General Medical Council v Srinivas

When deciding whether to extend an interim suspension order under Medical Act 1983, the court is the primary decision-maker. It must not determine the truth of allegations awaiting a fitness-to-practise hearing, but may consider whether they could have merit. The court must assess the allegations’ gravity, the evidence, the risk to patients, the reasons for delay and the prejudice caused by continuation of the order. It must consider the possibility that conditions could adequately protect the public, and must give appropriate weight to the Interim Orders Panel’s view without being bound by it. The court may grant the requested extension, a shorter extension, or refuse it, but cannot impose conditions itself.

The General Medical Council applied under sections 41A(6) and (7) of the Medical Act 1983 to extend an interim suspension order imposed on Dr Srinivas. The suspension followed allegations concerning inappropriate intimate examinations and alteration of medical records. Criminal proceedings had ended in acquittals, but the GMC continued investigating possible professional misconduct.

The suspension had previously been extended for five months by HH Judge Pelling QC in [2012] EWHC 670 (Admin), and for three months by consent. The GMC sought a further six-month extension. The central issues were whether suspension remained necessary and proportionate, whether conditions could suffice, and what length of any further extension was justified.

1. The application was granted in part. The interim suspension order was extended for four months, until 11 January 2013, rather than for the six months sought.

2. Applying GMC v Hiew [2007] EWCA Civ 369, the court was the primary decision-maker. It was not required, or entitled, to decide whether the allegations were true. It could examine whether they had potential merit and was required to scrutinise the evidence carefully.

3. The relevant assessment required consideration of the gravity of the allegations, the nature of the evidence, the risk of harm to patients, the reasons why the case had not concluded, and the prejudice to Dr Srinivas if suspension continued. The court had to consider the Interim Orders Panel’s opinion, but was not bound by it and could determine the weight to give it.

4. The allegations were serious and supported by patient evidence, medical records and expert evidence. If proved, they could demonstrate serious professional misconduct and a real risk to patients. The acquittals did not prevent the GMC from investigating or pursuing related professional allegations.

5. In assessing necessity and proportionality, the court could not ignore the possibility that conditions might be imposed if suspension were not extended. That possibility was relevant because refusal of an extension could permit the Interim Orders Panel to reconsider conditions.

6. The Interim Orders Panel’s view that conditions would not adequately protect the public was given great weight and accepted. Nevertheless, the period already elapsed, the acquittals and the continuing uncertainty about whether the allegations would reach a final hearing made expedition essential. Any further application would require evidence that the GMC had acted expeditiously.

First-instance application under sections 41A(6) and (7) of the Medical Act 1983. The judgment records an earlier five-month extension by HH Judge Pelling QC in [2012] EWHC 670 (Admin), followed by a three-month extension by consent.