This was the finding of the first tier tribunal in the case of Dr Sido John v Stockport Primary Care Trust. Dr John appealed against the decision by Stockport Primary Care Trust (the PCT) to remove him from the PCT’s Medical performers list on the basis that he had not performed services within the PCT’s area during the preceding 12 months. This decision was taken pursuant to regulation 10(6) of the NHS (Performers Lists) Regulations 2004 (as amended) (the regulations).

Dr John was receiving treatment for a head injury which he had sustained after falling down some stairs in December 2007. He hoped to return to work but there was no certainty as to if and when he would be able to do so. The PCT waited until 11 February 2010 before taking the decision to remove him from the list on the basis that he could reapply once he had recovered. In the interim, Dr John was suspended by the GMC on 20 January 2010 for a period of 18 months.

The tribunal found that it should be read into regulation 10(6) that any decision taken should be reasonable and proportionate in all the circumstances. They found that Dr John should not be removed from the performers list because such a step would be significantly more than the minimum required in order for the PCT to meet its objective. This was because:  

  • The PCT was able to keep the list up to date by noting that Dr John was the subject of special circumstances which for the time being meant he could not practise.  
  • On the available evidence, a point had not been reached where Dr John’s prospects of rehabilitation and remediation were not reasonable and there was no concluded view as to Dr John’s ability to return to work as a GP in the future.  
  • Dr John’s likelihood of return to practice would be significantly reduced if he were removed from the list.  
  • In terms of protecting the public, Dr John had insight into his condition and there was no suggestion that he would do anything other than comply with the advice of the professionals as to whether he is fit to practise. Furthermore, his suspension from the GMC means that he is unable to work as a doctor and if the PCT considers it appropriate, it could take action to contingently remove him.
  • The evidence available to the tribunal was not sufficiently detailed or wide ranging so as to enable the tribunal to come to a properly considered view with regard to contingent removal.

The tribunal also criticised the PCT’s decision making process on the basis that the decision to remove had been made during a conversation which was not documented and of which no minutes were taken. This made it difficult for the tribunal to consider the evidential basis for the PCT’s decision.