Houshian v General Medical Council

Under section 41A of the Medical Act 1983, the court exercises an original jurisdiction when reviewing an interim order. It gives appropriate weight to the expert panel’s decision but may intervene where the order was wrong.

An interim suspension imposed solely in the public interest requires a high threshold. The decision-maker must assess the likelihood and degree of serious damage to public confidence during the relevant period, and balance that risk against the practitioner’s interests. Serious but unproven allegations, without an identified risk to patients, will not alone justify suspension. Delay and the proximity of the substantive hearing may be relevant to proportionality.

The claimant, a consultant orthopaedic surgeon, challenged an 18-month interim suspension imposed by the General Medical Council’s Interim Orders Panel under section 41A of the Medical Act 1983. The suspension was imposed solely on the public-interest ground pending a 20-day Fitness to Practise hearing.

The allegations included dishonesty and fabrication of documents in earlier Employment Tribunal proceedings, together with allegations concerning treatment of colleagues and information given to patients. The claimant denied the allegations. The central issue was whether suspension was necessary and proportionate to protect public confidence while the allegations remained unresolved.

1. The suspension was terminated. The court exercised its original jurisdiction under section 41A(10) of the Medical Act 1983. It was required to give appropriate weight to the expert panel, but could interfere if satisfied that the order was wrong.
2. Where an interim order is imposed solely because it is otherwise in the public interest, the decision-maker must identify the relevant public-interest risk. The risk in this case was to public confidence, rather than patient safety. The seriousness of allegations was insufficient without assessing the likelihood and degree of serious damage to public confidence during the period before the substantive hearing.
3. The court accepted the two-stage approach in the GMC guidance: first, whether there may be impairment which may adversely affect the public interest; and secondly, after balancing the interests of the practitioner and the public, whether an interim order is necessary to guard against that risk. The guidance was not statutory and could not enlarge section 41A.
4. Proportionality required consideration of the profound effects of suspension on livelihood, reputation and the practitioner’s ability to demonstrate fitness to practise. The delay before referral to the Interim Orders Panel, the absence of comparable concerns during several years of subsequent practice, and the imminent full hearing were relevant. The Employment Tribunal findings were not criminal findings or findings of an internal disciplinary investigation, and the allegations remained unproved.
5. The Panel’s reasons did not adequately explain why the alleged damage to public confidence would be sufficiently serious to outweigh the claimant’s interests. Repeating the seriousness of the allegations and the Tribunal’s findings did not discharge that requirement. The decision to suspend was therefore wrong.

First-instance decision. The judgment does not state any prior appellate decision in the same litigation.