgment transcript be placed before any judge hearing such an application. The GMC was ordered to pay £290 plus VAT for costs wasted at the earlier hearing.

First-instance application under section 41 A(7) of the Medical Act 1983. The judgment records earlier extensions by the court and an earlier hearing before Wyn Williams J, but no appeal from a lower court decision.