This is the latest in a long history of legal cases between the doctor and the General Medical Council (GMC). We previously reported on the background and legal cases between the doctor and the GMC.
In the latest instalment, the doctor applied to the High Court to reopen a previous judgement and order following a collapse of the case against her. In the case preceding this, Mr Justice Fordham refused Dr Ramaswamy’s claim to revoke the “interim conditional registration” order (“ICRO”) and further imposed a cost order in favour of the GMC.
In Ramaswamy v General Medical Council (No. 2)  EWHC 2809 (Admin) (10 November 2023), Dr Ramaswamy applied for permission to re-open the judgement and cost order referred to above.
The circumstances leading to the application, relates to a new MPT determination that, whilst, Dr Ramaswamy had failed to comply [with a Directions for Health Assessment (“DHAs”)], she had “good reason”. The Tribunal said the central point was not whether there was a cause for concern, but whether the concern could be investigated without the necessity for a health assessment. On the particular facts, it could be investigated without the necessity for a health assessment, and so there was a “good reason”.
As a consequence, the GMC’s Case Examiners and IOT tribunal both closed the case against the doctor.
Dr Ramaswamy consequently sought permission for the High Court to reconsider its earlier judgement refusing to revoke the “interim conditional registration” order (“ICRO”) and cost order.
Mr Justice Fordham however refused the application, saying:
“I entirely accept that there may be a change of circumstances which puts into a new light the question whether an interim order can properly be maintained. I accept that the Tribunal’s Determination (25 January 2023), followed by the Case Examiners’ Decision (13 February 2023), raised that question for the GMC. In particular, I accept that, once the GMC reached the view that the ICRO could not properly be maintained, it was incumbent on it to act promptly. But that is what happened. The GMC did act promptly. The ICRO was promptly considered by the IOT. The submission was properly made that it should be revoked. It was revoked. It follows that there is no injustice from the continuation of an interim order which this Court upheld, in light of a change of circumstances. Quite the opposite is true. The change of circumstances has led to the ICRO being revoked. There could now be no new (or reopened) claim to have an ICRO set aside. It has already been set aside.
“I do not accept that the circumstances are so exceptional as to justify the reopening of the Judgment and Order, with that course being necessary in order to avoid real injustice. I can see nothing which has critically undermined the integrity of the litigation process. The GMC’s proceedings against Dr Ramaswamy have involved different decision-makers at different stages, asking different questions, for different purposes. Each has had to arrive at their own evaluative assessment of the materials that are put before them, so far as relevant to the question being asked. What I had to do in the Judgment was to conduct a “risk assessment” paying attention to the nature of the allegations and the evidence relied upon to support them, including the quality of the evidence and the possibility or prospect that it may not be sufficient to justify the view that there is a risk, but with no applicable threshold (Judgment §4). I explained that it was not the function of the Court – in dealing with “interim” orders – to try to arrive at definitive conclusions on contentious factual matters; but that the question of interim orders raises questions of risk-assessment, questions about the sufficiency of the quality of the evidence, questions of necessity and of proportionality (Judgment §45). It was Dr Ramaswamy’s statutory entitlement to bring her section 41A(10)(b) claim to the High Court, to have her interim order revocation claim heard in the High Court on its legal merits (Judgment §1). She did so and obtained a judgment of the Court on the revocation of the ICRO, on the evidence and submissions.”
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