Li, R (on the application of) v General Medical Council

A fitness to practise panel must balance the public interest against the doctor’s health and ability to participate when considering voluntary erasure or a stay. A declared intention to practise overseas may be relevant to public protection, but only where supported by compelling evidence that it is realistic. The interests of complainants are not an independent factor under the revised voluntary-erasure guidance. Where uncontested medical evidence establishes that a doctor cannot meaningfully participate, continuation of proceedings requires relevant and compelling exceptional circumstances, together with identified measures capable of preserving fairness and compliance with Article 6. A bare reservation that participation may be reconsidered later is insufficient.

The claimant, a doctor facing fitness to practise allegations concerning the deaths of two children, applied to an FTP panel for voluntary erasure from the medical register. Alternatively, he sought a stay because psychiatric illness made meaningful participation impossible and created a significant suicide risk. The panel refused both applications, relying on public protection, public confidence, the claimant’s stated intention to work in Australia, and the interests of the bereaved parents.

On judicial review, the central issues were whether the panel had taken irrelevant matters into account, irrationally assessed the medical evidence, and lawfully concluded that exceptional circumstances justified continuing proceedings in the claimant’s absence.

1. Voluntary erasure. The court approached the panel’s balancing exercise cautiously because the panel had specialist expertise and the medical evidence was for it to assess. Nevertheless, the panel had treated the claimant’s possible future practice in Australia as a significant consideration without adequately addressing whether that intention was realistic. A doctor’s intention to practise overseas may be relevant to public protection, consistently with the GMC guidance, but it cannot be treated as decisive without compelling supporting evidence.
2. The panel had also taken into account the bereaved parents’ interest in seeing professional culpability identified. Under the revised guidance, the private interests of complainants were no longer relevant. In a finely balanced case, that reference was capable of being an influential and legally irrelevant factor.
3. The panel’s conclusion that suicide risks could be adequately managed lacked a sound evidential basis. Given the uncontested evidence that the claimant could not participate meaningfully and the GMC’s concession that it would not proceed in his absence after a stay, a compelling justification was required before the doctor’s health interests could be outweighed. The refusal of voluntary erasure was therefore irrational.
4. Stay of proceedings. The ordinary approach to abuse-of-process stays was reversed where uncontested medical evidence established that the doctor could not participate. Proceedings should ordinarily be stayed unless exceptional circumstances existed. Those circumstances had to be relevant and compelling, and the panel had to identify how fairness and the doctor’s Article 6 rights could still be secured. The panel did neither. Its reliance on the same reasoning used for voluntary erasure, without addressing trial fairness or the practical absence of any meaningful defence, was irrational.
5. Both decisions were quashed and remitted to a freshly constituted panel for reconsideration. Further submissions were invited on whether a mandatory order and costs or other ancillary orders were appropriate.

The judgment is a first-instance judicial review decision. The claimant challenged the decisions of an FTP panel refusing voluntary erasure and a stay of fitness to practise proceedings.