The High Court has dismissed an appeal by a doctor who complained that an IOT’s restrictions are “significantly restrictive”.

In Cook v General Medical Council [2024] EWHC 1663 (Admin) (02 July 2024), the appellant brought an appeal under s.41A(10) of the Medical Act 1983 (“the Act”) for the court to revoke an order of the Interim Orders Tribunal (“the IOT”).

In September 2023, the IOT imposed conditions on a senior respiratory consultant which significantly restrict his ability to practice medicine. The IOT maintained the conditions in March 2024. The consultant had engaged in online discussions about meeting an 8-year-old child to sexually abuse her.

The consultant accepted that there should be conditions restricting his return to medical practice, there are two conditions imposed by the IOT that he objects to. They are a condition that he is clinically supervised by a senior practitioner on his return to treating patients, and that he should not take up any locum posts of fewer than 8 weeks’ duration. He appealed against the IOT’s imposition and continuation of these two conditions and seeks their revocation.

UK Fitness to Practise News

In dismissing the appeal, DHCJ Dexter Dias KC, said:

“For all the reasons provided, it is absolutely clear to this court that the appropriate order in this case was to impose a condition of clinical supervision. This had nothing to do with deskilling, and everything to do with a sensitivity to the stressors that are likely to accompany the appellant’s reintroduction to clinical work, and the mechanism of his mental health deterioration previously. The clinical supervisor does not perform a psychological assessment function, but instead is available to assess whether there are any issues in clinical performance that may be an indicator of an adverse reaction to workplace stress. Thus, the condition does not fall into the “real risk” category, but instead is a Subclause 2 intervention, being imposed to safeguard the public interest and to support the appellant as he seeks to re-establish his clinical practice. It would function as part of a broader package of conditions and restrictions and operates as part of an early warning mechanism responsive to any stress-related mental health relapse that the appellant remains vulnerable to experience.”

On the locum length issue, he ruled:

“A minimum duration of 8 weeks for a locum post is plainly necessary and proportionate to promote the vital objective of effective clinical supervision.”

In summary, he said:

“For the reasons given in this judgment, the court has no hesitation in concluding that the order of the Tribunal to impose and then maintain the two challenged conditions was not wrong. The court has considered the proportionality of the two conditions individually and in combination, and the second supports and enhances the effectiveness of the first. They are not disproportionate on either analysis and do not operate as a de facto suspension.

“This is a case in which public confidence in the proper regulation of the medical profession is acutely at stake. Dr Cook engaged in detailed, extensive and disturbing conversations about sexually abusing children. That these “fantasies”, if that is the correct term, about having what would inevitably be extremely damaging sexual intercourse with children under the age of 10 may be attributable to Dr Cook’s mental health disorder plainly necessitates careful supervision of his return to treating members of the public, with early warning mechanisms built in. The clinical supervision must be effective.

“The requirements of such supervision by a suitably qualified senior practitioner, in combination with a requirement of a minimum locum placement of 8 weeks to ensure continuity and effectiveness of supervision, are necessary and proportionate in all the circumstances of this case. They are entirely appropriate. They are not wrong.

“Dr Cook’s application is dismissed.”

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