Malik v General Medical Council

Under section 41A of the Medical Act 1983, suspension on interim grounds requires necessity for public protection. Suspension on the separate public-interest limb requires a sufficiently high threshold, having regard to proportionality and the serious consequences of suspension. On an application under section 41A(10), the court exercises an original power. It considers all the evidence, gives the interim panel’s opinion appropriate weight, but does not defer to it. A past probity concern does not justify continued suspension where the evidence shows no real clinical risk, no subsequent misconduct, and no serious risk of damage to the public interest from continued supervised practice.

The claimant, a doctor undergoing general-practice training, challenged the continuation of an interim suspension imposed by the Interim Orders Panel of the Medical Practitioners Tribunal Service on 14 March 2013. The suspension followed allegations that assessments in his training portfolio had been entered or signed without the relevant consultants’ involvement.

The claimant’s clinical supervisors reported no patient complaints or clinical concerns, and considered that he could progress in training. The central issues were whether suspension remained necessary for protection of the public or was otherwise justified in the public interest, and what approach the court should take under section 41A(10) of the Medical Act 1983.

1. The application was allowed and the suspension was terminated. The court exercised its original power under section 41A(10) of the Medical Act 1983. It considered all the evidence, not merely the material before the Interim Orders Panel. The Panel’s opinion was entitled to appropriate weight and respect, but the court was not bound by it and was not required to defer to it, following Hiew [2007] EWCA Civ 369 and the approach discussed in Sandler v GMC [2010] EWHC 1029 (Admin).
2. The statutory protection limb required necessity. The evidence did not establish any real risk to patients arising from lack of clinical competence. Although earlier foundation skills had not been properly confirmed, there had subsequently been adequate assessment of the claimant’s clinical ability, with no reservations from those responsible for his supervision and training. Suspension therefore could not be justified as necessary for public protection.
3. The public-interest limb was also not satisfied. Interim suspension is a grave and particularly draconian measure. Applying the guidance in Sheikh v General Dental Council [2007] EWHC 2972 (Admin), the threshold is high and suspension on public-interest grounds is likely to be relatively rare, although each case depends on its facts.
4. The historic allegations and differing explanations raised a serious issue of probity for determination by a Fitness to Practise Panel. They did not, on the evidence before this court, establish a serious risk of repetition or serious damage to the public interest. There was no allegation of dishonest conduct after the relevant period, and the claimant remained a trainee working under supervision.
5. The suspension was terminated. Costs were summarily assessed at £8,750 inclusive of VAT.

The Interim Orders Panel imposed the suspension on 14 March 2013. The High Court, exercising its original power under section 41A(10) of the Medical Act 1983, terminated the suspension.