Kashif v General Medical Council

When reviewing an interim suspension order imposed by a professional regulator, the court must assess proportionality on the case as it stands at the date of review. Relevant considerations include the gravity of the allegations, the evidence, the seriousness and risk of harm, the reasons for delay, and prejudice to the practitioner. The court must not determine disputed primary facts. A substantial narrowing of the allegations after the regulatory hearing may materially alter the proportionality assessment. Where continuation of the order is no longer proportionate, the court may terminate it under section 41A(10) of the Medical Act 1983.

Dr Adeela Kashif appealed against the General Medical Council Interim Orders Panel’s decision of 29 May 2013 maintaining an interim suspension order for 18 months. The allegations initially raised concerns about clinical skills, communications, probity and record-keeping. By the time of the appeal, the GMC’s rule 8 letter had substantially narrowed the allegations, principally concerning examinations of a patient and related accounts and records. The central issues were whether the court should consider the evidence and allegations as they then stood, and whether continuation of the suspension remained proportionate.

The court considered the approach stated in General Medical Council v Hiew and applied the reasoning in Malik v General Medical Council.

1. Appeal allowed. The interim suspension order was discharged.
2. Under section 41A(10) of the Medical Act 1983, the court could terminate an interim suspension order or substitute another period. The assessment required consideration of the gravity of the allegations, the nature of the evidence, the seriousness and risk of harm to patients, the reasons for delay, and prejudice to the practitioner. The burden lay on the GMC to the civil standard. The court’s function was not to make findings of primary fact: General Medical Council v Hiew [2007] EWCA Civ 369, paras 28 and 31.
3. The court had to consider the matter on the evidence and allegations as they stood before it, rather than treating the earlier Panel proceedings as determinative. The evidence was not confined to the material before the Interim Orders Panel: Malik v General Medical Council [2013] EWHC 2902 (Admin), para 3.
4. The allegations had been substantially narrowed after the Panel’s decision. Although they remained serious and involved issues of probity, the position before the court was materially different from that considered by the Panel. Taking the current allegations and evidence into account, continuation of the suspension would be disproportionate.
5. The suspension order was therefore discharged. The judgment records no separate substantive order on costs beyond the discussion of the parties’ costs figures.

• General Medical Council Interim Orders Panel: on 29 May 2013, maintained an interim suspension order for 18 months.
• High Court (Administrative Court): allowed the appeal and discharged the suspension order.