Nursing and Midwifery Council v Gates

An interim suspension order may be extended where the criteria for making the original order remain satisfied. The court must consider public protection, the public interest and the registrant’s own interests. Relevant factors include the gravity of the allegations, the nature of the evidence, the risk of harm to patients, the reason for delay, and prejudice to the registrant. The court must determine whether those matters justify prolonging the order. Serious mental illness, lack of insight and the need to protect patients, the registrant and the reputation of the profession may justify an extension where the regulatory hearing has been delayed by defective service and has been relisted promptly.

The Nursing and Midwifery Council applied for a six-month extension of an interim suspension order imposed under article 31(8) of the Nursing and Midwifery Order 2001. The order was due to expire on 19 August 2009, while the respondent’s final hearing had been relisted for 7 September 2009.

The delay arose because documents intended for the earlier hearing had not been served in a manner that the Council could prove. The respondent was unrepresented and did not attend. The central issue was whether the statutory criteria justified prolonging the interim order.

1. The application was granted and the interim suspension order was extended for six months under article 31(8) of the Nursing and Midwifery Order 2001.

2. When considering an extension, the court applies the same criteria as when making an interim order. Those criteria concern protection of the public, the public interest and the registrant’s own interests. The guidance in GMC v Dr Chee Cheung Hiew [2007] EWCA Civ 369 was treated as applicable by analogy, although it concerned the GMC statutory regime.

3. The court must consider the gravity of the allegations, the nature of the evidence, the seriousness of the risk of harm to patients, the reason why the regulatory case has not concluded, and the prejudice to the registrant. It must decide whether those matters justify prolonging the order.

4. The investigating committee had been properly directed and had found severe mental health problems requiring interim suspension for public protection, the public interest and the registrant’s own interests. The medical evidence continued to support that assessment. The respondent had paranoid schizophrenia, lacked insight into her condition, and was likely to remain without insight for a considerable period.

5. The delay resulted from defective proof of service rather than a failure to progress the case. The Council had taken steps to remedy the problem and had arranged an early final hearing. The importance of protecting patients and the reputation of the profession outweighed the limited hardship to the respondent, particularly as she had indicated a wish to leave the register.