High Court grants Medical Council's s. 60 application to suspend a doctor's registration due to public safety risks.

THE HIGH COURT

[APPROVED] [2025] IEHC 390

[REDACTED] 2025 85 MCA

IN THE MATTER OF SECTION 60 OF THE MEDICAL PRACTITIONERS

ACT 2007

AND IN THE MATTER OF A REGISTERED MEDICAL PRACTITIONER

AND ON THE APPLICATION OF THE MEDICAL COUNCIL

BETWEEN

THE MEDICAL COUNCIL

APPLICANT

AND

PQ (A MEDICAL PRACTITIONER)

RESPONDENT

JUDGMENT of Mr. Justice David Barniville, President of the High Court, delivered on the 10th day of July 2025 Index

1. Introduction………………………………………………………………….…......3

2. Overview……………………………………………………………………….…...3

3. Summary of Decision on Application…………………………………….…….....5

4. Factual Background and History……………………………………….…….......6

5. Council’s Meeting of 12 February 2025………………………………………....11

6. The Council’s Section 60 Application…………………………………………...15

7. Professor G’s Report………………………………………………………….…..21

8. Further Evidence in advance of Hearing………………………………………..23

9. The Hearing……………………………………………………………………….25

10. Section 60 of the 2007 Act………………………………………………….…...30

11. Summary of Applicable Legal Principles……………………………………...31

12. Decision on the Application………………………………………………….....34

13. Summary of Conclusions…………………………………………………….…42

1. Introduction

1. This is my judgment on an application brought by the Medical Council (the “Council”) for various orders in relation to the Respondent, a registered medical practitioner, pursuant to s. 60 of the Medical Practitioners Act, 2007 (as amended) (the “2007 Act”). The orders sought include orders directing that the Respondent’s registration in the Register of Medical Practitioners (the “Register”) be suspended and an order prohibiting the Respondent from engaging in the practice of medicine pending the completion of the fitness to practise procedures under the 2007 Act or until further order, as well as other consequential orders permitting the Council to provide a copy of the order to various persons and bodies, to respond to any query in relation to the Respondent’s registration status and reflecting any order made by the Court on the Council’s public facing Register.

2. Overview

2. The Respondent is a general practitioner and is registered in the General Division of the Register. Having qualified in Pakistan, the Respondent has been practising medicine in Ireland for about 35 years. The Council decided that it was necessary to bring this application following receipt of a communication in December 2024 from the directors of an out-of-hours general practitioner service in the Leinster area (the “Service”), for which the Respondent was working for a number of years until October 2024, arising from the Respondent’s unusual behaviour and complaints about his clinical practice, as well as concerns for his medical health. The Council decided to become the complainant in the matter and, separately, gave consideration to whether an application under s. 60 of the 2007 Act should be brought in relation to the Respondent.

The Council decided to bring this application at a meeting on 12 February 2025 and did so on 19 February 2025.

3. The Council’s application was adjourned on a number of occasions to allow the exchange of affidavits and the Respondent gave comprehensive undertakings to the Court not to practise for the periods of the various adjournments, both while he was legally represented and after he discharged his legal representatives.

4. While the Council’s application was pending before the Court, the Council arranged for the Respondent to be assessed by a consultant psychiatrist, Professor G. Professor G assessed the Respondent on 16 April 2025 and reported that, in his opinion, the Respondent has a “relevant medical disability”, being a “persistent delusional disorder of persecutory type”. While Professor G expressed the opinion that the Respondent’s medical disability had not, up to the date of his assessment, affected the Respondent’s fitness for work and that he should be permitted to continue his work as a medical practitioner, he recommended that, since delusional disorder is a condition which is “often characterised by poor insight, with the possibility of poor adherence to suggested treatment”, it should be a condition of the Respondent’s ongoing registration that he engage with a “supportive health service such as Practitioner Health” and that he should be referred to the Council’s Health Committee so that he could receive “appropriate help and support… with his current health issues”.

5. The Respondent does not accept Professor G’s opinion and recommendation and has contended that the assessment, and Professor G’s opinion and conclusions, were all arranged by a female “Garda detective” who has been keeping him under surveillance since 2010 and who he claimed was in Professor G’s office and met the Professor before the Respondent’s appointment. Professor G confirmed to the Council that he did not meet with a Garda detective before meeting with the Respondent.

6. At the hearing on 26 June 2025, the Council proffered a list of undertakings which should be given by the Respondent or conditions which should be attached to his registration, which the Council considered would be appropriate in the event that the Court was not disposed to grant the s. 60 orders sought. The Respondent strenuously opposed the imposition of those conditions and refused to give any undertakings. He did, however, agree to continue the undertakings he had previously given to enable the Court to give its judgment on the application (which it was estimated would take about two weeks from the date of the hearing on 26 June 2025).

3. Summary of Decision on Application

7. Having considered all of the affidavits sworn in connection with the application, the submissions on behalf of the Council and by the Respondent and the report of Professor G, I am satisfied that the Council has legitimate and reasonable concerns for the protection of the public if the Respondent were permitted to continue to practise pending completion of the fitness to practise procedures and processes arising from (a) the matters drawn to its attention by the directors of the Service, (b) the report of Professor G and his opinion that the respondent suffers from the “relevant medical disability” referred to above and that his registration should be subject to the conditions mentioned earlier, (c) the Respondent’s refusal to accept that opinion and his contention that it was produced, in effect, as part of a conspiracy against him and procured by the Garda detective, (d) the nature and content of the affidavits sworn by the Respondent (following the discharge of his legal representatives) and (e) the Respondent’s overall presentation in court during the hearing of the application and his repeated references to the conspiracy.

8. While it would not be appropriate for me on this application to resolve conflicts of evidence or to make findings of fact, the Respondent’s refusal to accept that there may be a problem and that his registration should be subject to conditions of the type recommended by Professor G or any conditions, is sufficient to persuade me that this is an appropriate case in which to make s. 60 orders in relation to the Respondent. I propose, therefore, to grant the orders sought by the Council pending further order of the Court and to give the Respondent liberty to apply so that if he is prepared to agree to the conditions proffered by the Council and to give undertakings to the Court in those terms, which are consistent with the recommendations made by Professor G, the order could be varied or modified so as to enable the Respondent to continue practise. Without those conditions or undertakings, I am satisfied that the orders are necessary to protect the public.

4. Factual Background and History

9. In December 2024, the Preliminary Proceedings Committee (the “PPC”) of the Council received a communication from the directors of the Service (the “Directors”) expressing a number of concerns in relation to the Respondent who had been participating on the duty roster at the Service for a number of years. The concerns related to medical care which the Respondent was providing and also his own health. The Directors alleged in their communication that during his time on the duty roster, there were ongoing difficulties with the Respondent, including in his interactions with patients, their carers and, at times, members of staff at the Service.

They referred to “significant difficulties and challenges” in the Respondent’s personal life, including a protracted separation from his partner. Reference was made to the fact that the Respondent had been attempting to establish a medical practice in a local town and that the Respondent reported having “very significant difficulty with sleeping” and that he was “evidently very significantly distressed by the challenges of reestablishing a practice” in the town. Those difficulties were said to include “apparently intractable difficulties” with a resident’s association (property management company) and that the Respondent was alleging that the Gardaí were involved and that he felt that he was being “observed” and “under active surveillance”.

The Respondent was further alleging that “undercover gardaí [were] observing him from” within the Service. The Directors also referred in their communication to the fact that during the previous twelve months, the medical care which the Respondent was providing had been the subject of “a relatively large and escalating number of complaints” and that these were “markedly more so than previously”. They claimed that a majority of the complaints related to the Respondent’s poor manner in consultations, a peremptory approach to those for whom he was caring and an approach which “intermittently appears clinically inadequate”, particularly in relation to gynaecological issues.

Reference was made to three instances in which it was alleged the Respondent had recently and inappropriately referred patients with “relatively simple gynaecological matters” to the Emergency Department. It was alleged that while the Respondent had been provided with guidance and support, nonetheless the frequency of complaints in relation to the Respondent had continued to escalate in the last quarter of 2024. It was further alleged that, in addition to difficulties with the Respondent’s professional manner, a “growing concern” existed in relation to the “quality and safety” of his clinical approach.

It was alleged that his notes were “scant” and that evidence of reasonable examination was “very limited indeed”.

10. It was further alleged that there were two very significant “near misses” involving the Respondent. The first, it was claimed, was where the Respondent’s approach to a patient with acute severe chest pain was “seriously deficient” in terms of his alleged inadequate examination of the patient, his failure to act at all on a high blood pressure reading and in terms of the Respondent’s clinical approach which was allegedly felt by the patient to have been “seriously dismissive”. It was claimed that this patient was subsequently diagnosed with a rib fracture in a chest x-ray organised by the patient’s own general practitioner the following day. The second “near miss” related to the alleged failure by the Respondent to engage adequately with and to examine an older patient with a chest infection. The patient was unhappy with the care provided by the Respondent and had a chest x-ray carried out at a local hospital which demonstrated a bilateral pneumonia which was subsequently treated by his own general practitioner.

11. The Directors claimed that despite engaging and attempting to support the Respondent, and acknowledging that he was “almost certainly … operating under a relatively high level of stress and distress”, and had been directed to attend a general practitioner for his own medical care, the Respondent had been “most reluctant and dilatory” in following that advice. It was their impression that the Respondent did not believe that he requires medical care.

12. In a summary of their concerns, the Directors stated:

“Concerns which exist therefore relate to patient safety, with respect to his clinical care, and also a significant level of concern regarding his own mental health and wellbeing. The impression of the Medical Director, who has been engaged with him in relation to responding to complaints is that of a background of significant moderately severe/severe anxiety, poor insight, paranoia, and possibly manipulative behaviour. Further, the impression is that his own social supports are very limited, and circumstances are increasingly difficult for him”.

It was noted that the Respondent had twice been requested in writing to make contact with the organisation known as “Practitioner Health” but had not done so. The Respondent was taken off the duty roster at the Service (in October 2024).

13. The material provided to the PPC included a communication from the Respondent to the CEO of the Service on 21 October 2024 in which he alleged that a female Garda detective had been present at the premises of the Service and had forced the Service to terminate the Respondent’s involvement with it. The Respondent alleged in that communication that this Garda detective was determined to cut off all of his financial income. In the same communication, he alleged that there were two more Gardaí working undercover in the Service, a receptionist and a driver, and that the particular female Garda detective, the Respondent’s former wife and three solicitors were all under criminal investigation and were all involved in acts of forgery for which he would be pursuing them in the High Court. The Respondent requested that he be reinstated to the service’s rota as that was his only income at the time (October 2024). He requested them not to be afraid of the “psychopath DETECTIVE”.

14. The Directors of the Service did not wish to make a complaint in relation to the Respondent but requested that their communication be brought to the attention of the CEO of the Council for consideration. The Council decided itself to become the complainant for the purposes of the fitness to practise procedures in relation to the Respondent.

15. Separately, the Council was considering whether it was necessary to bring an application to the High Court for s. 60 orders in relation to the Respondent. In advance of its decision to do so, a solicitor for the CEO of the Council telephoned the Respondent on his mobile phone on 29 January 2025. The Respondent asked whether he could call the solicitor back the next morning and it was agreed that he would. The solicitor received a text message the following morning from the Respondent from a different number stating that the number which the solicitor had called the previous evening was “tapped by Garda detective” and the solicitor was warned that her telephone number was most likely to be tapped also.

16. In the course of his engagements with the Council, the Respondent provided material to the Council including copies of correspondence which he had exchanged with various people including members of a property management company with whom he was in dispute about opening a new practice and with the management of the Service. He also provided copies of proceedings which he had attempted to issue in the Central Office against two solicitors (one being the solicitor acting for the management company and the other being the solicitor who acted for the Respondent’s former wife in family law proceedings). In that documentation, the Respondent alleged that the female Garda detective was involved in a conspiracy with his former wife and with three other solicitors which was directed against him and which involved various different acts on their part to damage him. It was alleged that the Garda detective was trying to prevent the Central Office from issuing the proceedings which the Respondent wished to issue and that she had done various other things to damage his life. In a communication with the Registrar in charge of the Central Office, the Respondent requested the Registrar to “dismiss this piece of shit (GD) out of your office” and that she “has nothing to do in [the] Central Office”. The material provided by the Respondent also included photographs of members of staff of the Service who the Respondent alleged were undercover Gardaí, as well as various other photographs including one which he said was of the female Garda detective to which he was referring.

17. The Council decided to hold a meeting on 12 February 2025 in order to consider whether an application should be brought to the High Court for s. 60 orders in relation to the Respondent. In advance of the meeting, the Respondent informed a solicitor acting for the CEO of the Council that he would inform his indemnifiers, if necessary, after the meeting.

5. Council Meeting of 12 February 2025

18. The Council met on 12 February 2025 to decide whether to bring an application for s. 60 orders in relation to the Respondent. The Respondent was invited to attend the meeting and was provided with a copy of the documentation which was to be considered at the meeting. He attended without representation.

19. In response to the concerns outlined at the meeting on behalf of the CEO, the Respondent set out the background to his practice of medicine in Ireland and recent personal circumstances which caused difficulties for him. He referred to issues which he said he had experienced with An Garda Síochána and with others, including his former wife. He outlined that he had been practising medicine in Ireland for the past 35 years. He previously ran a practice in a town outside Dublin between 2004 and 2015. However, he had to sell that practice when he separated from his wife. He claimed to be under surveillance by the Gardaí and, in particular, by a female Garda detective since 2010. He claimed that the Gardaí and, in particular, the female Garda detective. had collaborated with his former wife’s family in seeking to steal his money and that he was involved in family litigation in the High Court. He claimed that his documentation was stolen and that his signature was forged by the female Garda detective. He also claimed that various solicitors were involved, and that the female Garda detective was preventing the Central Office of the High Court from issuing proceedings which he wished to bring. He claimed that she was behind the termination of his relationship with the Service and the objections to the establishment of his new practice. The Respondent confirmed that (at that stage) he was still seeing patients in the practice of another GP one day a week and while that doctor was on holidays and had done so for the past four years. He claimed that he had to close down the new practice which he had sought to establish due to objections from the management company and that this was all done at the instigation of the female Garda detective.

20. When asked about his health, the Respondent said that he was very fit, did not drink, did not smoke and went swimming several times a week. He also said that he did not suffer from anxiety or any other issue relating to his mental health and he could not understand how the Directors of the Service could have claimed otherwise.

21. Having considered the submissions made on behalf of the CEO and on behalf of the Respondent and also having obtained legal advice from its legal assessor, the Council decided that it was necessary to bring an application to the High Court for s.

60 orders suspending the Respondent’s name from the Register and for other consequential orders. In its decision, the Council stated that the matter was sufficiently urgent to bring the application to the High Court and that that was a step which it was necessary to take in the public interest. The Council was of the view that there was a “very serious and immediate risk to public safety in this case”. In its decision, the Council stated: “In light of the specific concerns raised regarding the clinical care recently provided by [the Respondent], together with the concerns that have been expressed regarding his own health and wellbeing, the Council considers that there is a real and anticipated risk that patient safety will be impacted should [the Respondent] continue to practice in the period while the complaint is more fully investigated.”

22. Counsel stated that it was concerned that the Respondent may be suffering from a “relevant medical disability” and that his fitness to practise might be significantly impaired as a result. It should be noted here that the term “relevant medical disability” is defined in s. 2 of the 2007 Act, in relation to a medical practitioner as meaning “a physical or mental disability of the practitioner (including addiction to alcohol or drugs) which may impair the practitioner’s ability to practise medicine or a particular aspect thereof”.

23. The Council noted that, at the time of the meeting, there was no restriction on the Respondent’s ability to practise medicine and that, in light of the mental health concerns raised and the behaviour alleged when the Respondent was working for the Service, the public were being placed in danger. The Council noted that the Respondent was (at the time of the meeting) working part time one day a week in a GP practice and that he was seeking to operate his own practice from a residential apartment where there would be no support or oversight in respect of his practice. The Council felt that that significantly exacerbated the risk to the public and patient safety.

24. In deciding to bring an application for s. 60 orders, the Council had regard to the principles set out in the Council’s Guidance Note on Immediate Suspension Orders as well as the principles set out by the Supreme Court in O’Ceallaigh v An Bord Altranais [2000] 4 IR 54. It was satisfied that the complaint against the Respondent was serious and involved concerns regarding the clinical care that the Respondent provided to patients when working for the Service and noted that it was alleged that there was a “relatively large and escalating number of complaints”. It also considered the Respondent’s alleged interaction with patients and staff in the Service as well as his own mental health. It noted that, despite the concerns which his colleagues raised in relation to his mental health, including reference to a background of “significant moderately severe/severe anxiety, poor insight, paranoia and possibly manipulative behaviour” (according to the communication from the Directors of the Service in December 2024), the Respondent did not believe that he had any issues and had not sought any medical assistance. The Council was concerned that that might demonstrate a “worrying lack of insight” on the part of the Respondent. The Council was concerned, based on the totality of the information before it, that the Respondent might have “limited insight into the seriousness of the issues raised and whether he does suffer from a relevant medical disability”, which the Council noted was not a matter for it to decide at the meeting.

25. While noting that its function at the meeting was not to resolve conflicts of fact or to make findings of fact, the Council felt that there was a “strong prima facie case” against the Respondent and that the issues raised gave rise to “significant patient safety and public interest concerns”, noting also that the protection of the public was the “paramount consideration”. The Council was further satisfied that if the allegations against the Respondent were proven at inquiry, the likely sanction would be a restriction on the Respondent for practising for a specified period of time. While being cognisant of the potential hardship of an interim suspension order, having regard to all of the information before it and, in particular, to the seriousness of the allegations and the likely sanction, if those allegations were proven in the fitness to practise proceedings, the Council was satisfied that an application to the High Court for orders pursuant to s.

60 of the 2007 Act was necessary to protect the public in all the circumstances of the case. The Council urged the Respondent to use the supports available to him and recommended that he contact Practitioner Health and/or the Council’s Health Committee. It also urged the Respondent to contact his indemnifier for the purpose of obtaining legal assistance.

6. The Council’s Section 60 Application

26. The Council issued its application for section 60 orders in relation to the Respondent on 19 February 2025. The Council’s application was grounded on an affidavit sworn by Dr. Suzanne Crowe, the Council’s President. Having set out much of the material summarised earlier, and having outlined the decision made at the Council’s meeting on 12 February 2025, Dr. Crowe stated that the Council is “extremely concerned” that the Respondent poses a risk to patient safety.

27. The Council’s application first came before the Court on 24 February 2025. The Respondent was at that stage represented by solicitors and counsel. They sought time to enable the Respondent to reply to the application. The application was adjourned to

24 March 2025. Undertakings were given on behalf of the Respondent to last until the adjourned date. The Respondent undertook and consented not to engage in the practice of medicine until after the adjourned date and consented to the Council communicating the terms of the undertaking to various parties and reflecting the fact of the undertaking on the Register. The Respondent also consented to the Council releasing an alert on the Internal Market Information system in compliance with its obligations under the European Union (Recognition of Professional Qualifications) Regulations 2017.

28. The Respondent swore a replying affidavit on 20 March 2025. In that affidavit, he outlined his professional background. He qualified in Pakistan and has been practising medicine in Ireland for the last 35 years. He worked in several hospitals over that period. He operated a GP practice in a town outside Dublin from 2004, in a building which was jointly owned by himself and his former wife, a nurse. After they separated, the building was sold, and the practice was wound up in or around 2016. He stated in that affidavit that although he went through a separation and subsequent divorce, those matters “have now long since been resolved and are now of no relevance”. That is plainly not the case as will be seen from the various affidavits sworn by the Respondent after he discharged his legal representatives.

29. The Respondent explained that from around 2016 he worked as a locum GP. He commenced working with the Service, a GP out of hours service, in 2021. His work with the Service was initially by way of telephone consultation during the COVID-19 pandemic and then later by way of in-person consultation. He explained that the Service is not a regular GP practice but is an out of hours service for those urgently needing out of hours GP care. Following consultation with the patient, notes are sent to a patient’s regular GP for follow up. Routine GP services such as the taking of bloods, ordering X-rays and scans and so on, are not carried out by doctors working for the Service.

30. The Respondent explained that he also worked with another GP practice in a town outside Dublin since around 2021. He works in that practice one day a week and when the GP running the practice is on holidays. He asserted that no concerns were raised regarding the clinical care provided by him while working with that practice and that he had informed the GP in that practice of the correspondence sent by the Directors of the Service to the Council and of the Council’s application. The Respondent also explained that since 2024 he provided locum cover for another GP in a different practice one morning a week and also when that GP is on holidays. He also provided locum cover for other GPs in the locality from time to time but in more recent times he had only been working for the Service and for the two GPs just mentioned.

31. With respect to the concerns raised for his mental health and general wellbeing, the Respondent stated that he was a physically fit person who does not drink alcohol or smoke. He exercises regularly and does not take any regular medication. He stated that he has no issues with his mental health and that he has a good support network of friends. He said that he never attended the Medical Director of the Service for medical treatment and that his purported diagnosis of the Respondent was “unfounded”. He said that he has never required medical attention for his mental health. In the context of the Council’s application, he arranged to attend a GP (Dr. S) on 15 March 2025. He exhibited a very short note from Dr. S. That note stated that the Respondent was examined by the doctor on 15 March 2025. It said that the Respondent is not a regular patient of the practice. It then said: “However, as of today I have not found any evidence that [he] is suffering from anxiety or depression.” While not accepting that he is suffering from a “relevant medical disability”, the Respondent stated that he was willing to undertake to follow any directions or advice given by his GP in relation to his health, to include his mental health, if or when such issues arise.

32. The Respondent rejected the allegations made by the Directors of the Service concerning his clinical care of patients. In relation to the suggestion that he had a “peremptory” manner with patients, he noted that the Service is an out of hours service and not a routine GP service. He did not accept that his approach was clinically inadequate. In relation to the young person with a gynaecological complaint, he said that there was no female doctor available at the time and that if she wished to see a female doctor, she would have to return at a later time. He did not accept that there were any “near misses” as alleged in the correspondence from the Directors. As far as he could recall, while there was a man who attended him with chest pain, the patient had also been in attendance with his own GP earlier that day who had not identified the rib fracture. He did not accept that his note taking was “scant”. He observed that following attendance at the Service, notes are sent to the patient’s own GP for their records and review. He further stated that no complaint about him had ever been made by either of the GPs for whom he provides locum services.

33. With respect to the allegation that he was involved in a dispute with a local resident’s association, the Respondent stated that he had planned to open a practice from his home and sought and was granted planning permission to do so. However, that was objected to by the management company of his estate. He asserted that the dispute does not impact on his ability to practice medicine or on patient safety. The Respondent did not accept that he was under a high level of stress or that he was distressed. However, nonetheless, he confirmed that he was prepared to follow any directions of his own GP if or when he deems treatment necessary. In those circumstances, he asserted that his practice of medicine did not give rise to any risk to patients or members of the public and that his suspension was, therefore, not necessary.

34. The Council’s application was adjourned on 24 March 2025 to 28 April 2025 and the Respondent’s undertakings were continued. The Respondent swore a supplemental affidavit on 26 March 2025 in which he again rejected the suggestion that he is or was in a poor state of physical or mental well-being and rejected the contention that he is suffering or has suffered from “significant moderate severe/severe anxiety” (as alleged in the Directors’ Communication with the Council). He referred again to the examination by Dr. S on 15 March 2025 and Dr. S’s opinion. He also referred to a note from his own GP (Dr. L) who saw him on 23 March 2025. In his note of that date, Dr. L confirmed that the Respondent is a patient of the practice. He stated that he reviewed the Respondent on one occasion in his capacity as his GP. He confirmed that the Respondent is “generally healthy, active, is non-smoker” and that he was not aware of any substance issues. He further stated that in his engagement with the Respondent, he did not see any evidence of “depressive illness or generalised anxiety”. Dr. L also confirmed that the Respondent covered as a locum for him on a few occasions last year. He said that the Respondent’s work at the time “appeared to be satisfactory” that he did not receive “any negative feedback” that the Respondent appeared to communicate well with patients.

35. Prior to the adjourned date of 28 April 2025, the Council arranged for the Respondent to be assessed by Professor G. The assessment took place on 16 April 2025. Professor G’s report of that assessment is dated 19 April 2025. However, the Respondent was not agreeable to a copy of the report being provided to the Court or to the Council.

36. On the adjourned date of 28 April 2025, the Respondent’s solicitors applied successfully to come off record as solicitors for the Respondent and solicitors and counsel withdrew. The Respondent has represented himself since then. Having been informed of the fact that the Respondent was not prepared to consent to the release of Professor G’s report, I directed that a copy of the report be provided to the Court, to the Council and to the Respondent himself and adjourned the Council’s application to 26 May 2025 to enable that to be done and for the report to be considered. The Respondent agreed to continue the undertakings.

37. The Respondent swore a further affidavit on 13 May 2025. This was the first affidavit the Respondent swore without the benefit of legal representation. Having referred again to the opinions of Dr. S and Dr. L, the Respondent then gave an account of his meeting with Professor G on 16 April 2025 which he described as an “interrogation” rather than a clinical assessment. He said that Professor G asked him about certain documents and that he spoke to him about the female Garda detective as well as the two members of staff in the service who he claimed were undercover Gardaí. He said that Professor G asked him about his intended proceedings against various solicitors and about any complaints by patients. The Respondent objected to that line of questioning and contended that the meeting with Professor G’s was planned by the female Garda detective as well as by the Council’s solicitor and his own solicitor. He said that Professor G was satisfied with the clinical examination and assessment carried out by Dr. S and Dr. L and that he did not carry out any additional clinical assessment.

38. The Respondent then alleged that his solicitor and the Council’s solicitor both conspired to arrange for the assessment by Professor G “in an attempt to override the clinical assessments of two GPs”. He contended that they “lied to the court, deceive the court”. He further alleged that the female Garda detective was at Professor G’s office before his appointment and queried why that would be so. He then said that the female Garda detective was determined to get a report from Professor G that the Respondent was suffering from mental health issues in order to protect two solicitors against whom he was seeking to bring proceedings and against whom he said criminal allegations had been made. He concluded his affidavit by querying why the female garda detective was at Professor G’s office. Finally, he asked the court to dismiss the Council’s application based on the clinical assessments of Dr. S and Dr. L. He also asked the Court to “remove names of solicitors [Ms. K] and [Ms. L] from Law Society of Ireland, due to lying, deceiving the court” and he sought an order that the Council be responsible for up to €10,000 towards the cost of his insurance and to compensate him for loss of income estimated at €50,000.

7. Professor G’s report

39. Professor G’s report was provided to the court in advance of the adjourned date of 26 May 2025. In his report, Professor G outlined the DSM 5(1) features of delusional disorder, anxiety disorder and depressive disorder. Professor G noted in his report that the Respondent indicated that he understood the nature of the meeting and the need to provide information to the Council’s solicitors and to the Council and that he was consenting to the meeting proceeding. Professor G noted that the Respondent rejected any notion that he was paranoid or deluded and that when he suggested that some of the Respondent’s beliefs were implausible, the Respondent continued to assert that he believed those matters to be true. Professor G expressed the opinion, based on a review of the documents provided to him and on the basis of his assessment, that the Respondent suffers from a “relevant medical disability”. He noted that the Respondent reported a chronic history of being monitored by the Gardaí and collusion between his former wife, the Gardaí and solicitors and that his phone was being tapped. He reported agents of the Gardaí working within the service and that he was being spied on, his post was being opened, his bank account was being monitored and his domestic refuse was being checked. Professor G found those reports to be implausible. In his opinion, the Respondent suffers from “persistent delusional disorder of persecutory type” and he explained the basis for his opinion.

40. However, he stated that the Respondent’s functioning had not been affected as he continued to work “without interference of the delusionary system” since 2009 which was when he started having “beliefs of persecution”. Professor G opined that the genesis and commencement of the Respondent’s beliefs of persecution date back to an incident of mistaken identity when he was questioned at passport control in Istanbul Airport in 2009. The Respondent reported a belief that authorities in Turkey passed on information to the Gardaí about him. Professor G then stated: “As is often the case in delusional disorder, functionality and occupational performance was maintained over the years due to the encapsulated nature of the false beliefs. I do not see a connection between [the Respondent’s] recent experience of complaints and his belief systems. I could find no evidence of his belief system of persecution by his ex-wife and authorities interfering with or affecting patient care. …”

41. Professor G also expressed the opinion that the Respondent does not suffer from an anxiety or depressive disorder and that there was no evidence of anxiety or mood disturbance.

42. Professor G gave his opinion as to the Respondent’s fitness for work. He concluded that the Respondent’s medical disability has not “to date affected his fitness for work”. He stated that there was no evidence that the Respondent’s “chronic delusional beliefs” have affected his role as a medical practitioner. He observed that that was possible notwithstanding a diagnosis of delusional disorder “due to the encapsulated nature of some delusional systems”. Professor G’s opinion was that the Respondent should be permitted to continue his work as a medical practitioner. However, Professor G then stated: “It is the case that [the Respondent’s] medical disability may affect his fitness for work at some point in the future. From my examination of [the Respondent], I find this to be unlikely (consistent with the features of delusional disorder, whereby occupation and functionality are maintained) but it is possible that his delusionary system extends into patient care. In this regard it is my opinion that he should engage with a supportive health service such as Practitioner Health.

As delusional disorder is a condition often characterised by poor insight, with the possibility of poor adherence to suggested treatment, I recommend that this is a condition of [the Respondent’s] ongoing registration. I also recommend referral to the Medical Council’s Health Sub Committee. It is my opinion that [the respondent] will also receive appropriate help and support here with his current health issues.”

8. Further Evidence in advance of Hearing

43. On the adjourned date of 26 May 2025, I listed the Council’s application for hearing on 26 June 2025 and gave liberty to the parties to file further affidavits if necessary. I asked the Council to send a copy of the Respondent’s affidavit of 13 May 2025 to Professor G for any comments he might have on the contents of that affidavit. Dr. Crowe swore a further affidavit on 4 June 2025 and the Respondent swore two further affidavits on 12 June 2025 and 25 June 2025.

44. In her further affidavit, Dr. Crowe exhibited Professor G’s report. She exhibited a note from Professor G in which he stated that the Respondent’s affidavit did not make any difference to the view which he had expressed in his report. Dr. Crowe explained that the Council’s concerns in relation to the Respondent remained. She noted that the Respondent did not accept Professor G’s diagnosis and did not consider that he would benefit from support or treatment. She drew attention to the Respondent’s contention that the Garda detective was with Professor G before his appointment. Dr. Crowe stated that if the Respondent was displaying insight into his condition and was willing to engage with the appropriate supports, the Council’s application could be capable of being disposed with by way of restrictions that fell short of an interim suspension such as by directions regarding his engagement with appropriate treatment and support and with the Council’s Health Committee, with a return to practise as appropriate as part of that process. However, the Respondent was not demonstrating the required level of insight. The Council was concerned that unless and until the respondent demonstrated a willingness to seek appropriate supports and treatment in relation to his condition as diagnosed by Professor G, there remained a risk of the public being placed at risk.

45. Dr. Crowe referred to the complaint that the Respondent’s performance had deteriorated markedly in the period leading up to the complaint and the Council was concerned that the Respondent’s ability to exercise sound judgement might be impaired by reason of his condition. Dr. Crowe stated that if the Court did not consider that the suspension of the Respondent was required to protect the public, notwithstanding the poor insight demonstrated by the Respondent, the Council’s position was that the Respondent’s entitlement to practise should be conditional on engagement with the supports recommended by Professor G or any other supports which the Court might consider appropriate and that the Respondent should be required to engage properly with the supports before returning to practise.

46. The Respondent swore a further affidavit in response to Dr. Crowe’s affidavit on

12 June 2025. He repeated his allegations of being under surveillance by the female Garda detective since 2010 and made various other allegations against her including that she had arranged for someone to be at the Central Office to monitor every document which the Respondent sought to file. The Respondent also commented further on Professor G’s report noting his view that the Respondent did not suffer from anxiety or depression and that he should be permitted to go back to work. He made a series of requests of the Court including those previously made as well as a request that Professor G’s report should be rejected and should not be used in the proceedings. He repeated his contention that solicitors involved in the application had lied and deceived the Court and that their intention was to frame the Respondent so that the Garda detective would have the advantage of having a psychiatric report and put at risk the proceedings which he wished to bring against two other solicitors.

47. The Respondent swore a further affidavit on 25 June 2025, the day before the hearing in which he again repeated his allegation that Professor G’s assessment of the Respondent was all planned by the garda detective. Finally, Ms. Ayesha Ryan swore an affidavit on behalf of the Council on 19 June 2025 in which she exhibited an email from Professor G of 18 June 2025 in which he confirmed that he did not meet a Garda detective before meeting with the Respondent.

9. The Hearing

48. In his submissions at the hearing on 26 June 2025, counsel for the Council made clear that the Court is not being asked in this application to decide as a matter of fact that the Respondent has a “relevant medical disability” within the meaning of that term in section 2 of the 2007 Act. Nor is the Court being asked to decide whether the concerns expressed by the Directors of the Service and the subsequent complaint made by the Council against the Respondent are well founded or whether, as a matter of fact, the Respondent is fit for work at this time. Rather, counsel explained that the issue for the Court is whether the evidence on the Council’s application discloses that there is a risk to the public and, in particular, to patients being treated by the Respondent, which make is necessary for the Court to make orders under section 60 of the 2007 Act pending completion of the fitness to practise procedures and processes under the 2007 Act or further order, and, if so, the nature and extent of the orders which the Court should make.

49. The Council submitted that the material before the Court is sufficient to demonstrate that there is a risk to the public and, in particular, to patients of the Respondent, and that the orders sought are necessary to address that risk. It submitted that if the Respondent was prepared to agree to engage with the supports and assistance recommended by Professor G and to give the necessary undertakings to do so, it would not be necessary for the Court to grant the orders it was seeking. However, the Council submitted that it was clear from the Respondent’s correspondence, his affidavits and his approach to the application as well as from his submissions to the Court that the Respondent does not accept Professor G’s diagnosis or opinion or that there might even be a problem. On the contrary, the Respondent has alleged that, effectively, Professor G was improperly influenced in his opinion and report by the female Garda detective who the Respondent says is at the centre of the campaign and conspiracy against him. In those circumstances, the Council seeks the various orders under s. 60 referred to earlier.

50. Counsel for the Council took the court through the relevant documents and affidavits and opened Professor G’s report. He noted Professor G’s opinion that the Respondent is suffering from “persistent delusional disorder of persecutory type”, that this may affect his fitness to work although he felt that to be unlikely and that it should be a condition of the Respondent’s ongoing registration that he engage with a supportive health service such as Practitioner Health and with the Council’s Health Committee.

51. The Council relied on a number of significant features in support of its application:

(1) It stressed that concerns were expressed by five doctors in the Service, being the Board of Directors and Medical Director of the Service.

(2) It relied on Professor G’s diagnosis and opinion (referred to above).

(3) It referred to objective material including correspondence and affidavits from the respondent which disclosed a lack of rational thinking, including his allegation that he has been under surveillance since 2010 and the victim of a conspiracy involving several solicitors, including the solicitor acting for his former wife and the management company of the property where he intended opening a new medical practice, his own solicitor who acted for him initially in the section 60 application, the solicitor acting for the Council, the Council itself, Professor G, the Service for which he worked and a number of members of staff in that service who he alleged were undercover members of An Garda Síochána. All of this material, it submitted, disclosed a risk to the public if the Respondent were permitted to continue to practise unrestricted.

(4) It stressed that the Respondent was not working in a hospital environment where he might have the support of a team around him but rather for a number of years was working in his own practice and, more recently, providing locum services to a small number of GPs. He would not, therefore, have the sort of safety net which might otherwise exist were he working in a hospital setting.

(5) It relied on the alleged complete lack of insight on the part of the Respondent that there might be any cause for concern as well as his complete rejection of Professor G’s diagnosis that he is suffering from a delusional disorder of a persecutory type.

(6) It further relied on the concerns expressed by the Directors of the Service that over the twelve months prior to the expression of their concerns to the Council in December 2024, the medical care which the Respondent was providing was the subject of “a relatively large and escalating number of complaints”.

52. In the absence of the Respondent’s agreement to accept the report of Professor G and the restrictions on registration which he recommended and in the absence of his agreement to the various undertakings and conditions provided by the Council to the Court which were intended to put flesh on the recommendations of Professor G, the Council submitted that it is necessary for the court to make s. 60 orders in relation to the Respondent.

53. The Respondent represented himself. He was most polite and courteous to the Court in his submissions and presented as a pleasant man, albeit one who appeared to be convinced that he was the subject of constant surveillance by the Gardaí since 2010 and was greatly troubled by that. He also repeatedly stated that he could not agree to the recommendations of Professor G (which he did not accept, claiming that Professor G had effectively become part of the conspiracy at the behest of the female Garda detective to which he constantly referred) or to the conditions and undertakings put forward by the Council as an alternative to the Court making s. 60 orders, on the basis that it would adversely affect the several cases which he has sought to bring against a number of solicitors and the Garda Commissioner. In those circumstances the Respondent was resolutely opposed to agreeing to engage with the supportive health service or with the Council’s Health Committee as recommended by Professor G or to agree to any of the conditions or undertakings put forward by the Council.

54. The Respondent repeatedly protested that he was not making up his account of being under surveillance by the Gardaí and, in particular, by the female Garda detective to whom he constantly referred. He maintained that she had consistently interfered with his work, with his attempts to open a new practice, with the work which he was doing for the Service (which the Respondent maintained was terminated at the behest of the Garda detective) and with Professor G’s examination and diagnosis of the Respondent.

55. The Respondent maintained that he was fit and healthy, both physically and mentally, and that there was no impediment to him resuming work.

56. The Respondent disputed the concerns and complaints raised by the Directors of the Service. He rejected the complaints made in relation to the medical care of patients, saying that some patients lie and are just looking for money. He also rejected the complaints in relation to his note keeping. He maintained that his notes were necessarily short on the basis that they would be sent straight through to the patient’s GP for any necessary follow up. In the case of an emergency, he stated that he referred patients to hospital.

57. He disputed the suggestion made in the communication to the Council by the Directors of the Service that the Respondent had a background of “significant moderately severe/ severe anxiety, poor insight, paranoia, and possibly manipulative behaviour” and claimed that he had never been medically examined or accessed by any of the doctors in the Service which might have provided a basis for that assessment. The Respondent relied on the short reports or Dr. S and Dr. L that they had not seen any evidence of anxiety or depression. He rejected Professor G’s diagnosis of delusional disorder of a persecutory type and informed the Court that he knew as a matter of fact that the Garda detective was in Professor G’s office and that the Professor was lying when he denied that this was the case.

58. The Respondent’s submissions were replete with references to the surveillance and the actions of the female Garda detective which he maintained were all real and not imagined. He seemed to me to be very troubled and upset when referring to this. Finally, the Respondent informed the Court on several occasions in the course of his submissions that he only wanted to work as a locum doctor for a day here and a day there and that because of the limited nature of the work which he wished to be able to resume, there would be no risk to the public or to patients and that the Court should therefore refuse the Council’s application.

10. Section 60 of the 2007 Act

59. Section 60 of the 2007 Act provides as follows: -

“60.— (1) The Council may make an ex parte application to the Court for an order to suspend the registration of a registered medical practitioner, whether or not the practitioner is the subject of a complaint, if the Council considers that the suspension is necessary to protect the public until steps or further steps are taken under this Part and, if applicable, Parts 8 and 9.

…

(2) An application under subsection (1) … shall be heard otherwise than in public unless the Court considers it appropriate to hear the application in public.

(3) The Court may determine an application under subsection (1) by—

(a) making any order it considers appropriate, including an order directing the Council to suspend the registration of the registered medical practitioner the subject of the application for the period specified in the order, and

(b) giving to the Council any direction that the Court considers appropriate…”

60. While s. 60(1) enables the Council to make an application for orders under s. 60 on an ex parte basis, the application in this case was made on notice to the Respondent who participated fully in the application.

61. The application was heard otherwise than in public in accordance with section 60(2). It is appropriate, however, that this judgment be published but with the Respondent’s identity anonymised and with other information which might lead to the identification of the Respondent being redacted. Those redactions are made in accordance with the Court’s discretion under s. 60(2) of the 2007 Act and in reliance on s. 27 of the Civil Law (Miscellaneous Provisions) Act 2008, given the diagnosis Professor G has referred to.

62. The Council has brought this application on the basis that it considers, in accordance with s. 60(1), that the suspension of the registration of the Respondent is necessary to protect the public until the relevant steps are taken under the fitness to practise provisions of the 2007 Act.

11. Summary of Applicable Legal Principles

63. The legal principles applicable to this application have been considered in a number of different cases under section 60 of the 2007 Act and under a number of similar statutory provisions applicable to other regulated professions, including nurses and dentists. Those cases include O’Ceallaigh v an Bord Altranais [2000] 4 IR 54 (Supreme Court), Medical Council v Waters [2021] IEHC 252 (High Court, Irvine P), Medical Council v Bukhari [2022] IEHC 723 (High Court, Barniville P), Medical Council v A Medical Practitioner [2023] IEHC 171 (High Court, Barniville P), Medical Council v A Medical Practitioner [2023] IEHC 679 (High Court, O’Higgins J) and Dental Council v A Dentist [2024] IEHC 731 (High Court, Barniville P).

64. For the purposes of this application and the issues raised here, the relevant principles may be summarised as follows: -

(1) The court has a very wide discretion and a broad jurisdiction in terms of the possible orders it may make in an application such as this.

(2) The court’s task on such an application is to access whether it is in the public interest that the orders sought should be made. As Geoghegan, J. stated in the Supreme Court in O’Ceallaigh, the “paramount consideration” in an application such as this is whether the orders sought are necessary to prevent “immediate danger to the public” (at pg. 133).

(3) On an application such as this, the court is not deciding the underlying complaint. It does not resolve conflicts of evidence and does not make findings of fact, save in exceptional circumstances.

(4) Before an application such as this may be brought by the relevant professional disciplinary body, such as the Council in this case, it was made clear by Barron, J. in his judgment in the Supreme Court in O’Ceallaigh that the relevant body must be satisfied of the following three matters: -

(a) That the complaint is a serious one in terms of the conduct

complained of;

(b) That the case against the relevant professional is a strong one; and

(c) That, in the event of an adverse finding in the fitness to practise proceedings, the appropriate sanction would be to cancel the registration of the relevant professional either permanently or for a defined period. As noted by Kelly, P. in Medical Council v F.C.M.

[2018] IEHC 616, other serious sanctions such as conditional

registration and cessation from practice until certain conditions are fulfilled would also meet the test.

(5) In considering whether to make the orders sought on such an application, the court must also be satisfied of the three matters referred to by Barron J in O’Ceallaigh.

(6) Even if the court is satisfied of these three matters, because of the significant adverse consequences for the relevant professional person of an interim suspension order being made, in terms of his or her constitutional rights to a good name and reputation and to earn a livelihood, the courts have repeatedly stressed that such an order should only be made “when no other order would serve to protect the community” (as stated by Morris, J. in Medical Council v Whelan (unreported, High Court 20 February 2001) and should be reserved for “exceptional cases” (as stated by Kelly, J. in Casey v Medical Council [1999] 2 IR 534 at p. 549).

(7) Because suspension orders are reserved for exceptional cases and should only be made when no other order or measure would adequately protect the public or address the issues of public concern arising, consideration should be given in each case as to whether or not appropriate undertakings should be accepted in place of interim suspension orders. Undertakings may be offered to the relevant professional disciplinary body or to the court. There is, however, no obligation on the professional body (or indeed on the court) to accept such undertakings as may be offered. An undertaking given to the court as opposed to one given to the relevant professional body is enforceable as if it were an order of the court.

(8) In each case, the court must engage in a balancing exercise between the public interest (in terms of the need to protect the public) which is said to be served by the interim suspension orders sought and the various constitutional rights of the relevant professional which may be engaged in the case. The court must decide in each case and on the basis of the particular facts of the case where the balance should be drawn. In particular, the court must ask itself whether, on the particular facts, the public interest and the need to protect the public outweigh the constitutional rights of the professional to a good name and reputation and to earn a livelihood.

(9) Some additional principles will apply where the relevant professional is the subject of a criminal investigation or criminal proceedings. Those principles are not applicable in this case as there is no evidence that the Respondent is the subject of a criminal investigation or criminal proceedings.

65. These, therefore, are the principles which I will apply in determining the Council’s application.

12. Decision on the Application

66. Having carefully considered all of the affidavits sworn in connection with the application, the submissions on behalf of the Council and by the Respondent as well as the other material before the Court, including the report of Professor G, and having regard to the applicable legal principles summarised above, I have concluded that this an appropriate case to in which to make orders under s. 60 of the 2007 Act in relation to the Respondent.

67. I am satisfied, on the evidence, that the Council has real and legitimate concerns for the protection of the public and, in particular, for his patients, if the Respondent were permitted to continue to practise without restrictions pending completion of the fitness to practise procedures under Part 7 and, if applicable, Parts 8 and 9 of the 2007 Act. Those legitimate concerns for the protection of the public and for patient safety arise not just from the matters of concern which were brought to the attention of the Council by the Directors of the Service in December 2024 but, even more significantly, from the report of the examination carried out in relation to the Respondent by Professor G in April 2025 as well as from the manner in which the Respondent has defended the application. Having regard to the fact that the protection of the public and, in particular, patients of the Respondent is the court’s paramount consideration on an application such as this, it is first necessary for me to confirm that, in my view, there are real and legitimate concerns for patient safety arising from the allegations made in relation to the respondent’s patient care while working with the Service and, even more significantly, from the recent diagnosis of Professor G that the Respondent is suffering from “delusional disorder of a persecutory type” (a diagnosis which the Respondent resolutely disputes).

68. I am also satisfied that in deciding to bring and to maintain this application against the Respondent, the Council correctly identified and applied the three elements of the test set out by the Supreme Court in O’Ceallaigh. I must also apply that test in determining the Council’s application. I am satisfied that each element of the test is met in this case.

69. The matters alleged against, and in relation to the Respondent, are serious. The concerns in relation to his patient care which were brought to the attention of the Council by the Directors of the Service in December 2024 are undoubtedly serious, including allegations of a poor manner in his consultation with patients, his note keeping, the absence of evidence of reasonable examination and an allegedly clinically inadequate approach to issues which arose during his practice and, in particular, to gynaecological issues. Also serious are the alleged significant “near misses” in his assessment of two patients presenting with chest issues. However, those allegations in themselves (all of which are disputed by the Respondent) would not ordinarily justify the Council applying for s. 60 orders. However, those allegations must also be seen in the context of the allegation by the Directors of the Service that in the previous twelve months there were “relatively large and escalating number of complaints”, and significantly more so than previously. Those concerns would appear to tie in with the impression of the Medical Director of the Service who engaged with the Respondent in relation to the complaints (albeit that the Respondent claims that he never met the Medical Director in person) that there was in the case of the Respondent “a background of significant moderately severe/ severe anxiety, poor insight, paranoia, and possibly manipulative behaviour” and that the impression was that the Respondent’s “own social supports are very limited” and that circumstances were “increasingly difficult for him”. The Respondent denies all of this but those concerns must also be considered in the context of the evidence which the Respondent has provided in response to the Council’s application (in the form of the various affidavits which he swore and which I felt it necessary to outline in some detail earlier in my judgment) and in the context of Professor G’s subsequent diagnosis (in April 2025) that the Respondent is suffering from a “relevant medical disability”, namely, a delusional disorder of a persecutory type.

70. While the Respondent disputes the diagnosis and the conditions to the Respondent’s registration recommended by Professor G, and indeed maintains that the diagnosis was influenced by the female Garda detective to which the Respondent makes repeated reference, it cannot be disputed that the concerns and allegations (in respect of which the Council itself is now the complainant) are serious in terms of what is being alleged. It is of further concern that the Respondent is not prepared to accept the independence of Professor G and of his opinion. That is particularly so in circumstances where Professor G was of the view that the Respondent is fit for work but that his registration should be subject to conditions requiring his engagement with the supportive health service and with the Council’s Health Committee. The fact that the Respondent was not prepared to accept this and alleged that Professor G was lying when he denied that any Garda detective was present at his office, is of further serious concern.

71. I have to say that I am somewhat surprised that Professor G did not consider that the nature and content of the Respondent’s affidavit and the allegations contained in that affidavit did not affect his view that the Respondent was fit for work (albeit that his registration should be subject to those conditions). It will ultimately be a matter for the relevant statutory body under the 2007 Act to make findings of fact in relation to the Respondent’s diagnosis and his fitness for work. I should say, however, that I did have the opportunity of observing the Respondent at close quarters in court on a number of occasions both before and after he discharged his legal representatives and over the course of a number of hours at the recent hearing of the Council’s application. While professing no medical expertise whatsoever, I must confess that I was very concerned for the Respondent’s mental health on the basis of what I witnessed. This included the Respondent’s repeated, constant and almost mantra-like references to being under surveillance by the Gardaí since around 2010, the repeated references to the female Garda detective allegedly involved in that surveillance and who, in view of the Respondent, was constantly involved in actions intended to damage the Respondent, whether in his personal or professional life, the Respondent’s repeated and bizarre allegations against a whole host of solicitors, including his own solicitor in the s. 60 application and a solicitor who until recently represented the Council in the application, as well as against the Council itself and against Professor G.

72. His rejection outright of Professor G’s opinion and his reliance on the short reports of Dr. S and Dr. L also trouble me. It is, however, not my role to second guess any of those medical opinions but the fact that the Respondent has sought to link the doctors and the staff in the Service for which he worked until October 2024, going so far as to identify two members of the staff as being undercover Gardaí, and Professor G himself with the alleged conspiracy involving the female Garda detective is sufficient to create the necessary connection to the Respondent’s professional role as a medical practitioner. In my view, all of this, combined with the allegations of escalating complaints in relation to his patient care, provide sufficient support for the Council’s concerns as to public and patient safety and demonstrate the requisite degree of seriousness to satisfy the first element in the O’Ceallaigh test.

73. The second element in the O’Ceallaigh test is also satisfied in that the material before the court discloses that the case to the effect that the Respondent is suffering from a “relevant medical disability” at least, appears to be strong, based on Professor G’s report. While the Respondent disputes Professor G’s diagnosis, it cannot be disputed that, at this stage of the process at least, the evidence appears to be strong. While Professor G expressed the opinion that the Respondent is fit for work, he also recommended the attachment of the conditions to which I have referred to the Respondent’s registration (something which the Respondent also completely rejects). I am satisfied that the second element of the O’Ceallaigh test is satisfied here.

74. As regards the third element of the test, while it is not suggested that an adverse finding being made against the Respondent in fitness to practise proceedings would lead to the cancellation of the Respondent’s registration either permanently or for a defined period, a conditional registration and cessation from practice until certain conditions are fulfilled might well be the appropriate sanction in the event of such an adverse finding. That would meet the third element of the O’Ceallaigh test (as noted by Kelly P. in the F.C.M case).

75. In order to afford the Respondent the opportunity of avoiding a possibility of s.

60 orders being made against him, the Council purposed a series of undertaking by the Respondent or conditions to his entitlement to continue to practise pending the determination of any fitness to practise proceedings, during the course of the hearing.

Those undertakings or conditions were as follows: -

1. “That, within two weeks, [the Respondent] attend with his general practitioner to discuss the concerns he has expressed to date regarding the garda detective and others he feels are involved in the conspiracy against him.

2. That [the Respondent] permit the Medical Council to provide the details of the complaint, to include any correspondence and affidavits from [the Respondent] to his general practitioner.

3. That the [the Respondent] agree to undergo any regime of treatment, to include counselling or other intervention as may be recommended by his general practitioner.

4. That [the Respondent] request that his general practitioner refer him to a consultant psychiatrist for assessment without delay.

5. That [the Respondent] attend for an assessment by a consultant psychiatrist at the first available opportunity after the referral is made by his general practitioner.

6. That [the Respondent] agree to undergo any regime of treatment as maybe recommended by the consultant psychiatrist concerned.

7. That [the Respondent] self-refer to the Medical Council’s Health Committee within one week and that he provides a report from his general practitioner, following on from the consultation referred to at (1) above to the Health Committee outlining the matters discussed at the consultation, any diagnosis made, and regime of treatment recommended.

8. Until such time as he is released by the Health Committee, that [the Respondent] attend meetings with the Health Committee for a review as directed by the Health Committee and that he comply with any directions made by the Health Committee.

9. That [the Respondent] self-refer to Practitioner Health to seek supports in relation to his mental health and wellbeing and that, for so long as is recommended by Practitioner Health, he attend meetings for review by Practitioner Health as maybe directed and that he comply with any recommendations made by Practitioner Health in relation to his ongoing care or treatment.

10. That [the Respondent] consent to his treating doctors and Practitioner Health providing information to the Health Committee upon request.

11. That [the Respondent] notify any perspective employer (to include any locum agency) of these conditions in advance of taking up any offer of employment with them.

12. That [the Respondent] not return to practice until such a time as he has met with his general practitioner as required at (1) and attended at his first meeting with the Health Committee in accordance with (7) and (8).”

76. These undertakings or conditions were intended to give effect to the recommendation contained in Professor G’s report. All seem to me to be reasonable and appropriate to address the risks to the public and the patients to which I have referred earlier. However, the Respondent does not accept that any of these conditions are appropriate and is not prepared to provide any of the undertakings sought. Nor does his accept Professor G’s recommendations. So far as I could ascertain during the course of the hearing, the main reason why the Respondent was not prepared to accept any of these is because of the impact he perceives that will have on the cases which he wishes to bring against various solicitors and against the Garda Commissioner. During the course of the hearing, I was prepared to give the Respondent an opportunity of engaging with the Council to agree these conditions and undertakings, but the Respondent resolutely set his face against doing so, primarily on the basis of the impact which that would have on his cases. In my view that further supports the validity of the concerns which the Council has for public and patient safety.

77. Having concluded that the three elements of the test O’Ceallaigh are satisfied in this case, I must then move to conduct the required balancing exercise. I must balance the public interest which would be served by the s. 60 orders, namely, the protection of the public and patient safety, and the various constitutional rights and other interests of the Respondent which are engaged on the facts of this case. I must decide where that balance should lie.

78. On one side of the balance is, of course, the risk to the public and to patients and the consequent public interest in making the orders sought by the Council. On the other side of the balance are the Respondent’s constitutional rights to earn a livelihood and his right to the protection of his good name.

79. I am satisfied that on the facts of this case the balance lies very much in favour of granting the s. 60 orders sought by the Council. While the Respondent stated that he only wishes to work a few days here and a few days there as part of locum services provided to a number of general practitioners, in my view, the risk of the Respondent doing so (in the absence of conditions of the type recommended by Professor G) remains significant and is not eliminated by the fact that the Respondent does not wish to work on a full time basis.

80. In circumstances where the conditions and undertakings to which I have referred were put forward by the Council in an attempt to enable to the Respondent to return to work as soon as possible, and where the Respondent rejected those conditions or undertakings for the reasons mentioned, I do not attach any significant weight to the Respondent’s constitutional right to earn a livelihood in this case. Nor do I attach significant weight to his constitutional right to his good name, in the particular circumstances of this case. By agreeing to the conditions and undertakings put forward, the Respondent would be in a position to avoid suspension orders and would be in a position to continue to practise as a doctor.

81. In my view, therefore, the balance lies very much in favour of granting the s. 60 orders sought by the Council in order to ensure the protection of the public and patients.

13. Summary of Conclusions

82. In summary, I have concluded that the Council is entitled to the orders sought against the Respondent under s. 60 of the 2007 Act in order to protect the public. In reaching that conclusion, I have applied the relevant legal principles and have conducted the required balancing exercise dictated by the case law.

83. In those circumstances, I will make the orders sought by the Council at paragraphs 1, 2, 3, 4 and 5 of the Originating Motion Ex Parte, those orders to continue pending further order of the Court. I will give the Respondent liberty to apply so that if he is prepared to agree to the conditions and undertakings put forward by the Council, the order could be varied or modified so as to enable the Respondent to resume and continue practice. There should also be a general liberty to apply provision.

84. I will list the matter at 10am on Wednesday 16 July 2025 (remotely) to deal with any outstanding issues.