General Medical Council v Madu

When extending an interim order restricting medical practice, the court applies the same criteria as for the original order. The relevant considerations are protection of the public, the public interest and the practitioner’s own interests. The court may consider the gravity of the allegations, the evidence, the risk of harm to patients, the reasons for delay and prejudice to the practitioner. The applicant bears the burden of proof on the civil standard. The court must examine the evidence carefully and balance the practitioner’s interest in finality against the public interest in completing a proper investigation.

The General Medical Council sought, under the Medical Act 1983, a further 12-month extension of interim conditions and restrictions on Dr Anthony Madu’s medical practice while allegations concerning his fitness to practise remained under investigation. Dr Madu disputed the allegations, challenged the conduct and duration of the investigation, and resisted the extension. He also alleged defective service of the Part 8 claim.

The court therefore considered whether the claim had been properly served and whether the statutory criteria justified continuation of the interim order.

1. The claim form had been properly and effectively served. The order permitting alternative service fixed no separate time limit, so CPR Part 7.5 applied and service within four months was permitted. The methods used complied with the order allowing alternative service.

2. Under section 41A(7) of the Medical Act 1983, the court applies the criteria applicable to the original interim order under section 41A(1): protection of the public, the public interest or the practitioner’s own interests. The guidance in General Medical Council v Hiew [2007] EWCA Civ 369 was applied.

3. The court could take account of the gravity and breadth of the allegations, the supporting evidence, the risk to patients, the reasons why the investigation remained incomplete and the prejudice to Dr Madu. The GMC bore the burden of satisfying the court on the balance of probabilities. Dr Madu’s challenges to the merits of the allegations were largely matters for the eventual regulatory process, not matters to be adjudicated at the extension hearing.

4. It was in the public interest, and also in Dr Madu’s interests, that the allegations be thoroughly investigated. The investigation had been delayed in part because he had not made himself available for interview under caution. He remained able to work, and the interim order was subject to periodic review. A further 12-month extension was therefore reasonable and proportionate, although the order might end sooner if the investigation was completed.

5. The extension was granted as sought. Costs followed the event, but the GMC’s claimed costs were summarily reduced to £2,000, payable within 21 days.

First-instance application in the Administrative Court. No prior appellate decision in the present litigation was stated.