Uwen v The General Medical Council (Rev 1)

An interim suspension order may be imposed where the available information establishes a real and serious continuing risk that a doctor will practise without appropriate indemnity cover. The court exercises an original jurisdiction under section 41A(10) of the Medical Act 1983, but gives appropriate weight to the expert tribunal’s decision and considers whether it was wrong on the information before that tribunal. The absence of findings of fact does not prevent an interim tribunal from assessing risk. A condition requiring proof of insurance may be unworkable where the doctor lacks insight into the nature of the statutory obligation. The public-interest limb requires careful proportionality assessment, but an order justified independently by public protection will stand even if the public-confidence justification is insufficient.

The claimant, a locum consultant psychiatrist, applied under section 41A(10) of the Medical Act 1983 to terminate an interim suspension order imposed by the General Medical Council’s Interim Orders Tribunal on 13 April 2018. The order followed allegations that she had practised privately without appropriate professional indemnity cover and had relied on solicitors’ legal cover instead.

The Tribunal considered that the allegations raised risks to public safety and public confidence, and that no workable conditions would address those risks. The claimant challenged the findings of continuing risk, the public-interest reasoning and the proportionality of suspension.

1. Application dismissed. The court exercised an original jurisdiction under section 41A(10) of the Medical Act 1983. It was required to consider whether the Interim Orders Tribunal’s decision was wrong, while giving appropriate weight to that expert body. The relevant assessment had to be based on the information available to the Tribunal when it made the order.

2. The Tribunal was entitled to conclude that interim suspension was necessary for protection of the public. It made no findings of fact, but was required to assess risk. The information showed that the claimant had practised outside the NHS without appropriate indemnity cover, had little insight into the seriousness of that failure, and had not acknowledged the need to comply with her statutory and professional obligations independently of any contractual requirement imposed by an employer.

3. The risk was prospective. The Tribunal was entitled to find a real and serious continuing risk that, absent an interim order, the claimant would practise without adequate indemnity cover during the GMC investigation. The fact that no claim had yet materialised did not remove that risk. A condition requiring production of an insurance certificate depended on the claimant understanding what constituted appropriate cover. A condition restricting practice to the NHS would not address the underlying lack of insight.

4. The order was proportionate despite removing the claimant’s ability to practise. The Tribunal had considered whether workable conditions could protect patients and the wider public interest. The claimant’s personal and financial circumstances, relied upon before the court, had not been placed before the Tribunal and could not alter the assessment of whether its decision was wrong on the material then available.

5. The court considered that, if public protection had not independently justified the order, the evidence of dishonesty or misleading conduct was sufficiently ambiguous that public confidence might not have required suspension. The claimant’s unblemished professional record was relevant. That conclusion could not affect the outcome because the public-protection ground independently supported the order.

6. The 13-month duration was not shown to be disproportionate, having regard to the anticipated investigation. The application was dismissed. At the forthcoming review, the claimant could place before the Tribunal evidence of insight, acknowledgment of error, future indemnity arrangements and relevant personal circumstances.

The judgment records no earlier judicial decision in the same proceedings. The application was made directly to the High Court under section 41A(10) of the Medical Act 1983 to challenge an interim suspension order made by the GMC’s Interim Orders Tribunal.