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High Court overturns suspension of a GP for his alleged actions as a school governor

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8701 (Published 28 December 2012) Cite this as: BMJ 2012;345:e8701
  1. Clare Dyer
  1. 1BMJ

The High Court has overturned a General Medical Council decision to restrict a doctor’s practice pending a full hearing, in the fifth such ruling in four months.

High Court judge Mr Justice Eady lifted a suspension imposed on 73 year old GP Indravadan Patel last July by an interim orders panel of the Medical Practitioners Tribunal Service, the operationally independent arm of the GMC.

In four of the five cases, doctors had been suspended by the panel and unable to practise medicine while awaiting a hearing on charges against them. In the fifth, and latest ruling, the panel had imposed conditions on the doctor which the High Court found amounted to “a significant fetter on his ability to practise medicine in an area where the material demonstrates that he is regarded as a competent and effective practitioner and where no allegations of any sort relevant to patient safety have ever been made.” 1 2 3 4

Judges’ criticism in the spate of judgments suggests that interim order panels can be too heavy handed in cases where patient safety is not an issue, and too ready to suspend doctors on the ground of public interest pending the hearing of allegations against them.

In the latest case, Patel was a governor of a school in Brent, North London, and chairman of the finance committee. He has been charged with conspiracy to defraud, with four others, in relation to £1.8m payments in bonuses or incentives to teachers, said to have been paid between 2003 and 2009, and is due to stand trial in 2013.

Mr Justice Eady said the interim orders panel knew that the primary care trust was not aware of any concerns about Patel’s fitness to practise and no concerns had been raised in the past. His role as school governor was a voluntary one, with no remuneration, and it was not alleged that he benefited financially from the alleged conspiracy.

The judge said he had to ask what a reasonable onlooker would think, in the event that the doctor was eventually convicted, about the fact that he had been allowed to go on practising in the meantime. Would confidence in the profession be undermined?

The reasonable onlooker would need to know certain relevant facts, including that in 40 years of general practice no complaint had previously been made about Patel’s clinical competence or his honesty. Other facts included that the charges arose in administering a bonus scheme which began in 1995; that whenever a payment was made it would need to be authorised by Patel as chairman of the finance committee, and payments were communicated quite openly to the London Borough of Brent; and it was no part of the prosecution case that the GP made any personal gain.

The judge said the legal framework for the incentive scheme would have to be analysed when the case came to court, as part of the inquiry into whether Patel’s authorisation of the payments “was indeed to be characterised as dishonest.”

He concluded, “In all the circumstances, it is my judgment that no reasonable and properly informed members of the public, in Brent or elsewhere, would be offended or surprised to learn, even following a hypothetical conviction at some point next year, that the applicant has been permitted to go on serving his patients in the interim. There is no evidence of any threat at all to their welfare.

“I do not believe that such a decision would undermine confidence in the medical profession. I consider that most citizens well understand the notion that a person is to be treated as innocent until proved guilty—and its practical implications. Nor can it be said, for any other reason, that the public interest requires his registration to be suspended.”

Notes

Cite this as: BMJ 2012;345:e8701

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