Summary of Opinion — Judge Tait

Factual and Procedural Background

The Petitioner is a general medical practitioner registered with the Respondent. An Interim Order Tribunal ("IOT") of the Medical Practitioners Tribunal Service determined on 18 August 2025 that an interim suspension order of 15 months should be imposed on the Petitioner. The Petitioner says he first received notice of the IOT hearing the day before it sat because he was on holiday and promptly instructed representation through Company A. A request to postpone the IOT hearing was refused; the Petitioner’s representative withdrew from active participation and the IOT proceeded in the absence of the Petitioner and of any representation. The IOT explained that it considered notice to have been properly served and that it was in the public interest to proceed given the concerns and the Petitioner’s fitness-to-practise history.

On 29 August 2025 the Petitioner applied to the Assistant Registrar for an early review of the interim suspension order; that request was refused on 3 September 2025. The Petitioner brought proceedings under section 41A(10) of the Medical Act 1983 seeking (i) termination of the interim suspension order and (ii) declarators that (a) the decision to proceed with the IOT hearing and (b) the imposition of the interim suspension were unlawful.

Legal Issues Presented

1. Whether the court should, under section 41A(10) of the Medical Act 1983, terminate the interim suspension order imposed on 18 August 2025.
2. Whether the IOT's decision to proceed with the hearing in the Petitioner’s absence (after refusing a postponement) and its imposition of an interim suspension were unlawful by reason of procedural unfairness.
3. Whether the Assistant Registrar acted irrationally or unlawfully in refusing to permit an early review of the interim suspension order.

Arguments of the Parties

Petitioner's Arguments

• The procedure before the IOT was unfair: the Petitioner did not receive timely notice (being on holiday), his representative was refused an adjournment and withdrew, and the IOT proceeded without the Petitioner or representation.
• The IOT proceeded on incorrect and misleading material about the Petitioner’s fitness-to-practise history; adverse submissions made at the IOT about prior breaches and patterns of inappropriate conduct were inaccurate.
• An interim suspension order is not "necessary" under section 41A(1) because it is not proportionate: the Petitioner can work remotely, there is limited and historical evidence, and less intrusive measures (conditions, remote consultations, observers, recordings, audits) could manage any risk.
• The Assistant Registrar’s refusal of an early review was irrational because review is the appropriate avenue to allow participation where the original hearing was missed and because there was new information (employer confirmation of remote work) relevant to proportionality.
• The court should give no material weight to the IOT decision because it followed a manifestly unfair process.

Respondent's Arguments

• The interim suspension satisfied the statutory test in section 41A(1): it was necessary for protection of the public and otherwise in the public interest.
• The court exercises an original jurisdiction and should give appropriate weight to the IOT determination because of the IOT’s expertise and experience in assessing clinical risk and public confidence.
• The alleged conduct is very serious (sexualised conduct in a clinical setting, including intimate examinations and voyeuristic elements) and arises from multiple complainers; suspension is justified as the least intrusive means given the nature and number of allegations.
• Remote consultations and the presence of a chaperone would not sufficiently mitigate the identified risks; there is relevant and cogent additional evidence (statements obtained during the investigation) supporting the seriousness of the allegations.
• The Assistant Registrar’s refusal to grant an early review was reasonable on the basis of the material before that officer and not amenable to challenge under section 41A.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Kumar v General Medical Council [2013] EWHC 452 (Admin)	Confirms availability of court procedure under section 41A(10) to challenge IOT decisions.	Cited to show statutory route for challenging an IOT decision under s41A(10).
General Medical Council v Hiew [2007] 1 WLR 2007	When exercising jurisdiction under s41A(10) the court acts in an original (not appellate or review) capacity; sets out principles for interim orders.	Used to explain that the court has original jurisdiction and to adopt the approach in considering necessity and proportionality of interim orders.
GMC v K (2023 SC 1)	Affirms principles from Hiew and guidance on court's approach to interim orders.	Followed for stating the court's original-jurisdiction task and the appropriate factors to consider.
Bank Mellat v HM Treasury [2014] AC 700	Sets out the four-stage proportionality test for interferences with rights.	Relied upon by the Petitioner to frame the proportionality assessment required before imposing an interim order.
Nursing and Midwifery Council, Petitioner 2025 SLT 777	Emphasises that interim orders often interfere with Convention rights and require proportionality; less intrusive alternatives should be used where possible.	Quoted to underscore the need for proportionality and consideration of less restrictive measures when imposing interim orders.
R (on the application of Shiekh) v General Dental Council [2007] EWHC 2972 (Admin)	Supports proposition that public interest alone will only exceptionally justify an interim order.	Adopted in support of the principle that public-interest-only justifications for interim orders are exceptional.
Persand [2023] EWHC 3356 (Admin)	Cautions against perfunctory statements of public interest when imposing interim orders.	Cited by the Petitioner to criticise the IOT’s short justification; the Court considered the quality of the IOT’s reasoning but ultimately found the statutory test met on the evidence before it.
Yusuf v Royal Pharmaceutical Society of Great Britain [2009] EWHC 867 (Admin)	Sets limits on proceeding in the absence of a party; proceeding in absence should be used cautiously and only where voluntary absence is established.	Relied on by the Petitioner to argue unfairness where the IOT proceeded without the Petitioner being present or represented.
R (on the application of Osborne) v Parole Board [2014] AC 1115	Addresses importance of the right to be heard and to a fair hearing.	Cited to support the Petitioner's fair-hearing arguments about the consequences of a party being unable to influence proceedings.
Secretary of State for the Home Department v AF (No.3) [2010] 2 AC 269	Observations on the unfairness felt when a party cannot influence the result of proceedings.	Used to buttress the Petitioner's submission regarding procedural unfairness and its corrosive effect.
Chief Constable of Lothian and Borders v Lothian and Borders Police Board 2015 SLT 315	Authority referenced in context of treating certain assertions with caution.	Cited by the Petitioner to argue that relying on the continued presence of an observing solicitor as representation was untenable.
Gupta v General Medical Council [2002] 1 WLR 1691	Personal prejudice (financial or otherwise) is outweighed if suspension is otherwise justified to maintain public trust.	Relying on this, the Respondent submitted that personal prejudice does not negate suspension if required in the public interest.
Patel v General Medical Council [2013] 1 WLR 2694	Addresses the public-interest limb: whether a reasonable member of the public would be concerned that a doctor could continue to practise.	Applied to support the view that suspension may be appropriate where allegations would alarm or offend the public.
GMC v Srinivas [2012] EWHC 2513 (Admin)	Explains that intimate examinations without clear clinical indication may justify suspension; assesses seriousness of risk to patients.	Relied upon by the Respondent to support the seriousness of the allegations and the need for suspension.
B v GMC 2022 SLT 961	Summarises and adopts principles in Hiew regarding interim orders.	Referenced to show the Inner House's adoption of Hiew's principles and their application to interim orders.

Court's Reasoning and Analysis

The court began by identifying the statutory test under section 41A(1) (necessity for protection of members of the public and/or otherwise in the public interest) and the need for proportionality in any interference with rights. The court acknowledged it was exercising an original jurisdiction under section 41A(10) and that it should give appropriate weight to the IOT's specialist assessment, while ultimately deciding the statutory question for itself.

The court reviewed the allegations and the available evidence: allegations from multiple complainers (eleven in total, with ten prepared to provide statements and four final statements lodged), describing conduct in a clinical setting between 2007 and 2013 of a sexual nature (intimate examinations, voyeuristic conduct, and alleged penetrative examinations), and an absence of contemporaneous medical-record entries explaining such examinations.

The Petitioner denied the allegations. The Petitioner relied heavily on procedural unfairness (late notice, refusal to adjourn, absence of representation) and on errors or mischaracterisations in the presentation of the Petitioner’s fitness-to-practise history. The court accepted that these matters affected the weight to be given to the IOT decision but emphasised that its task was to determine the statutory test anew.

In weighing necessity and proportionality the court considered:

• The gravity, number and similarities of the allegations;
• The Petitioner’s fitness-to-practise history (including earlier findings concerning improper photographs and an interim conditions order and subsequent warning);
• The quality and amount of investigation material (including witness statements obtained after the IOT hearing);
• The efficacy of less intrusive measures (remote consultation, chaperones, recording, audits) and whether they would adequately mitigate the identified risk.

The court concluded that, although the Petitioner had legitimate complaints about the IOT process that affected the IOT's weight, the statutory test was nonetheless met on the material before the court. The court found that the alleged conduct—if established—posed an appreciable risk in a clinical setting (including voyeurism and inappropriate sexual touching) and that the public interest was engaged. The court was not satisfied that remote practice or chaperones would sufficiently mitigate the risks given the nature of the allegations and the Petitioner’s fitness-to-practise history. On that basis the court found suspension to be the least intrusive effective measure in the circumstances.

Holding and Implications

DISMISSED — The petition to terminate the interim suspension order is refused.

Holding: The court determined that an interim suspension order of 15 months was necessary for the protection of members of the public and was otherwise in the public interest, and that the order was proportionate on the facts and material before the court.

Implications:

• The interim suspension order imposed on 18 August 2025 remains in force as a proportionate precautionary measure; the court assessed the statutory test itself and was satisfied it was met.
• The court declined to grant the declarators sought by the Petitioner regarding unlawfulness of the IOT hearing and the imposition of the order; it gave weight to the IOT but made an independent assessment under section 41A(10).
• The court reserved questions of expenses for the time being.
• No novel legal precedent was created: the decision applied established principles concerning the court’s original jurisdiction under s41A(10), the need for proportionality when imposing interim measures, and the weight to be accorded to specialist tribunals.