General Medical Council v Sondhi

On an application to extend an interim suspension, the Administrative Court is the primary decision-maker. It must apply the statutory criteria afresh and decide whether suspension remains necessary for public protection, the public interest or the practitioner’s interests. The court must not determine the truth of the allegations or make primary findings of fact. It may consider the gravity of the allegations, the evidence, the risk of harm, the reasons for delay and the prejudice caused by continued suspension. The interim regime is not a substitute for a fitness-to-practise hearing. Applications must therefore be scrutinised with increasing rigour as time passes. Suspension must be proportionate, meaning the minimum interference necessary to protect the relevant public interest. Where conditions would provide sufficient protection, continued suspension is unjustified.

The General Medical Council applied under section 41A(6) and (7) of the Medical Act 1983 for a further nine-month extension of Dr Sondhi’s interim suspension. The suspension had begun on 11 January 2010 and the Fitness to Practise Panel hearing had proceeded for only nine evidential days before being adjourned part heard, with relisting difficulties extending into 2014.

The allegations concerned financial dealings and probity in the management of a private company, arrangements for out-of-hours medical cover, record-keeping and conduct towards colleagues. The central issue was whether continued suspension was necessary for patient protection or the public interest, including protection of public confidence in the medical profession.

The application was refused. The existing interim suspension was not extended. The General Medical Council was ordered to pay the costs of the application, subject to the judge’s summary assessment.

1. Statutory approach. Section 41A of the Medical Act 1983 provides an interim mechanism pending a full Fitness to Practise Panel hearing. It is not a substitute for that hearing or for a final disciplinary order. The statutory limits of 18 months for the initial order and up to 12 months for a court extension require rigorous scrutiny, increasing as the period of suspension lengthens.
2. Applicable principles. Applying General Medical Council v Hiew [2007] EWCA Civ 369, the court had to decide for itself whether an extension was appropriate. It could grant no extension, the period sought or a lesser period. It had to apply the same criteria as under section 41A(1), while considering the allegations rather than deciding their truth. Relevant matters included the gravity of the allegations, the evidence, risk of harm, the reason for delay and prejudice to the practitioner.
3. Evidence and fairness. The court could not extend suspension on allegations or evidence no longer relied on before the Fitness to Practise Panel. The supporting evidence should have been an accurate, objective and properly cross-referenced summary. Evidence heard by the Panel was to be taken at its highest for this application, without the court evaluating it or making primary findings of fact.
4. Proportionality and application. The patient-safety allegations did not establish actual harm or a realistic future risk in the work the defendant could undertake. Conditions excluding financial, managerial or administrative work would have provided sufficient protection. The probity allegations concerned a private company rather than patient treatment or public money, and the defendant had an otherwise unblemished 29-year clinical record.
5. The length and unexplained nature of the delay materially increased the prejudice caused by suspension, including loss of income and progressive deskilling. Although delay alone would not necessarily defeat an extension where suspension was proportionately necessary, suspension was unnecessary and disproportionate on these facts.