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

An Interim Orders Panel deciding whether to continue an interim suspension does not determine the truth of the underlying fitness-to-practise allegations. Its task is to assess whether continuation is necessary for public protection, the public interest or the practitioner’s interests. The court’s review is supervisory and respects the professional regulator’s expertise. Intervention requires unlawfulness, procedural unfairness, reliance on irrelevant matters, failure to consider relevant matters, fundamental flaw or a conclusion outside the range reasonably open to the Panel. Allegations may be taken into account without findings that they are proved. The court may consider whether conditions would adequately address the identified risk, but it must not conduct the fact-finding reserved for the Fitness to Practise Panel.

Dr Ali applied under section 41A(10)(a) of the Medical Act 1983 to terminate an interim suspension of his medical registration imposed by the General Medical Council’s Interim Orders Panel. The suspension followed concerns arising from his professional history and a performance assessment which identified substantial deficiencies.

He challenged the assessment, the constitution and conduct of the assessment team, alleged bias and manipulation of evidence, and relied on favourable assessments from other doctors. The central issue was whether the Interim Orders Panel had acted unlawfully in continuing the suspension without determining the truth of the allegations.

1. Application dismissed. The Interim Orders Panel had lawfully continued the suspension, and the claimant was ordered to pay the GMC’s costs of £5,000.
2. Under section 41A of the Medical Act 1983, an interim suspension may be imposed where necessary for public protection, the public interest or the practitioner’s interests. Unlike a Fitness to Practise Panel acting under section 35D, an Interim Orders Panel is not required to find that the allegations are proved or that fitness to practise is impaired.
3. The procedural distinction was material. Fitness to Practise Rules 2004, rule 17, provides for fact-finding and determination of impairment. Rule 27 permits an Interim Orders Panel to receive evidence which appears fair and relevant, but does not give the practitioner an unrestricted right to call oral evidence. The Panel therefore must not determine the allegations on the balance of probabilities.
4. The Panel was entitled to consider the seriousness of the allegations and the performance assessment material, while treating the allegations as unresolved. It was entitled to conclude that unrestricted practice posed a real risk to patients and that no conditions would adequately protect the public.
5. The supervisory approach described in R (Dr “X”) v General Medical Council [2001] EWHC (Admin) 447 and the principles stated in Vale v General Dental Council were relevant. The court’s intervention remained limited to reviewing legality and the rationality and fairness of the decision. The approach in General Medical Council v Hiew [2007] EWCA (Civ) 369 confirmed that the court should examine whether the allegations justified interim protection, rather than decide their truth.
6. The allegations of bias, racist remarks and manipulation were insufficiently evidenced and did not establish that the Panel’s proceedings were unlawful. The claimant could challenge the factual allegations at the subsequent Fitness to Practise hearing.