DR MXM v GENERAL MEDICAL COUNCIL

An application under section 41A(10) of the Medical Act 1983 requires the court to decide for itself whether an interim order remains justified and proportionate. The court is not confined to judicial review principles, although it should recognise the specialist tribunal’s expertise.

An interim suspension requires careful assessment of the alleged conduct, the likelihood of repetition during the investigation, the risks to patient safety and public confidence, and the doctor’s interests. Proportionality applies both to the choice between conditions and suspension and to the duration of the order. Eighteen months is a maximum, not a default period. Where conditions can adequately address the identified risk, interim suspension is disproportionate.

The applicant, a general practitioner, challenged an Interim Orders Tribunal decision made under the Medical Act 1983. The tribunal had imposed an interim suspension order for 18 months while the GMC investigated allegations concerning a sexual relationship, treatment of the woman’s husband, sexual activity at surgery premises, online material, and interference with counselling.

The GMC had sought interim conditions rather than suspension. The applicant argued that the tribunal had misunderstood the relevance of private conduct, misassessed risks to patient safety and public confidence, failed to consider proportionality, and gave inadequate reasons. The central issue was whether the suspension was wrong, justified and proportionate under section 41A(10).

1. The application succeeded. The court terminated the interim suspension order. It had jurisdiction to consider all relevant evidence and arguments and was not limited to a judicial review approach. The tribunal’s specialist expertise remained relevant, but the weight to be given to its view was for the court to determine.

2. The statutory assessment required two stages: first, whether an interim order was necessary to protect the public or desirable in the public interest; and second, whether conditions or suspension was the proportionate form of order. Proportionality also applied to the duration of any order.

3. The tribunal was entitled to regard the allegations concerning treatment of the woman and her husband, sexual activity in a clinical setting, and interference with counselling as matters capable of raising fitness to practise concerns. The relationship’s origin before the professional connection, the single consultation, and the absence of an allegation that it arose from a breach of doctor-patient trust were nevertheless highly material to the assessment of seriousness and repetition risk.

4. The allegations did not concern the applicant’s clinical knowledge, skill or care, apart from the possible failure to treat the husband with appropriate respect. The allegation concerning interference with counselling warranted limited weight because the evidence was vague and opaque. On proper analysis, the relevant interim risk was principally to public confidence, rather than patient safety.

5. The tribunal’s reasons were inadequate, particularly because it had imposed the most stringent order despite the GMC seeking conditions. It did not explain why conditions could not manage the identified risks, why suspension was proportionate, or why 18 months was proportionate. An 18-month period was not a default and required proper consideration of the profound effects of suspension.

6. The court considered that standard conditions providing increased monitoring and scrutiny could address the public-confidence risk. It had no power under section 41A(10) to substitute conditions, but the GMC remained entitled to apply for a new interim order.

This was a first-instance application to the Administrative Court under section 41A(10) of the Medical Act 1983. The court terminated the Interim Orders Tribunal’s 18-month interim suspension order.