Abdullah v General Medical Council

When reviewing an interim suspension under section 41A of the Medical Act 1983, the court exercises an original jurisdiction rather than a conventional judicial-review jurisdiction. It must decide whether suspension is justified and proportionate, while giving appropriate weight to the specialist panel’s assessment.

Serious allegations of sexual misconduct with a patient may justify interim suspension both to protect the public and to maintain confidence in the medical profession, even where criminal proceedings have not resulted and factual allegations remain unproved. Suspension is not automatic. The individual circumstances, evidential weight, alternatives, proportionality, and the doctor’s interests must be considered. Reasons need identify the relevant statutory interests and explain the decision sufficiently, but need not be elaborate. The period of suspension must itself remain proportionate.

The claimant, a general practitioner, challenged an Interim Orders Panel decision under section 41A(10) of the Medical Act 1983. The panel had suspended his registration for 18 months while the GMC investigated allegations that he had engaged in sexual misconduct with a vulnerable patient.

The claimant argued that the allegations were inconsistent and inadequately evidenced, that suspension was unnecessary and disproportionate, that the panel’s reasons were inadequate, and that it had failed to explain its departure from a Primary Care Trust decision not to suspend him from its performers list. The central issues were whether suspension was justified for public protection or in the public interest, whether conditional registration would suffice, and whether the 18-month period was proportionate.

1. The court’s jurisdiction under section 41A(10) of the Medical Act 1983 was not confined to judicial review. The court had to decide whether the interim suspension was justified and proportionate, while attaching appropriate weight to the IOP’s specialist assessment. It was not required to resolve the underlying factual disputes.
2. The question suggested in Sosanya—whether it would be acceptable not to suspend if the allegations were proved, and acceptable to suspend if the practitioner were ultimately exonerated—was a useful consideration in serious cases. It did not impose an additional statutory test and had to be applied with regard to the individual facts.
3. The allegations concerned serious sexual misconduct with a vulnerable patient. In accordance with the GMC guidance, they raised both a real potential risk to patients and significant public-confidence concerns. The IOP was entitled to conclude that interim suspension was necessary for public protection and otherwise in the public interest, notwithstanding the absence of a prosecution and the fact that the allegations had not been proved.
4. Suspension was proportionate. The IOP had considered the claimant’s professional history, the consequences of suspension, the possibility of interim conditions, and the need for workable and enforceable restrictions. Conditions would not adequately address alleged conduct both within the surgery and through telephone contact outside it, nor would they avoid the damage to public confidence inherent in allowing the claimant to remain in practice while the allegations were investigated.
5. The IOP’s reasons were adequate. They identified the statutory interests relied upon, summarised the allegations and competing submissions, addressed the factual controversies, explained why conditions were insufficient, dealt with proportionality, and gave the reason for the proposed period. The IOP did not have to provide reasons for its reasons or expressly discuss every point.
6. The IOP was entitled to reach a different conclusion from the PCT. The two bodies operated under different statutory regimes and processes, and the PCT’s preliminary conclusion was not binding. The court preferred the IOP’s more cautious assessment.
7. The 18-month period was excessive. The investigation could reasonably be completed within 12 months, and the grave effect of suspension on the claimant’s livelihood and reputation made a longer period disproportionate. The suspension was therefore maintained, but the period was substituted with 12 months.

The application was made directly to the High Court under section 41A(10) of the Medical Act 1983 against an interim suspension order imposed by an Interim Orders Panel on 10 July 2012. The court declined to terminate the suspension but substituted a period of 12 months for the original 18-month period.