General Medical Council v Bonhoeffer

When deciding whether to extend an interim suspension order, the court applies the same criteria as the regulatory body applies when making the order. Relevant considerations include the gravity of the allegations, the seriousness of any risk of harm to patients, the reasons for delay, and prejudice to the practitioner. The regulatory body bears the burden of showing, on the balance of probabilities, that the criteria are met and that an extension should be granted. Public protection and the need for proper investigation must be balanced against the practitioner’s prejudice. A further extension may be justified where proceedings have progressed with reasonable expedition and a fitness to practise hearing is imminent.

The General Medical Council applied under section 41(a)(6) and (7) of the Medical Act 1983 to extend an interim suspension order imposed on a paediatric cardiology professor facing grave allegations concerning sexual abuse of children in Kenya. Earlier extensions had been granted, and the defendant had consented to the most recent extension. The investigations had since concluded, a Fitness to Practise Panel had been convened, and a five-week hearing, preceded by a preliminary hearing, was imminent. The issue was whether a further five-month extension was justified.

1. The application was granted. The interim suspension order was extended for five months, from 30 June 2012 to 29 November 2012.
2. The criteria for extending an interim order are the same as those applicable when the GMC makes an interim order. They include the gravity of the allegations, the seriousness of the risk of harm to patients, the reasons why the case has not concluded, and prejudice to the practitioner: GMC v Hiew [2007] EWCA Civ 369.
3. The GMC bore the burden of establishing on the balance of probabilities that the relevant criteria were satisfied and that an extension should be granted.
4. The grave allegations, the importance of public protection, and the potential risk to patients strongly favoured continuation while the complaints were investigated and adjudicated.
5. The court took account of the prejudice caused by the outstanding allegations. That prejudice was materially reduced because the defendant had indicated that he would take no further part in the disciplinary proceedings and did not intend to practise in the United Kingdom.
6. The court also considered the procedural history and the reasons for delay. The GMC had proceeded with reasonable expedition, the case had been listed before a Fitness to Practise Panel, and the proceedings were expected to conclude within the proposed extension.

The judgment records earlier extensions of the interim order, including an earlier decision of the Administrative Court, [2011] EWHC 2353 (Admin). This was a further application for extension, not an appeal.