General Medical Council v Haque

An application to extend an interim suspension order must be determined by applying the same test as the original order. The court must ask whether the extension is necessary and proportionate for public protection, the protection of the doctor or otherwise in the public interest.

The court must focus on the nature of the allegations and should not determine their merits at an interim stage. It must give appropriate weight to the decision of the Interim Orders Panel, while making its own distinct decision. Serious concerns about clinical standards, record-keeping and retrospective alteration of records may justify continued suspension when considered cumulatively. The duration of the extension must also be proportionate, having regard to case progress and the need for an effective fitness-to-practise hearing.

The General Medical Council applied under section 41A(6) and (7) of the Medical Act for a nine-month extension of an interim order suspending the defendant, a doctor. The order had originally been made by an Interim Orders Panel.

The defendant did not attend or appear by representation. The court first considered whether the application had been properly served. It then considered whether continued suspension was necessary and proportionate, and whether the nine-month period sought was justified despite an anticipated fitness-to-practise hearing within approximately seven months.

1. Service. Service at the defendant’s registered address by tracked first-class post was proper. The address was a proper address for service under the Medical Act and was also the usual last known residential or business address known to the claimant.
2. Applicable test. The test for extending an interim suspension was the same test applicable when the Interim Orders Panel first imposed it: whether the order was necessary and proportionate for the protection of the public, the protection of the doctor or otherwise in the public interest. Applying GMC v Hiew, the court had to focus on the nature of the allegations and was not required to resolve them at an interim hearing. It had to give appropriate weight to the Panel’s decision but make its own distinct decision.
3. Application of the test. The evidence indicated that the doctor’s care fell below the expected standard in 19 cases and seriously below that standard in six. Poor record-keeping, inadequate examination, misinterpretation of X-rays and retrospective alteration of records supported continued suspension. Conflicts with patients and staff and inappropriate language would not alone have justified suspension, but could contribute when considered with the more serious allegations.
4. Duration. A nine-month extension was proportionate. The existing period was not yet objectively unacceptable by the standards of GMC proceedings, although it was lengthy and any further extension would require careful consideration. The order would end earlier if the Fitness to Practise Panel imposed conditions or made no order.
5. Order. The interim suspension was extended for nine months, expiring on 12 June 2014. The defendant was ordered to pay costs assessed at £1,835.50.