General Medical Council v Sondhi

The court considered an application by the General Medical Council under section 41A(6) and (7) of the Medical Act 1983 to extend an interim suspension order. The governing principles were those in General Medical Council v Hiew [2007] EWCA Civ 369: the court must decide as primary decision-maker whether an extension is necessary for the protection of the public, the public interest or the practitioner's own interest, applying a proportionality assessment and generally having regard to the allegations rather than their truth.

Applying those principles the judge found that most allegations (failure to keep records, rota management and punctuality) did not show a present risk to patients and would, if anything, have been met proportionately by conditions restricting management or out-of-hours work rather than suspension. The allegations of probity related to management of a private company and not to patient care; no patient harm was shown; some allegations had been withdrawn or were no longer relied upon; and there were serious procedural and evidential deficiencies and undue delay. For those reasons the application to extend the interim suspension was refused.

Background and procedural posture. The General Medical Council applied under section 41A(6) and (7) of the Medical Act 1983 for a nine month extension of an interim suspension first imposed on 11 January 2010. A Fitness to Practise Panel hearing had commenced in June 2013 but proceeded only part-heard; various interim extension applications had previously been made and mostly resolved by consent; the cumulative period of interim suspension exceeded three years at an earlier stage and was, overall, lengthy.

Nature of the application. The GMC sought a further extension of an interim suspension order pending completion of FTP proceedings.

Issues framed by the court.

• Whether an extension was necessary for the protection of members of the public, the public interest, or the practitioner’s own interest under section 41A.
• What weight to give to the allegations and to the IOP/Fitness to Practise Panel material, particularly where some allegations or evidence were no longer relied upon or had been withdrawn.
• Whether suspension remained a proportionate response as opposed to conditions.
• Whether undue delay and deficiencies in the GMC's evidence affected the balance.

Relevant factual matters. The defendant was a long‑standing GP and director and chairman of Croydoc, an out‑of‑hours provider. Allegations before the FTP Panel included misuse of company funds/advances, misleading an auditor/board, inadequate out‑of‑hours cover and record keeping, and inappropriate or abusive instant messages. Some allegations concerning payments to the defendant’s wife and certain witness allegations were withdrawn or not pursued.

Court’s reasoning and conclusion. The judge applied the Hiew principles: the court acts as primary decision‑maker and decides whether, given the allegations and evidence, an extension is necessary and proportionate. The judge found no evidence that patients had been harmed and no expert evidence that cover had been objectively inadequate; the probity allegations concerned a private company and not public money; many non‑probity allegations could have been met by conditions restricting management or out‑of‑hours work; the GMC’s evidence was deficient in identifying abandoned allegations and the bundles were undigested; and there had been unacceptable delay. Balancing public protection against the doctor’s interests, the judge concluded suspension was not necessary or proportionate and refused the application. The court also made a summary assessment of costs, allowing reductions in certain claimed items.

The application to extend the interim suspension is refused. The judge held that, applying the principles in Hiew and section 41A Medical Act 1983, extension was not necessary for the protection of patients or otherwise in the public interest because (i) the probity allegations concerned management of a private company rather than patient care, (ii) there was no evidence of patient harm or expert evidence of inadequate cover, (iii) conditions (for example excluding managerial/administrative duties or out‑of‑hours work) would have been a proportionate response, and (iv) there were material procedural/evidential deficiencies and undue delay that weighed against extending suspension.