High Court confirms that Interim Suspension Order is necessary but reduces period of suspension in absence of adequate reasoning by Panel as to the appropriate length.

Judgement date: 3 April 2014

The appellant doctor (H) appealed against an order made by an Interim Orders Panel (the Panel) of the General Medical Council (GMC) on 18 September 2013 that his registration be suspended for the maximum period of 18 months.  At the hearing on 18 September, the Panel had before them reports by two doctors which criticized H in a number of significant respects, which included concerns about record-keeping, prescribing, general lack of knowledge and about probity.   The conclusion of one of the doctors who had compiled the reports was that the standards of medical care provided by H was ‘significantly deficient in the entire core principles expected of a GP applying Good Medical Practice’.

Since the first meeting of the Panel in September 2013 allegations have come to light that H made a false claim against an insurance policy.  This is vehemently denied by H and the police are still investigating. A Review Panel considered this aspect and identified that this further pointed forcefully in favour of continuing the suspension.

On appeal Charles J held that the Panel were absolutely right to impose a period of suspension rather than conditions and H’s appeal against the nature of the Order was wholly and relatively swiftly rejected.  However, the Court had more to say on the subject of the length of the order.  The Court found that the approach taken by the panel to the length of the suspension was ‘troubling’.  It was said that ‘the guidance…very clearly and obviously demonstrates that there is a judgemental or balancing exercise to be carried out in deciding the period of a suspension just as there is in ordering the suspension itself’. [29]

The Court was troubled that there was no real reasoning as to why the maximum of 18 months was chosen.  It was said that;

As soon as you stop to think of what you are doing to a doctor who is suspended, and when you identify what is being done to [H]; given the mortgage that he has taken out to buy the premise for his practice and the expenditure he has, the considerable significance of depriving somebody of being able to make his living by exercising his professional qualifications as a doctor is very apparent. ..it follows that there is a real need to identify what the next steps are, and how long they are going to take and thereby to seek to minimise the period of any suspension. [32]

I am sorry to say that it seems to me there is an absence of that approach both in the decision made in September, and in the decision made on review.  Indeed, in the decision made on review there is no mention at all of the period’. [33]

There was no mention by the Panel as to the need to ‘get on with’ the assessment of relevant risk and to keep the period of suspension as minimal as possible.  The learned Judge therefore shortened the period of suspension until the end of October.

This case reminds Panels that their reasoning as to the length of any order must be just as cogent and detailed as their decision on the type of order that is appropriate.  It warns against an approach where the main focus is on the nature of the order, with the length being an almost automatic after-thought. Without this, there is a risk that the pressure on the regulator to complete their investigation is off, and the livelihoods of those who are subject to the Orders are further damaged.