Sandler v General Medical Council

On an application under section 41A(10) of the Medical Act 1983, the court exercises its own judgment rather than a judicial review jurisdiction. It nevertheless starts from the extant interim order and should terminate it only if satisfied that it is wrong.

Public-interest suspension does not carry the express statutory requirement of necessity applicable to public protection. It must at least be desirable, and the decision-maker must assess proportionality by balancing the damage to public confidence if the doctor continues to practise against the harm caused to the doctor. Serious allegations of repeated dishonesty arising from clinical duties may justify suspension before their determination where conditions would not adequately protect public confidence.

The General Medical Council’s Interim Orders Panel suspended the claimant doctor’s registration for 18 months. The order followed criminal charges alleging that he had wilfully signed numerous false cremation certificates. The Panel found no need for an interim order to protect patients, but considered suspension necessary in the wider public interest to maintain professional standards and public confidence.

The doctor applied under section 41A(10) of the Medical Act 1983 to terminate the suspension. He argued that suspension was disproportionate, particularly because his employer had permitted him to continue practising subject to conditions and the eventual disciplinary hearing might be delayed substantially. He also sought to introduce two witness statements served shortly before the hearing. The principal questions were the nature of the court’s jurisdiction, the admissibility of the late evidence, and whether public-interest considerations justified continuing the suspension.

1. The application was dismissed. Section 41A(10) of the Medical Act 1983 confers original powers rather than a judicial review jurisdiction. The court must decide for itself whether termination is appropriate and may consider subsequent developments and fresh evidence. Nevertheless, because an extant Panel order is in force, the court starts from that position and should terminate the order only if it considers the order wrong.

2. The Panel’s expert opinion was entitled to appropriate weight, but the court was neither bound by it nor required to defer automatically. Weight depended on a holistic assessment of the opinion’s persuasiveness, content, source and relevant circumstances, consistently with GMC v Hiew [2007] 1 WLR 2007. The court remained responsible for reaching its own conclusion.

3. The public-interest limb of section 41A(1) does not contain the express requirement of necessity governing public protection. Interim suspension on public-interest grounds must at least be desirable. Proportionality requires careful comparison between the harm to the public interest if the doctor continues to practise and the damage caused to the doctor by suspension. The court should be cautious about adding a free-standing necessity test that Parliament did not enact.

4. The allegations were serious and were not manifestly baseless. They concerned repeated wilful falsification of cremation certificates over several years and arose during clinical duties. The alleged scale, the doctor’s influential professional positions and the potential damage to confidence in the profession justified an interim measure. The employer’s decision to impose only conditions did not bind the GMC, which had wider statutory responsibilities. The delay before referral was adequately explained by the police investigation.

5. Conditions would not adequately protect the public interest. Giving considerable but not automatic weight to the Panel’s assessment, the court independently concluded that the damage to public confidence if the doctor continued practising outweighed the serious effects of suspension. The possibility of a later extension beyond 18 months was a matter for any future application under section 41A(7), not the present application.

6. The court refused permission to rely on the two late witness statements. Their service shortly before the hearing was unexplained, prejudiced the GMC and deprived the court of the Panel’s assessment of the new material. The imminent Panel review provided an opportunity for the doctor to rely on that evidence.

• High Court (Administrative Court): Dismissed the doctor’s application under section 41A(10) of the Medical Act 1983 to terminate the interim suspension.
• General Medical Council Interim Orders Panel: Suspended the doctor’s registration for 18 months on public-interest grounds.