General Medical Council v Makki

The High Court may extend interim conditions imposed on a doctor where the statutory power exists and the extension remains justified by a balance between the risk to the public and the impact on the doctor. The court must consider the reason for delay, the likely duration of the fitness-to-practise proceedings and the practical period needed for any further application. Conditions causing little direct interference with the doctor may remain appropriate where there is a small but real public risk. Prejudice caused by publicity surrounding proceedings must be distinguished from prejudice caused by the conditions themselves.

The General Medical Council applied to extend interim notification conditions imposed on Dr Makki while fitness-to-practise proceedings remained outstanding. Earlier extensions had been granted by the Administrative Court, and the substantive hearing had been delayed partly because a vulnerable witness required video-link evidence.

The application sought an extension until six weeks after the anticipated conclusion of the hearing. The issues were whether the court had power to extend the conditions, whether the balance between public protection and prejudice to the doctor justified doing so, and whether Dr Makki should pay the additional costs of opposing the application.

1. Power and governing approach. Section 41A(7) of the Act conferred power on the High Court to extend the interim conditions. The court was referred to GMC v Hiew [2007] EWCA 369 and to Shorten v GMC for the need to balance the risk to the public against the impact on the doctor.
2. Balancing exercise. The conditions were notification requirements which would operate only if Dr Makki changed employment before the substantive hearing concluded. Their direct impact was therefore small. The employer’s decision to remove him from direct patient contact was prejudice caused by publicity surrounding the proceedings, rather than by the interim conditions.
3. Delay and public protection. The delay was unfortunate but was not attributable to the GMC. The GMC had acted properly in seeking the vulnerable witness’s evidence by video link and was effectively obliged to take that course. There remained a small risk to the public if Dr Makki’s account was rejected, which justified continuing notification conditions.
4. Duration. Extending the conditions until 19 December 2014, approximately six weeks after the anticipated end of the substantive hearing, was reasonable. The additional period allowed time for the Fitness to Practise Panel to conclude its work and for any further extension application to be made.
5. Costs. It was unreasonable for Dr Makki to oppose the extension. The GMC was awarded £1,477.10, representing the additional costs caused by the contested hearing rather than the costs of making the application itself.

Not an appeal. The judgment concerned an application to extend interim conditions during pending fitness-to-practise proceedings.