Bhatnagar v The General Medical Council

An application under section 41A(10) of the Medical Act 1983 engages the court’s original jurisdiction. The court must decide for itself whether an interim order remains appropriate, while giving careful consideration and appropriate weight to the Interim Orders Panel’s decision.

For an interim suspension imposed in the public interest, the relevant question is whether a reasonable onlooker would be seriously concerned by the practitioner continuing unrestricted practice pending resolution of the allegations. That assessment combines necessity and proportionality. The seriousness and cogency of the allegations, their connection with professional practice, public confidence, the availability of conditions and the consequences for the practitioner must all be considered. Serious, cogently supported allegations of dishonesty directed at regulatory processes may justify suspension even without evidence of patient harm.

Dr Promod Kumar Bhatnagar, a consultant ophthalmologist and proprietor of private hospitals, applied under section 41A(10) of the Medical Act 1983 to terminate a 12-month interim suspension imposed by the GMC’s Interim Orders Panel on 17 January 2013.

The application challenged the order as unfair, disproportionate and wrong, and alleged that the Panel had failed to give adequate reasons. The allegations included clinical governance failures, dishonesty in producing or altering documents for regulatory proceedings, and obstructive conduct towards solicitors. The central issues were the court’s jurisdiction, the public-interest test for interim suspension, proportionality, the sufficiency of the evidence and the adequacy of the Panel’s reasons.

1. Jurisdiction and approach. The application was an exercise of original jurisdiction under section 41A(10) of the Medical Act 1983, rather than mere judicial review. The court had to make up its own mind, while starting from the fact that an extant Interim Orders Panel order was in force and giving it appropriate weight.
2. Public-interest test. The court accepted the reasonable-onlooker approach. The question was whether, assuming the allegations were ultimately proved, a reasonable onlooker would be concerned about the doctor continuing unrestricted practice. This was effectively a combined assessment of necessity and proportionality.
3. The court was entitled to consider both the gravity of allegations and, where possible, the cogency of the evidence supporting them. The allegations of fabricating or altering documents to mislead regulatory proceedings were closely connected with the doctor’s professional activities and went to the integrity of the regulatory process. They were materially reinforced by the earlier finding of dishonesty and by independent evidence concerning obstructive conduct.
4. The absence of direct patient harm was important but not decisive. The allegations of professional dishonesty could justify interim suspension where they created a serious risk to public confidence. The court accepted that conditions could not adequately address the circumstances. Suspension was a severe measure, particularly given the doctor’s age and difficulty in finding other work, but it was neither unnecessary nor disproportionate on the material before the Panel.
5. The Panel’s reasons were adequate. It identified the public-interest ground, the repeated and serious probity concerns, the absence of sufficient safeguards through conditions, the risk to public confidence and the proportionality assessment.
6. The court declined to alter its decision after later review panels replaced suspension with conditions. Those decisions related to later circumstances, appeared to involve additional material, and did not provide compelling grounds for changing a decision already communicated to the parties.

The application was dismissed.

Not stated in the judgment.