General Medical Council v E

When deciding whether to extend an interim order, the court is the primary decision-maker and applies the same protective criteria as for the original order. The applicant must provide evidence addressing the gravity and current nature of the allegations, the available evidence, risk to patients, reasons for delay, public interest and prejudice to the practitioner. The court must conduct its own proportionality assessment and give appropriate weight, but not deference, to the regulator’s view. Continued restrictions cannot be justified by historic allegations where the evidential and procedural position has materially changed. A failure to explain delay or to conduct the necessary balancing exercise may require refusal of an extension.

The General Medical Council applied under section 41A of the Medical Act 1983 for an eight-month extension of interim conditions imposed on Dr E’s registration. The conditions followed allegations involving a former vulnerable patient, but the GMC had since abandoned the most serious allegations, including rape and sexual conduct during the doctor-patient relationship.

The application was opposed. The court considered the effect of prolonged investigative delay, the changed allegations and evidence, the risk to patients, and the prejudice caused by the conditions. The central issue was whether the GMC had shown that continued conditions were necessary and proportionate.

1. Application refused. The court declined to extend the interim order. The residual allegations remained serious, but the GMC had not satisfied the court that the existing conditions required continuation.
2. Under section 41A(7) of the Medical Act 1983, the court acts as the primary decision-maker. It applies the same criteria as for an original interim order under section 41A(1), including protection of the public, the public interest and the practitioner’s own interests. The burden rests on the GMC.
3. Following General Medical Council v Hiew [2007] EWCA Civ 369, the court must consider the gravity of the allegations, the nature of the evidence, the risk of harm to patients, the reasons for delay and prejudice to the practitioner. It must scrutinise the application evidence and may take account of an apparently weak case, although it does not ordinarily determine the merits or make primary findings of fact.
4. The GMC’s evidence did not address those matters. It failed to explain the delay in issuing the Rule 7 letter, the nature and strength of the remaining evidence, the current risk to patients, the public-interest case, or the prejudice caused by the conditions. Earlier opinions of the Interim Orders Panel could not be relied upon confidently because they had been formed when substantially more serious allegations were being pursued.
5. The court accepted that a theoretical risk remained, but considered that it could be overstated. Dr E had practised for many years without other similar complaints, and the changed allegations required a fresh assessment of whether all the conditions remained necessary. Proportionality required balancing the risks against the substantial restrictions imposed on Dr E.
6. The GMC had already received warnings about delay. The court referred to General Medical Council v Jooste [2013] EWHC 1751 (Admin) as indicating that the problem was not isolated. Given the total failure to provide the necessary analysis, granting even a short extension would have been wrong in principle.
7. The GMC was ordered to pay costs assessed at £3,000, together with VAT if certified irrecoverable.

The judgment records an earlier High Court decision by His Honour Judge Pelling QC, which varied the conditions and extended the interim order for six months: [2013] EWHC 3425 (Admin). The present application for a further extension was refused.