"... not all the delay that has occurred can be explained by reference to [the complainant's] vulnerability. On the contrary, large parts of it can be explained only by inactivity on the part of the GMC for prolonged periods."
"As was accepted by counsel for the GMC, conditions that are proportionate when they are first imposed can become disproportionate with the passage of time and thus delay is a material consideration in deciding whether it would be proportionate to continue the interim conditions order or relax it in whole or part. There has been significant delay here. The delay that has occurred is not something that I alone have been critical about. The IOP that considered the conditions again in March 2013 was critical of the delay that had occurred too, for it said as follows: 'The Panel has had regard to length of time that the GMC investigation has taken and was disappointed at the apparent lack of progress....'"
"The final question that I have to consider is the length of the extension. I am prepared to extend the conditions as varied in the way I have described for a further period of 6 months. By then the defendant will have been subjected to an interim order of conditions for 2 years. By then the claimant will have or ought reasonably to have decided whether it wishes to proceed and, if so, on what basis. If [the complainant] gives a statement and if that necessitates further enquiries which require additional time then there will have to be a further application. Had the GMC not delayed in the way I have described I would have expected that this case could have been much more advanced and possibly even concluded by now."
"In effect there had been no, aside from the High Court extension orders, material changes since the hearing in July in [2013]."
"Sir, the position is, in summary that the investigation is ongoing. I am instructed that the GMC believes they would be in a position to issue the Rule 7 letter within about two weeks so progress can be made and the doctor will know the proper formulation of the allegations at that stage in more detail."
"1. You must notify the GMC promptly of any professional appointment you accept for which registration with the GMC is required and provide the contact details of your employer and The NHS England Area Team on whose Medical Performers List you are included, or seeking inclusion (at the time of application), or the local Health Board/Health & Social Care Board if employed in Scotland, Wales and Northern Ireland. 2. You must allow the GMC to exchange information with your employer or any contracting body for which you provide medical services. 3. You must inform the GMC of any formal disciplinary proceedings taken against you, from the date of this determination. 4. You must inform the GMC if you apply for medical employment outside the UK. 5. You must not undertake any out-of-hours’ work. 6. a. You must not treat or have any personal contact with any female patient other than in a consultation fixed by prior appointment at a GP’s surgery or other NHS unit. b. You must not have telephone contact with any female patient other than to respond to calls from patients to the GP’s surgery or other NHS unit at which you are employed and/or contracted to work. c. You must not make contact with any female patient by email other than to respond to emails received from a patient sent to a GP’s surgery or other NHS unit at which you are employed and/or contracted to work. d. Except in life threatening emergencies you must not undertake a consultation with any female patient more than 3 times in any 3 month period. e. Save to the extent provided by sub paragraphs (a) to (d) above you must not make contact with any female patients or visit or meet with such patients. f. Except in life threatening emergencies, you must not undertake consultations with female patients without offering that patient a chaperone. 7. a. You must maintain a log detailing every case where you have undertaken a consultation with a female patient. If a chaperone is present, the log must be countersigned by the chaperone. b. You must maintain a log detailing every case where you have undertaken a consultation with a female patient in a life threatening emergency, without a chaperone present. c. You must provide a copy of these logs to the GMC prior to any review hearing of this Panel or, alternatively, confirm that there have been no such cases during that period."
"10. The Panel has determined that, based on the information before it today, there may be impairment of your fitness to practise which poses a real risk to members of the public and which may adversely affect the public interest. After balancing your interests and the interests of the public an interim order remains necessary to guard against such a risk. 11. In reaching its decision, the Panel has noted the serious sexual allegations which you face and the inherent risk to patients and the public interest that these may pose. 12. The Panel has very carefully considered the whole of the judgment of HHJ Pelling QC dated17 October 2013 and his order dated22 October 2013 . The Panel is of the view that you should not undertake and out-of-hours’ work as this could make it difficult for you to comply with condition 6d. It has made a number of other alterations to the conditions to reflect the substance of HHJ Pelling's judgment and order. It has amended condition 7(a) to enable you to provide proof of compliance with condition 6(d). The Panel has decided that it was not appropriate to amend condition 6(e) as this was not part of HHJ Pelling's judgment or order. 13. Whilst the Panel notes that the order has restricted your ability to practise medicine it is satisfied that the order imposed is the proportionate response to the serious concerns raised. The Panel considers that the order of conditions will protect the public and the wider public interest whilst permitting you to continue in clinical practice."
"(6) The General Council may apply to the relevant court for an order made by an Interim Orders Panel or a Fitness to Practise Panel under subsection (1) or (3) above to be extended, and may apply again for further extensions. (7) On such an application the relevant court may extend (or further extend) for up to 12 months the period for which the order has effect."
"the exercise in decision-making is to be performed by the court as the primary decision maker."
"... the criteria for the exercise by the court of its power under [section 41A(7)]... must be the same as for the original interim order under section 41A(1), namely the protection of the public, the public interest or the practitioner's own interests. This means ... that the court can take into account such matters as the gravity of the allegations, the nature of the evidence, the seriousness of the risk of harm to patients, the reasons why the case has not been concluded and the prejudice to the practitioner if an interim order is continued. The onus of satisfying the court that the criteria are met falls on the GMC as the applicant for the extension under section 41A(7)."
"The judge must... reach his decision as to whether to grant an extension on the basis of the evidence on the application. He will need to examine that evidence with care ... In my judgment the witness statement should fairly explain, in summary, but as a self-standing document, the reasons for the application for an extension."
"... it is not the function of the judge under section 41A(7) to make the findings of primary fact about the events that have led to the suspension or to consider the merits of the case for suspension. There is, moreover, no express threshold test to be satisfied before the court can exercise its power under section 41A(7), such as a condition that the court should be satisfied that there is evidence showing that there is a case to answer in respect of misconduct or any other matter. On the other hand, if the judge can clearly see that the case has little merit, he may take that factor into account in weighing his decision on the application. But this is to be done as part of the ordinary task of making a judicial decision, and a case where a statutory body makes an application on obviously wholly unsupportable grounds is likely to be rare."
"The evidence on the application will include evidence as to the opinion of the GMC, and the IOP or Fitness to Practise Panel, as to the need for an interim order. It is for the court to decide what weight to give to that opinion. It is certainly not bound to follow that opinion. Nor should it defer to that opinion. All that is required is that the court should give that opinion such weight as in the circumstances of the case it thinks fit."
"... the function of the court is to ascertain whether the allegations made against the medical practitioner, rather than their truth or falsity, justify the prolongation of the suspension. In general, it need not look beyond the allegations."
"... whilst condition 5(a) would undoubtedly be an appropriate one to impose where the allegations made were of physical assaults in the course of medical examinations, it may not be appropriate to adopt that approach where as here the medical practitioner is alleged to have groomed a single vulnerable patient over time, with a view to cultivating a relationship which became physical in consequence."
"It remains the case however that the claimant commenced a relationship with someone who was, on his own case, a former patient and who he knew or must have known was a vulnerable adult by reason of her mental health issues. It also remains the case that the defendant is credibly alleged to have actively misled his former partners on the question of whether the former patient he admitted having a relationship with was a vulnerable person. Whilst I would regard it as unsafe and unsound to extrapolate from that isolated allegation, which concerns conduct which arose in circumstances that must on any view have been highly pressured, a conclusion that the defendant is so untrustworthy that he ought not to be permitted to practise at all. However, simply looking at the allegations that are made rather than arriving at any judgments concerning their truth or accuracy, it does mean that there is a risk that he might attempt to develop a relationship with a vulnerable patient and, if the only control was a log, that he would seek to disguise or conceal such an occurrence."
"is of the view that interim order remains necessary and is proportionate to the serious concerns relating to [Dr E's] fitness to practise"
"The IOP first considered [Dr E's] case on23rd April 2012 and determined that it was necessary... in the public interest, to impose the order of conditions on Dr E's registration for a period of 18 months."