This judgment was handed down remotely at 10.30am on [date] by circulation to the parties or their representatives by e-mail and by release to the National Archives.
Aidan Eardley KC:
Introduction
- In these Part 8 proceedings the Claimant challenges a decision of the Interim Orders Tribunal (the IOC) of the General Medical Council (the GMC) dated 20 February 2026, to suspend him from practice for 12 months while his fitness to practise is investigated.
Factual background
- The Claimant is a consultant general physician with an interest in cardiology. He is registered with the GMC and is based in Guernsey. He qualified in 1992, was elected a Member of the Royal College of Physicians (RCP) in 1997 and became a Fellow in 2012. He is a person of good character and, prior to the matters giving rise to the present proceedings, had not been the subject of any investigations or findings by the GMC.
- Until expelled as a partner, the Claimant provided services via the Medical Specialist Group LLP (MSG), a private partnership of consultants that provides secondary care services under contract with the States of Guernsey. (Public healthcare in Guernsey is organised somewhat differently from care provided by the NHS: a "consultant-led" model is used rather than entrusting a patient to a team of junior and senior doctors – a point on which the Claimant places some reliance).
- The Claimant also has interests external to MSG, viz: (a) he is a director and sole owner of Sellogic Ltd which provides ECG monitoring and analysis of CT coronary arteriograms; (b) he trades as "Biome-me Health"; and (c) he is chairman of the "Cardiac Action Group", a Guernsey charity.
- During the Covid-19 pandemic, the Claimant developed concerns about the response of public health authorities in Guernsey and elsewhere, and the safety of vaccines that were developed to combat the disease. In particular he developed a concern that the vaccines may have caused cardiac damage in patients, in particular myocarditis and pericarditis. He posted/re-posted material connected with his concerns on social media. This social media activity was prolific: the hearing bundle contained 99 pages of printouts.
- MSG's governance lead (Dr Graham Beck) requested that the Claimant cease his social media activities but the Claimant persisted. This, and another matter (an allegation that the Claimant had failed to follow a States of Guernsey policy that required the wearing of a mask on hospital premises or a sunflower lanyard indicating that the person was exempt from the requirement to wear a mask), were investigated by MSG in 2023. The investigation, conducted by Dr Steve Evans, concluded that there was sufficient evidence to support concerns that the Claimant had breached MSG's disciplinary policy and code of conduct and recommended a hearing before MSG's disciplinary panel.
- MSG's disciplinary hearing, convened for 25 September 2023, was postponed when MSG became aware of the Claimant's outside commercial interests and learned that the Claimant had used the personal data of MSG patients in the course of his private business, potentially in breach of MSG's data protection policies. On 27 September 2023 the Claimant gave undertakings to take urgent steps to secure the information that he had taken outside MSG. The potential breaches of data protection policy were then investigated by Dr Graham Beck.
- The MSG disciplinary hearing finally took place on 4 December 2023. The Claimant was found to have breached MSG's disciplinary policy and code of conduct through his social media activity (and the matter concerning the face mask), and to have breached MSG's data protection policy, code of conduct, and LLP partnership agreement, through his transfer of patient data to his company Sellogic Ltd. MSG recorded that it had notified the Office of the Data Protection Authority (ODPA) and the patients affected. The sanction imposed by MSG was the issue of a written warning, to be held on the Claimant's personnel file until December 2024. The Claimant was also issued with an advisory letter with recommendations as to his future conduct.
- In February 2024 the Claimant wrote an open letter to Charlie Massey, Chair of the GMC's Executive Board, in support of another doctor, Dr Asseem Malhotra, who was under investigation (the Massey Letter). Among other things the Massey letter discussed the Claimant's own clinical experience of patients who had received Covid vaccines and suggested that there was a causal link between the vaccines and an increased number of adverse cardiac events. The Massey Letter was republished on Dr Malhotra's website and reported in the local media and on social media.
- On 28 February 2024, Dr Peter Rabey, of Guernsey's Office of the Committee for Health and Social Care (the OCHSC), wrote to the Claimant identifying factual errors in the Massey Letter and inviting his to correct them. Those were said to be: a misstatement of the number of Covid cases in Guernsey in 2020 (298 not, as stated, 20,000); and a claim that there had been a recent doubling in the number of strokes (which, Dr Rabey said, was not supported by figures reported by the Island's stroke co-ordinator, which showed no appreciable increase). Dr Rabey also expressed concern that the Massey Letter contained information capable of identifying individual patients. The OCHSC requested that the Claimant correct the factual inaccuracies, repeating that request at a meeting on 5 March 2024 and in a further letter dated 7 March 2024.
- The Claimant amended the Massey Letter on 19 March 2024 and re-sent it to Mr Massey but he did not change the factual errors identified by the OCHSC. The Massey Letter was published in full that day by the Guernsey Press along with an interview with the Claimant. As it happens, the Guernsey Press used the original Massey Letter, not the amended version, through no fault of the Claimant, but nothing turns on this since both versions contained the elements that the OCHSC had found objectionable. The OCHSC repeated its concerns in a further letter dated 21 March 2024.
- On 15 May 2024 (the Guernsey Press having apparently published the Claimant's interview online the previous day) the husband of a deceased patient made a complaint to MSG that the interview had included medical details of his late wife, who he claimed had been identified by her friends and family from the details contained in the interview. I was shown the Claimant's response to his late patient's husband in which he apologised for the distress caused but argued that he had been acting "for the greater good".
- The Claimant's conduct in giving the interview to the Guernsey Press was investigated by MSG which, in July 2024, identified a potential breach of its LLP agreement, breach of confidence, and breach of MSG's policies and procedures, recommending a further disciplinary hearing.
- Dr Rabey initiated a "Maintaining High Professional Standards" (MHPS) investigation into the Claimant's conduct in relation to the Massey letter and press coverage (the First MHPS Investigation). (MHPS refers to a NHS framework for formal investigations into concerns about medical practitioners. Materially the same process is adopted in Guernsey).
- The terms of reference for the First MHPS Investigation covered the alleged inaccuracy of the Massey letter, the alleged disclosure of confidential information about identifiable patients, and an allegation that the Claimant had not reported to the Medicine and Healthcare products Regulatory Agency, under its "Yellow Card" scheme, all the suspected adverse reactions to the Covid-19 vaccine that he claimed to have encountered.
- Vicky Turner, MSG's governance manager, was appointed as Case Investigator and she interviewed the Claimant in the course of her investigation. She produced a Case Investigator's Report on June 2024 which then formed the basis of Dr Rabey's Case Manager's Report dated 26 June 2024. His conclusions were as follows:
"Dr Patterson is found to have:
- Sent letters containing factual inaccuracies,
- Made no attempt to correct factual inaccuracies in published versions of his letter(s) despite being asked to do so.
This has allowed information which Dr Patterson knows to be inaccurate to remain in the public domain.
- Disclosed information which allowed the identification of patients, and made no attempt to correct this when asked to do so, despite acknowledging that he should have sought consent.
This has led to a formal complaint from a family who were upset by the identification of their loved one from local media reports of Dr Patterson's letters.
- Failed to report all cases using the Yellow Card Scheme, and not corrected this when requested.
In doing so he is in breach of GMC standards as set out in the TOR 1e and 3b."
- Dr Rabey noted some points made in mitigation by the Claimant but concluded that nevertheless his actions had fallen below the standard expected. He noted that:
"Dr Patterson has repeatedly failed to engage with attempts to point out inaccuracies or request to correct them. He did not take the opportunity to mask the identity of individuals in the information he made public, or to seek consent for publishing identifiable information. There is no evidence from the investigation to indicate that he will now seek to comply with further attempts to engage him in remedying the issues."
- Dr Rabey's recommendation was that the matter be referred into the MSG disciplinary process for consideration of disciplinary action. He also asked MSG to consider the fact that the Claimant has used a personal email address to make his MHRA reports (a matter not covered by the terms of reference for the First MHPS investigation).
- In the course of 2024, information emerged that, despite the undertaking and disciplinary findings in 2023, the Claimant had continued to act in breach of MSG's data protection policy. This was investigated by MSG's Dr Nicholas Crabtree, who produced a report dated 18 October 2024. He concluded that (i) the Claimant had continued to send "patient information and CT scans outside of the MSG for the purposes of Cari Heart analysis [a service offered by a private company call Caristo Diagnostics]" without MSG being aware; (ii) the Claimant had failed to complete a data protection impact assessment and there was no data processing agreement with Caristo in place. The Claimant had also admitted not completing mandatory data protection training despite being requested by MSG management to do so; (iii) the Claimant had received payment for this service directly or via Sellogic Ltd rather than via MSG. These findings were said to give rise to breaches of MSG's disciplinary and data protection policies, its code of conduct and the LLP Partnership agreement. Dr Crabtree recommended a further internal disciplinary process.
- Later in 2024 Dr Rabey requested, and the RCP agreed, to undertake an "invited review" of the Claimant's work. The terms of reference required the RCP to review the medical records of 31 patients who received care from the Claimant and whom the Claimant believed may have developed Covid vaccine-induced cardiac injuries. The 31 patients were selected from a spreadsheet of cases identified by the Claimant. The review team then met with the Claimant in January 2025 to discuss 11 of the cases. The review team observed that the Claimant was underprepared for this session and lacked insight into the situation which had led to the request for a review. They then provided "initial feedback" in February 2025. Also in February 2025, the Claimant ceased working for a time, citing burnout.
- The Claimant returned to work in August 2025 and submitted a document to the RCP taking issue with its initial feedback document.
- The RCP issued its final report in September 2025. In its "conclusions" section the report noted that 10 of the cases reviewed showed good practice overall; 15 were graded "room for improvement" and 4 were graded unsatisfactory overall. (I understand that there was insufficient data to make findings about the other 2 cases) The report commented "This meant that several aspects of clinical care were well below what the review team would have expected from themselves, their resident doctors and their institution". As to the Claimant's diagnosis of myocarditis and/or pericarditis, the report found that his diagnosis was definitively correct in only 2 cases (and the probable explanation in 4 more cases). As to the Claimant's contention about links between these serious conditions and the COVID-19 vaccination, the report found that there was only one clear and unambiguous example of acute myocarditis which had a temporal relationship with vaccination, and 2 further cases of probable pericarditis where there was a temporal relationship between the symptoms and vaccination.
- The RCP report then identified 12 "themes" that emerged from its review:
(1) misdiagnosis, said to be the result of "marked confirmation bias" in some cases, as where myocarditis/pericarditis were diagnosed with little or no supportive evidence and when this was a much less likely explanation than the presence of a common cardiac condition;
(2) mismanagement of common cardiac conditions (acute coronary syndromes not being treated in line with standard UK guidelines);
(3) failures to undertake necessary assessment and investigation (linked in some cases with the Claimant's confirmation bias such that his use of investigations appeared to be guided by his aim to find evidence to support his concerns about vaccine-induced injury);
(4) over-investigation (undertaking unnecessary or repetitive investigations, potentially causing patients unnecessary concern, and again linked to the Claimant's biased assumption that the patient had experienced a vaccine-induced cardiac injury
(5) misinterpretation of the results of investigations (again, influenced by the Claimant's preconceived views about vaccine-induced cardiac injury);
(6) lack of "MDT working" (i.e. a failure to seek external advice or opinion where the case would have benefited from a more pluralistic view);
(7) advice to patients not to have any further COVID-19 vaccinations, including patients in groups identified as being particularly vulnerable to the complications of COVID-19 infection. For the most part the reviewers considered that this was not in the patients' best interests and noted with concern that the Claimant had said that, with very few exceptions, he continues to advise patients against vaccination, because of his concern about vaccination safety, despite such advice being contrary to UK public health advice;
(8) unclear, and sometimes misleading, communications with patients and their GPs, including presenting investigation findings as supporting a vaccine-induced event when the investigation results did not provide that level of certainty;
(9) recommending "off-label" treatments without sufficient rationale, including unnecessary treatment schedules for non-cardiac chest-pain syndromes which the Claimant attributed to vaccine-induced myocardial injury;
(10) concerns about the use of conventional treatments which (sometimes linked to inaccurate diagnosis) was not in line with the European Society of Cardiology guidelines and which in some cases put patients at risk of harm;
(11) concerns about the model of the cardiology service in Guernsey given that it is led by the Claimant and one other consultant but the Claimant himself has not completed specialist cardiology training and is not registered as a cardiologist;
(12) the Claimant's public statements about COVID-19 vaccines which (based on the anomalies in his analysis of cases) may amount to misinformation to which added weight is attached by reason of his standing as a consultant physician
- On 22 September 2025 the Claimant was excluded (or as some of the contemporaneous documents put it, suspended) from MSG following a vote of the management board. The terms of exclusion included a prohibition on engaging in any medical practice or rendering any medical services, or engaging with patients, service users, employees, partners or stakeholders. As a result the Claimant lost his right to admit patients to the Princess Elizabeth Hospital, the only hospital in Guernsey.
- The RCP report caused the OCHC to instigate another MHPS investigation (the Second MHPS Investigation) in October 2025 with Dr Rabey as Case Manager and Dr Beck as Case Investigator. The terms of reference (ToR) for this investigation (following some small revisions) were as follows:
"TOR1) Considering the RCP letters, and final report: Has Dr Patterson's practice met the required standards in relation to:
a. Cardiology practice?
b. Advice given to patients regarding Covid-19 vaccination?
c. Off-licence prescribing?
d. Compliance with evidence-based guidelines and standards?
TOR 2) [omitted, as the Claimant was found to have no case to answer under this TOR]
TOR 3) Regarding 3rd party laboratory testing organised by Dr Patterson:
a. Were any medical investigations arranged by Dr Patterson for himself compliant with GMC guidelines?
b. Was all 3rd party testing arranged in compliance with MSG, HSC and GMC policy/guidelines on Laboratory testing, data protection and business arrangements.
c. For what purpose was this testing being performed?
d. Investigate if appropriate approval, patient consent and provision information to patients had been obtained for this testing.
TOR 4) Has Dr Patterson complied with the requirements of any previous investigations into his practice by MSG and /or HSC?"
- Before making his Case Investigator's report, Dr Beck discussed the matters subject to investigation at a meeting with the Claimant that lasted 2 ¼ hours. He also received and considered further information that the Claimant subsequently submitted by email.
- Based on Dr Beck's report, Dr Rabey made his Case Manager's Report in the Second MHPS Investigation in November 2025.
- In respect of TOR 1, Dr Rabey concluded that the Claimant had fallen below the required standards in that he had not updated and maintained the skills and qualifications for his role; had not adequately engaged with CPD related to non-COVID matters; had not completed any mandatory training in the last 5 years; did not provide appropriate evidence regarding COVID vaccination to patients, nor on social media; used off-licence drugs on the basis of a flawed assessment of evidence; frequently recommended treatments and management plans outside of established guidelines; and demonstrates bias against mainstream peer-reviewed literature, preferring alternative non-peer-reviewed sources. Dr Rabey also accepted the RCP investigators' conclusions about the Claimant's clinical shortcomings. Dr Rabey concluded that the findings under TOR 1 meant that the Claimant's practice was in breach of GMC Standards.
- In respect of TOR 3, Dr Rabey found, in summary, that the Claimant had sent blood samples of 19 patients to a laboratory in Germany (which purports to specialise in identifying evidence of vaccine components) for research purposes without complying with appropriate processes and data protection requirements (including failing to obtain informed consent from patients). He also held that the Claimant had given a false assurance to the Case Investigator that "no patient data was stored outside of MSG/Hospital systems at any time", because it subsequently emerged that he had forwarded patient data to his personal email address without protection or anonymisation. He said "This relates directly to Dr Patterson's probity". Again, Dr Rabey concluded that these findings meant that the Claimant had fallen below the standards expected and had practiced in breach of GMC standards.
- In respect of TOR 4 , Dr Rabey found that the Claimant had not complied with the requirements of previous investigations or disciplinary processes; that he had not demonstrated a willingness to change behaviours or to engage with and learn from previous investigations and disciplinary processes. Dr Rabey noted that, despite being advised, at the end of the December 2023 disciplinary process, to keep up to date with data protection and mandatory training, he had done no mandatory training since then, not even data protection training that he was instructed specifically to do. Dr Rabey also found that the Claimant had given inconsistent responses to different investigators about registration with the ODPA, such that, on the balance of probabilities, the Claimant had either given an incorrect account to one or more investigators or to the ODPA. Again, Dr Rabey concluded that these findings meant that the Claimant was in breach of GMC standards.
- On 11 December 2025 Dr Rabey made a referral to the GMC. He drew attention to the Claimant's social media activities, the Massie Letter and its uncorrected inaccuracies, the First MHPS Investigation, the RCP investigation, and the second MHPS Investigation. As to the Claimant's response to the concerns raised about him, Dr Rabey observed:
"There has been absolutely no insight demonstrated by the doctor. He has not engaged in any discussion about remediation. Our MHPS investigation found that hr has failed to maintain his skills and knowledge over recent years, and that this has not improved. He has not carried out any of the instructions or recommendations of previous disciplinary investigations … and has in fact done no mandatory training in the last 5 years … He has continued to prepare and post on social media about his findings of vaccine-induced cardiac damage. He does not accept any of the failings identified about his practice."
- Dr Rabey appended various documents including the Case Investigator and Case Manager Reports for both MHPS Investigations and the RCP report.
- As a consequence of Dr Rabey's referral, the GMC commenced an investigation into whether the Claimant [87]:
"- Made factually incorrect assertions in social media posts and in a letter to Charlie Massey, and failed to provide appropriate evidence of his statements.
- Failed to provide appropriate information to patients.
- Failed to keep medical knowledge, training and CPD up to date.
- Sent blood samples without following the appropriate process.
- Sent blood samples without obtaining informed consent.
- Sent patient data to his personal email.
- Falsely stated that no patient data was stored outside of MSG.
- Failed to comply with requirements of previous disciplinary actions.
- Dismissed common diagnoses in favour of unlikely ones.
- Holds a distinct bias which impacts patient care.
- Misinterpreted investigation results.
- Failed to treat patients in line with guidelines.
- Failed to undertake appropriate assessments and obtain relevant family history.
- Advised patients to not have further COVID vaccinations.
- Failed to provide appropriate information to patients' GPs.
- Recommended off-licence medication without rationale."
- In January 2026 MSG's disciplinary panel found that the Claimant had committed misconduct or gross misconduct and recommended that he be expelled from MSG. The Claimant appealed.
- On 3 February 2026 the Claimant was informed that his case had been referred to the IOT, following receipt of information from Dr Rabey. The letter annexed the referral decision of the GMC's case examiner which referenced the findings of the two MHPS investigations and the RCP investigation, listed the matters the GMC had decided to investigate, and explained why an interim order was being sought.
- On 19 February 2026, the Claimant produced a "reflective statement". In this, among other things, he acknowledged some of the RCP's criticisms including its references to confirmation bias (while maintaining that aspects of the RCP review were methodologically flawed). He referred to the relative isolation that consultants in the Guernsey system experience, meaning that they have less access to peer-review and second opinions. He referred to the pressures created by the COVID-19 pandemic and some significant personal mitigation (which I do not need to set out in this public judgment). He stated that he had ceased all social media activity in relation to COVID-19 vaccination and vaccine safety matters, recognising that "social media carries particular risks as a platform for raising clinical concerns, and that a senior consultant's public statements carry a weight and consequence that I did not adequately appreciate at the time". He said that he had now completed various training modules, and agreed to undergo a GMC performance assessment as a means of objectively evaluating his clinical competencies.
- The IOT hearing took place on 20 February 2026. The panel had before them Dr Rabey's referral letter to the GMC and the supporting documents he had sent, including both reports from each of the MHPS Investigations and the RCP Report. The panel also had a letter from the Claimant requesting deferral of the hearing, a letter from him titled "chronology of systematic obstruction and professional ostracization", his reflective statement, a number of testimonials from professional colleagues and patients, his CPD record and his clinical appraisal from 30 July 2024 (which did not identify any fitness to practice concerns and recorded the Claimant's stated wish to draw a line under vaccine matters and to refocus on routine cardiology).
- The Claimant was represented by counsel at the IOT hearing, as was the GMC. The GMC was seeking the imposition of conditions for a period of 18 months rather than suspension but did not specify what conditions would be appropriate. In answer to questions from the IOT, counsel for the GMC confirmed that its case was that the information before the tribunal raised concerns about the Claimant's probity as well as his clinical practice.
The IOT Decision
- The IOT began by setting out the whole of Dr Rabey's referral to the GMC, which I have summarised above. At [4]-[7] the IOT recited the material that had been placed before it and confirmed it had all been considered. At [8]-[20] the IOT recorded counsel's submissions. At [21]-[22] the IOT directed itself as to the correct legal approach in terms that the Claimant does not take issue with.
- At [23] the IOT said that "Taking into account the information before it today, the Tribunal considered that the level of seriousness is high. The Tribunal also considered the probity concerns and was satisfied, in all of the circumstances of this case, that there was a risk of repetition." . At [24] the IOT found that there were concerns regarding the Claimant's fitness to practise which indicated "there is a real and immediate risk to patient safety" such that an interim order was necessary for the protection of the public and was in the public interest. It reiterated at [29] that, in its view "there is a real risk to patient safety…and that a member of the public would be shocked and appalled to discover that Dr Patterson was allowed to continue to practise whilst the concerns are investigated".
- At [25] the IOT stated it had reached its conclusion after balancing the risks to the protection of the public and the public interest against the adverse consequences for the Claimant, and repeated again at [29] that it was satisfied its order was a proportionate response.
- The Tribunal identified a number of features that, in its view, justified its decision. Thus, it considered that the Claimant's behaviour was "persistent and repeated over a significant period of time" , that "his poor performance was directed to patients who were potentially vulnerable and included the suggestion that patients should not have the Covid vaccine" and that his behaviour was "premeditated in holding the view that he did and an abuse of his professional position" [26]. Further it held that "there was information to suggest a reckless disregard for patient safety and professional standards" and that the Claimant "appears to have failed to heed advice from his professional colleagues which also undermined collaborative working., putting his own interests about those of other patients" [27], and further still that much of Dr Patterson's CPD was completed immediately prior to this hearing which may indicate limited insight".
- In reaching its findings, the IOT said that it had "placed great weight on the reports from MHPS investigation [sic] and the Royal College of Physicians" [29].
- As to the choice between conditions and suspension, the IOT said "there was sufficient information before it to satisfy that it could not formulate conditions which would adequately address the risks identify [sic]" [29].
- As to the length of suspension (which was less than the period for which the GMC was seeking conditions), the IOT said that it "noted the time required for Dr Patterson agreed [sic] to undergo a performance assessment. However, it also bore in mind that the GMC already has the reports from the HMPS Investigation and the Royal College of Physicians" [30].
Events and evidence post-dating the IOT decision
- The Claimant's appeal against MSG's disciplinary panel decision recommending his expulsion was heard on 23 February 2026 and the result was communicated to him on 13 March 2026. His appeal was unsuccessful and I understand that he has now been expelled. Some details about the appeal can be gleaned from a "Responding to Fitness to Practise Concerns" form filled in by MSG in March 2026. This includes comments that the Claimant "has demonstrated little insight during the process, and has not engaged with previous discussions around remediation" and that during the disciplinary appeal hearing he repeatedly claimed that "due to his concerns about patient safety, he felt that his actions were justified and excused the breaches of the LLP agreement, LLP policies or procedures, and applicable professional standards. It is my view that Dr Patterson did not fully understand or recognise the concerns relating to his conduct…".
- The Claimant also produced, in February 2026, a revised version of the objections he had made to the RCP in August 2025 entitled "RCP Review: Critical Analysis of Factual Errors, Methodological Failures and Systematic diagnostic Minimisation", the executive summary of which seeks to discredit the RCP report on the basis that it contains 7 identified flaws, each of them said to be matters of verifiable fact, not clinical opinion. The Claimant also provided detailed notes on the cases that the RCP had looked at, defending his analysis and treatment, sometimes footnoting large numbers of academic articles said to support his approach.
- The amount of material available to me greatly exceeded what had been before the IOT. The bundle had grown to some 2500 pages.
Legal principles
The statutory scheme and the role of the IOT
- The main objective of the GMC, in exercising its functions, is to "protect, promote and maintain the health and safety of the public": Medical Act 1983 s1(1A) (the 1983 Act).
- Under s35C of the 1983 Act, the GMC is tasked with investigating allegations that a registered practitioner's fitness to practise is impaired ("fitness to practise" is exhaustively defined and includes misconduct and deficient professional performance).
- The procedure governing the investigation of fitness to practise allegations is provided for by the General Medical Council (Fitness to Practise Rules 2004 (the FTP Rules). They provide that "If, at any stage, the Registrar is of the opinion that an Interim Orders Panel should consider making an interim order in relation to a practitioner, he shall refer the allegation to an Interim Orders Panel accordingly": FTP Rule 6.
- The GMC has produced non-statutory guidance entitled "Decisions on interim orders (Doctors)" (June 2025: the GMC Guidance). At [10] the GMC Guidance confirms that a referral to the IOT can be made at any time after the GMC has opened an investigation and adds that "It is important cases are referred as soon as possible after information becomes available that an interim order may be needed".
- Prior to an IOT hearing, the Registrar must (among other things) set out the reasons why it is necessary to make an interim order and provide a copy of any written evidence obtained by the GMC which is relevant to the question of whether or not an interim order should be made: FTP Rule 26. FTP Rules 26 and 27 also include further requirements as to the notice that must be given to a practitioner about an IOT hearing and the conduct of the hearing.
- The IOT's powers are set out in s41A(1) of the 1983 Act:
(1) Where an Interim Orders Tribunal …are satisfied that it is necessary for the protection of members of the public or is otherwise in the public interest, or is in the interests of a fully registered person, for the registration of that person to be suspended or to be made subject to conditions, the Tribunal may make an order—
(a) that his registration in the register shall be suspended (that is to say, shall not have effect) during such period not exceeding eighteen months as may be specified in the order (an "interim suspension order"); or
(b) that his registration shall be conditional on his compliance, during such period not exceeding eighteen months as may be specified in the order, with such requirements so specified as the Tribunal think fit to impose (an "order for interim conditional registration").
- Thus, there are 3 alternative bases on which the IOT can exercise its discretion to impose an interim order (the third of which is irrelevant to this case). As to the second basis ("otherwise in the public interest"), there is no strict test of necessity, but the interim order must at least be desirable in the public interest and there must be careful consideration of the proportionality of making an order on this basis: see e.g. Sandler v GMC [2010] EWHC 1029 (Admin) at [14] (Nicol J).
- An interim order (which can only be made for a maximum of 18 months) must be reviewed at intervals of no more than 6 months and, on review, the IOT may revoke an order or change it from a suspension order to an order for interim conditional registration or vice versa: s41A(2)-(3).
- There is non-statutory guidance by the Medical Practitioners Tribunal Service (in force since 24 November 2025: the MPTS Guidance) which sets out a structured approach that the IOT should take in its decision-making. Thus, at "Step 1a" the IOT should asses the risk arising from the information that has been placed before it (considering the seriousness of the concern/allegation, the likelihood of repetition, and the weight of the available information); at "Step 1b" the IOT should consider if it is necessary to restrict the doctor's registration (by reference to the 3 statutory bases in s41A); at "Step 2a" the IOT should consider whether the order should be for suspension or the imposition of conditions; and at "Step 2b" the IOT should consider the period for which it is proportionate to impose an order. Interim conditions, the MPTS Guidance states, should usually be drawn from the "interim conditions bank", which sets out the available conditions, divided between "standard" and "discretionary" interim conditions. There is specific guidance on cases involving dishonesty, where it is said (at [106] that "Given the impact these cases will usually have on public confidence, where an interim order is necessary, the risk to the public interest is likely to require consideration to be given to an interim order of suspension". There is also specific guidance for cases that concern a doctor's exercise of their right to freedom of expression under ECHR Art 10.
- The following points about the approach required of the IOT emerge from the authorities:
(1) The IOT is not engaged in making findings of fact: R(Ali) v General Medical Council [2008] EWHC 1630 (Admin) at [35] & [38]. Its role is to conduct a risk assessment, considering whether the information before it discloses a real risk to patient safety or the public interest (or the doctor's own interests) that is sufficient to require an interim order: Howells v General Medical Council [2015] EWHC 348 (Admin) at [36]-[37] & [48] (Laing J);
(2) It follows that, while the IOT will need to be satisfied that the information before it raises at least a prima facie case of impaired fitness to practise, it is not required to investigate the facts further. As Underhill J put it I Kumar v General Medical Council [2013] EWHC 452 (Admin) at [27], the IOT's role:
"… is not to undertake the definitive examination of the allegations against the doctor or to decide on the fairness of the investigation. The Panel can at most satisfy itself that there is a prima facie case that the allegations are well-founded. To use the phrase quoted by the applicant himself, ie that the "may" be impairment of a practitioner's fitness to practise", I accept that consideration of that question may in an appropriate case, involve some consideration of the investigative process that underlies the allegations made; but again it is only in a plain case that the IOP could find that there had been unfairness such as to undermine any even prima facie case. If that threshold is met, the definitive decision on the issue of competence, including so far as appropriate the fairness of the investigation, is for the Fitness to Practise Panel…"
(3) When considering the risk to the public interest, it is legitimate for the IOT to ask whether "a fair minded member of the public appraised of the facts would be offended by the Applicant continuing to practise pending a full hearing fixed for resolution of the allegations at which he will have an opportunity to defend himself and his professional body will determine the appropriate sanction in respect of any fitness to practise allegations that may ultimately be found proved": MXM v General Medical Council [2022] EWHC 817 (Admin) at [93] (Steyn J);
(4) Proportionality needs to be considered both when considering whether to make any interim order and again, if so, in what terms: MXM at [24]. The potentially serious impact of even an interim order on a practitioner has been noted (ibid at [25]-[26]) but, ultimately, "[t]he best that can be done is for the body making the interim decision to do its best to hold the balance fairly" : Kumar at [39] and "…in this statutory scheme the impact on the practitioner is not the IOP's primary consideration. Its main considerations are risk to patients and the public interest": Howells at [59];
(5) The IOT may make an interim suspension order even where the GMC itself was contending only for the imposition of conditions. Whether to suspend rather than impose conditions is "quintessentially a matter for the IOP's own expert judgment" : Abdullah v General Medical Council [2012] EWHC 2506 at [106] (Lindblom J);
(6) The IOT must give reasons for its decision but the reasons need not be particularly lengthy or detailed: "What the IOP had to do – no more and no less – was to explain why their decision was the one they had announced. In most cases…this can be done briefly…Reasons were required but not reasons for reasons" : Abdullah at [102].
The role of the Court
- A decision of the IOT may be challenged in the High Court (s40 of the 1983 Act). S41A(10) provides that, on such an appeal:
"… the relevant court may—
(a) in the case of an interim suspension order, terminate the suspension;
(b) in the case of an order for interim conditional registration, revoke or vary any condition imposed by the order;
(c) in either case, substitute for the period specified in the order (or in the order extending it) some other period which could have been specified in the order when it was made (or in the order extending it),
and the decision of the relevant court under any application under this subsection shall be final."
- When hearing such an application, the Court is not limited to reviewing the IOT's decision on public law grounds. It can terminate the suspension if (but only if) it considers the IOT's decision is "wrong": Sandler at [12].
- Mr Kosmin for the GMC referred me to what was said by the Privy Council in Vale v General Dental Council (unreported, 14 October 1988), which was then the relevant court for appeals from the medical regulators, and which was subsequently endorsed by a divisional court in X v General Medical Council [2001] EWHC 447 (Admin):
"It is vital to acknowledge in matters of this kind that a committee as such as that under review here reaches its decision in circumstances such as concern us as a matter of discretion. Therefore it must be recognised that unless it can be demonstrated that in exercising the discretion the committee has not taken account of something it should have done, or has taken account of something it ought not to have done, it is unlikely that this Court would be in a position to say that the order of the committee appealed against was wrong unless it concluded that otherwise the decision was manifestly wrong".
- Mr Hoar, for the Claimant, pointed out (citing Agoe v General Medical Council [2020] EWHC 39 (Admin), Julian Knowles J) that subsequent cases have not used the term "manifestly wrong" but simply ask whether the decision under challenge was "wrong".
- Despite the occasional difference in language, I do not detect any difference in substance in the case law as to the approach this Court should take. In all the cases cited to me, the point being made was that, although this Court is exercising an original jurisdiction, it must nevertheless show a significant (though variable) degree of deference to the decision of the IOT. That is for at least two reasons. First, under the statutory scheme, it is the IOT, not the Court, which is the primary decision maker. The Court does not start with a blank canvas, rather (as Nicol J put it in Sandler at [12]), "My consideration of the application must surely start from the position that the IOP has thought that interim suspension is the right course". Second, the IOT is an expert body, composed of a legally qualified chair, a medical member and a lay member. It has expertise and experience that this Court cannot replicate. The degree of deference due on this second ground will be case-specific. This Court may be surer of its own views when assessing allegations of non-clinical misconduct which is said to undermine public confidence in the medical profession (as arose in MXM) but much less equipped to do so when assessing how serious allegations of clinical malpractice are and the level of risk the alleged clinical conduct might be said to pose to patients.
- A number of further pertinent points arise from the authorities on the question of the Court's approach:
(1) Inadequacy of reasoning on the part of the IOT "does not itself provide a ground for terminating an order of suspension. But if the reasoning is inadequate or opaque the weight to be attached to the professional opinion of the Panel will be diminished…": Harry v General Medical council [2012] EWHC 2762 (QB) at [2] (Burnett J);
(2) The Court may have regard to subsequent developments and (where appropriate) fresh evidence when considering whether the continuation of the interim order is wrong: Sandler at [12]; Anyam-Osigwe at [15] and MXM at [37];
(3) The Court does not have the same power as the IOT to replace an interim suspension order with an order imposing conditions on practice. If satisfied that a decision to impose an interim suspension for the specified period was "wrong", the Court is bound to terminate it or (as the case may be) shorten it: see MXM at [38]. Such an outcome may be something of a windfall to a practitioner who (as here) has accepted all along that the imposition of certain conditions on his practice would be proportionate. The GMC's remedy in such circumstances is to apply for a new interim order: MXM at [95].
The parties' cases in outline
- The Claimant admits that he sent patient samples for research without following appropriate procedure and sent information to a personal email address. He says that, when properly understood and contextualised, these allegations merited no more than the imposition of conditions by the IOT. In all other respects, the Claimant disputes the allegations against him and contends that the IOT decision was wrong (including because it is disproportionate). He says that the IOT's reasoning is so meagre that I should place no weight on it and decide for myself whether their decision was wrong. He stresses that he has acted throughout from genuine concerns about patient safety which are based on a view which, while unorthodox, is nevertheless reasonable and respectable and that this, along with the very detailed criticisms he has made of the methodology and conclusions of the RCP report, argues in favour of allowing him to maintain his practice while the GMC investigate. He stresses that none of his patients have complained about him and there are no findings that any patients have come to harm because of his approach. He urges me to disregard findings against him made by MSG which are based only on breaches of the LLP agreement and do no not concern patient safety or public confidence. The Claimant has set out his specific criticisms of the decision under 11 "grounds" which I address below.
- The GMC say that the IOT's decision is appropriately reasoned and that I should uphold it. They say that, by bringing such a detailed and document-heavy challenge to the methodology and conclusions of the various reports that were before the IOC, the Claimant is inappropriately asking this Court to resolve matters that may require determination at a final fitness to practise hearing but which are not capable of undermining the IOT's risk assessment, which it carried out correctly on the material before it. The GMC submit that, if anything, the risk is even more clearly demonstrated by the materials now before me but which the IOT had not seen. The GMC contest each of the 11 grounds.
Discussion and conclusion
- I begin by addressing each of the Claimant's grounds.
Ground 1: [The IOT] proceeded to consider findings in the Terms of Reference by Dr Rabey of December 2025…, the only structured account of the allegations of misconduct being investigated by the GMC, that were unparticularised and, in a breach of Dr Patterson's right to natural justice, did not permit him to know the case against him
- This criticism is not well-founded. It is well established in public law that questions of procedural fairness are highly context-dependent. Here the relevant context is that: (1) a referral to the IOT can be made at any time after an investigation is opened and the GMC guidance recommends that cases are referred as soon as possible after information becomes available that indicates that an interim order may be needed; (2) the IOT does not make specific (or any) findings of fact, it is engaged in a risk assessment; (3) the IOT is empowered only to make interim orders, for a limited duration, and subject to periodic review; (4) none of the FTP Rules, the GMC Guidance or the MPTS Guidance require the practitioner to be served with particularised "charges" or similar.
- These factors all indicate that it is inappropriate to expect the GMC to formulate a case before the IOT with the same level of particularity as may be required, for example, when seeking a definitive determination of a doctor's fitness to practise. In particular, the requirement for a speedy referral means that the IOT may have to consider a case before the GMC has been able to define with any precision the scope of its investigation.
- The degree of notice given to the Claimant in this case amply satisfies the requirement of procedural fairness in the circumstances. He was notified of the decision to make a referral to the IOT on 3 February 2026. In that communication, the GMC set out the 16 matters that it was investigating and made clear that each of these arose from the findings that had been made in the 2 MHPS investigations and the RCP investigation (all of which are clearly stated).
- It is unsurprising, therefore, that no complaint of procedural unfairness was made to the IOT itself and (as the transcript shows) the Claimant's counsel was fully able to engage with the case being made against him.
Ground 2: [the IOT] failed, in its Determination, to consider the misconduct alleged in the TOR Findings by reference to each finding and so failed to evaluate the seriousness of Dr Patterson's alleged misconduct by reference to the same
- I also reject this ground. The Claimant again confuses, in my judgement, the function of the IOT with the function of a disciplinary tribunal making definitive findings as to a doctor's fitness to practice. The IOT's task, as explained in the case law and guidance I have cited, was to consider whether there was a prima facie case of impairment, to consider whether the alleged impairment gave rise to a risk to patient safety or the public interest and then to decide, in all the circumstances, whether an interim order was needed in order to guard against those risks pending investigation.
- Step 1a in the MPTS Guidance required the IOT to consider "the seriousness of the concern or allegation" but I do not accept that this required the IOT to make discrete findings on each of the 16 allegations the GMC had listed. Whatever might be said about the gravity of some of the allegations, the IOT had before it the RCP Report which included findings that the Claimant had provided advice and treatment that put patients at risk of harm and about which he was unrepentant. Those matters alone justified the IOT's conclusion that "the level of seriousness is high" and that there was a "real and immediate risk to patient safety". In the circumstances, I cannot say that the IOT's decision was wrong simply because it did not set out individual findings about the seriousness of each allegation, nor that the seriousness of the concerns overall fell below the point at which an interim suspension order could be justified.
Ground 3: [The IOT] failed to consider whether the Claimant had a real prospect of establishing that the treatment/advice he gave was supported by a reasonable body of medical opinion as he asserted it to be;
Ground 4: [The IOT] imposed an interim order on grounds of findings of poor treatment without determining whether the Claimant had a real prospect of establishing that the treatment/advice he gave was supported by a reasonable body of medical opinion
- I can take these two grounds together, as did the parties in their submissions. As the drafting of the grounds suggests, what the Claimant was seeking to invoke here is the well-known principle from medical negligence cases that treatment (and by extension, advice) should not be regarded as negligent if it accords with a reasonable body of medical opinion (Bolam v Friern Hospital Management Committee [1957] 1 WLR 583 as refined in Bolitho v City and Hackney Health Authority [1998] AC 232). He submitted (without dissent from the GMC) that the same approach would be required when assessing whether a doctor's fitness to practise was impaired.
- The submission made in Mr Hoar's skeleton was that "Where a practitioner relies on a body of medical opinion to support his advice or treatment, the Tribunal (at an interim stage) must consider at least whether he has a real prospect of establishing that such a body of medical opinion relating to that issue exists and is not illogical". That is not a submission that was made before the IOT and it appears to lack any supporting authority. It is in tension with the principle, stated e.g. in Kumar that the IOT is not required to investigate the merits of the allegations beyond considering whether there is a prima facie case.
- In oral submissions Mr Hoar advanced his case in more muted terms: he submitted that, where the allegation is one of poor patient care as to which opinions may differ (rather than an obvious piece of negligent conduct such as removing the wrong organ in surgery) and where the doctor has put forward an explanation for how he acted, that is something that should be borne in mind when assessing the proportionality of an interim order. He points out that, in this case, the Claimant has provided a detailed critique of the RCP's assessment of his clinical judgements, including by reference to academic articles.
- I accept that it is open to the Claimant to dispute the determination in the more muted terms of Mr Hoar's oral submissions, but I do not think it takes him anywhere. One of the things the IOT had to consider was the quality of the information before it (see the MPTS Guidance Step 1a and [27]: "the tribunal may consider it is appropriate to give greater weight to objective evidence that's available, such as the outcome of an assessment of the doctor's performance"). The IOT clearly found that the RCP Report and the MHPS investigation reports were authoritative and persuasive. The IOT did not have before it the detailed rebuttals that the Claimant has now provided but - lacking the specialist expertise of the IOT – I cannot possibly conclude that the materials now placed before me show that the IOT was "wrong" to attach the weight that it did to the various critical reports it considered. That is a matter that can be considered by the IOT itself upon the six-monthly review of the Claimant's suspension. The most I can say, given the deference that the law requires on such matters, is that this case is different from others in that the Claimant is vociferously contesting the evidence against him and that it concerns (in part) questions of clinical judgement which may be contestable rather than plain and obvious malpractice. None of that allows me to find that the IOT's decision was "wrong".
Ground 5: [The IOT failed] to direct itself about the test that should be applied when determining whether an order should be imposed that interfered with the Claimant's right to freedom of expression under art.10 ECHR, which the IOT (as a public body) had a duty not to interfere with disproportionately pursuant to ss.6 and 12 HRA;
Ground 6: [The IOT] imposed an interim order on the grounds of the Claimant's exercise of his freedom of expression without making findings capable of satisfying the high threshold before such an order could be imposed at an interim stage
- Again, I can address these grounds together, as did the parties.
- I agree with the Claimant that the interim order for suspension amounts to an interference with his right to freedom of expression under ECHR Art 10(1). That is because it was imposed, in part, because of how he had expressed himself on social media and in the Massey Letter. It does not matter that the interim order did not itself prohibit the Claimant from expressing himself going forward. See by analogy the situation in which a court orders the payment of damages and costs for the publication of a libel. That is recognised as amounting to an interference with the defendant's ECHR Art 10 rights that requires justification even if no injunctive relief is granted.
- It follows that it is for me (and not the IOT) to decide whether the interference was prescribed by law, pursued one of the legitimate aims identified in Art 10(2) and was "necessary in a democratic society" (i.e. proportionate).
- The imposition of an interim order was clearly "prescribed by law" in the Convention sense (see the parts of the 1983 Act I have referred to above) and pursued the legitimate aims of public safety and protecting health (both expressly recognised in Art 10(2)).
- As to proportionality: doctors, like anyone else, have a right to express their views and their right to do so on topics falling within their area of expertise may well attract particularly strong weight in the proportionality balancing exercise. In the present case, there are three reasons why the Claimant's article 10 rights carry limited weight. First, in his Reflective Statement, he appears to accept that his use of social media to discuss his concerns about vaccine safety was inappropriate; second, there is the significant concern (not yet adjudicated upon in these proceedings but based on the findings of the MHPS Reports and RCP Report) that the Massey Letter may have been inaccurate and misleading; third, the Claimant accepts that he publicised information about at least one identifiable patient, causing their family distress. Moreover the interim suspension order does not prevent the Claimant from publicising his views.
- Ultimately however, it does not matter whether the interim suspension order could be justified as a proportionate sanction for the Claimant's social media activity (etc) alone, because there was clearly other evidence that justified the suspension, most notably the conclusions in the RCP report that the Claimant's clinical practice compromised patient safety and the fact that the Claimant had continued to dissuade patients from taking vaccines when this was contrary to their best interests.
- For these reasons, the ECHR article 10 challenge to the IOT's determination fails.
Ground 7: [The IOT] failed to take any, alternatively any adequate, account of the fact that the Claimant was setting out facts as a 'whistleblower' in what would have been protected disclosures were those facts to have been revealed to an employer
- I pressed Mr Hoar to identify the specific activities of the Claimant which, on his case, ought to have been regarded as something akin to whistleblowing and which had contributed to the IOT's determination that he should be suspended from practice. Mr Hoar's answer was that the Massey Letter (and only the Massey Letter) fell into this category.
- The Massey Letter was clearly not a "protected disclosure" under the Employment Rights Act 1996 and there is recent case law (R (Gould) v Devon County Council [2026] EWCA Civ 687) affirming that a decision maker is not required to take into account a statutory scheme that is not engaged and will only breach public law requirements if the statutory provisions were "obviously material" to the decision under challenge.
- In my judgement, the protected disclosure regime in employment legislation was not obviously material to the determination the IOT was required to make. The GMC is not analogous to an employer of the Claimant and, in any event, the Claimant publicised the Massey Letter widely (including to the Guernsey Press). The IOT did not fall into error by failing to consider the Massey Letter as akin to a protected disclosure.
- The point that can be made in the Claimant's favour is that, in writing the Massey Letter (and in his practice generally) he was motivated by a genuinely held concern about patient safety. This was not disputed and the IOT were aware of it (the Claimant's counsel stressed it repeatedly at the IOT hearing). It does not render the decision wrong however: a well-intentioned but misguided practitioner (which is how the RCP assessed the Claimant) can pose just as much risk to patient safety and public confidence as one who is malign or incompetent.
Ground 8: [The IOT] relied on findings by Dr Rabey that Dr Patterson had failed to obtain patients' consent to using their blood samples in research that were flawed in circumstances where Dr Rabey had failed to inquire with those patients whether oral permission had been sought
- This needs some unpacking. It is common ground that the Claimant sent the blood samples of 19 patients to a German laboratory called Inmodia and that he did not have their written consent to do so. He admits that this was for research purposes and not (or not exclusively) for the purpose of diagnosing and treating the patients concerned.
- As part of the Second MHPS Investigation, Dr Beck examined the records of the affected patients and found evidence in 6 of those cases that the patient had given verbal consent. In the other cases, he found, there was either no evidence or the position was unclear. Where verbal consent could be demonstrated, Dr Beck nevertheless noted that, "there was no documentation to suggest that the patients were aware the test was only approved for research purposes or was 'experimental'. There was also no evidence that the test results may be used in research. I would therefore consider the consent process invalid for all patients as relevant information was not disclosed."
- Dr Rabey then wrote, in his Case Manager's Report in the Second MHPS Investigation:
Patients were not given appropriate information about the purpose and use of their samples, nor that the test was only approved for research purposes or was 'experimental'. Informed consent from patients was not obtained for either research or clinical diagnostic purposes. The samples / results may yet be used by the company in future research without appropriate consent having been obtained. In short, Dr Patterson did not comply with relevant processes and policies, nor data protection requirements.
- The Claimant's position is that all necessary patient consents were obtained and that his only shortcoming was his failure to obtain this in writing.
- The Claimant appears to be right to say that neither Dr Beck nor Dr Rabey actually approached the patients concerned to check whether they gave oral consent and if so on the basis of what information. However, it does not follow, as the Claimant submits, that the IOT should have disregarded Dr Rabey's finding that informed consent was not obtained. Perhaps that finding will prove to be incorrect if it is pursued at a fitness to practise hearing but the IOT was at least entitled to consider that the matters identified by Dr Beck raised a prima facie case that appropriate and valid consent had not been secured, and to take that into account when undertaking its risk assessment.
Ground 9: Save through a reference to testimonials from Dr Patterson's professional colleagues and patients …and to his (then) counsel's description of him as 'an experienced, highly regarded doctor dedicated to patient safety', [ the IOT] failed to acknowledge his positive good character or direct itself as to how it should take that into account
- The Claimant's previous good character was known to the IOT and the IOT was presented with testimonials from the Claimant's patients and professional colleagues. The submission that this was overlooked or given insufficient weight by the IOT is hopeless. The transcript shows that the Claimant's counsel placed heavy reliance on these matters in argument and they are expressly acknowledged in the Determination. They are clearly not decisive. As Underhill J said in Kumar at [25] (in response to a similarly impressive set of testimonials), "I have no reason, from what I have seen, to doubt that the testimonials in question represent the genuinely held views of those expressing them, but the fact that a doctor has on many occasions been competent and made a good impression on colleagues and patients is not unfortunately inconsistent with his having performed below a level of competence on other occasions".
Ground 10: [The IOT] failed, in the premises, to impose an interim order that was proportionate
- The Claimant accepts that an order for interim conditional registration would have been proportionate. The choice between conditions and suspension is, as I have set out above, "quintessentially" a matter for the IOT and one which this Court should be slow to interfere with.
- In this case, there was ample material before the IOT to support its conclusion that there was no workable regime of conditions that could adequately address the identified risks. In particular, the RCP Report indicated that the Claimant's biases were affecting all areas of his clinical practice, making it difficult to manage the risks by (e.g.) greater supervision or requiring him to refrain from certain activities. Furthermore there was material that seriously calls into question whether the Claimant would adhere to conditions if any could be devised: see in particular the conclusions of Dr Rabey in the Second MHPS Report concerning the Claimant's lack of insight, lack of probity and his lack of "willingness to change behaviours or to engage with and learn from previous investigations and disciplinary processes" (paras 29 and 30 above). Those concerns are now further underlined by the contents of the "Responding to Fitness to Practice Concerns" form completed by MSG in March 2026 and commenting on the Claimant's conduct during the MSG disciplinary process (para 46 above).
- I did not understand Mr Hoar to be bringing a separate proportionality challenge on the basis of the length of the suspension but, on this too, I would defer to the expertise of the Tribunal, who know how long a GMC investigation of the sort contemplated here is likely to take, and who gave their reasons for settling on a 12-month period.
Ground 11: [The IOT] made findings so devoid of analysis and lacking in detail and including findings (including recklessness) for where was no evidence that the Court should conclude they may have been biased against the Claimant
- Mr Hoar did not place reliance on this ground in his oral submissions and rightly so. Circumstances in which the legal test for apparent bias is satisfied purely on the basis of the way in which a tribunal has expressed itself in a determination will be few and far between. Here the IOT's sometimes robust criticisms of the Claimant were clearly grounded in the material placed before it and no fair-minded and informed observer would conclude that there was a real possibility that the tribunal was biased.
Standing back
- Mr Hoar was keen that, when working through his 11 grounds of appeal, I should not lose sight of the wood for the trees. I have therefore stood back and considered the IOT determination in the round.
- Even looking at the determination holistically, I am unable to conclude that it was wrong. The reasoning is short, but it is clear that the Tribunal has gone through the steps set out in the MPTS Guidance and why it has reached the conclusions it did. The allegations (which include acts and advice that are identified as compromising patient safety) are clearly serious. In his reflective statement, the Claimant definitively commits to staying off social media, but there are no similar unequivocal statements about making changes to his practice and there is a wealth of evidence indicating that he remains wedded to the beliefs which (in the RCP's view) caused him to practise in the risky manner alleged. There is clearly therefore a likelihood that he will repeat some or all of the impugned conduct. As to "the weight of the information available", the Tribunal had before it apparently credible, authoritative and detailed reports from three separate investigations based on document reviews and interviews with the Claimant himself. The sort of detailed critique to which the Claimant subjected these reports in the course of argument may assist him before a tribunal tasked with assessing whether the authors' conclusions are well-founded but they have no real purchase in the context of the risk assessment the IOT was required to undertake. None of them could be said to be knockout points which so undermine the reliability of the reports as to call into question the Tribunal's assessment of the risk.
- Having clearly assessed the risk in the structured way required by the MPTS Guidance and reached tenable conclusions about it, it was clearly also open to the Tribunal to conclude that it was necessary to restrict the Claimant's registration. I have already explained why its views that only suspension would suffice, and for 12 months, should be respected.
Conclusion
- For these reasons, the IOT's determination was not wrong and I decline to interfere with it. The Claimant will have an opportunity to seek to persuade the Tribunal to revise its views at the first review hearing in August 2026. Like the IOT itself, I have not made any findings of fact about the Claimant's fitness to practise. Although it has been necessary to set out the history at some length, it should be remembered that, for the purposes of the GMC investigation, the matters mentioned remain unproven allegations.
