Nursing and Midwifery Council v Okeke

MR JUSTICE SINGH: There is before the court an application by the Nursing and Midwifery Council under article 31(8) of the Nursing and Midwifery Order 2001 for an extension of an interim order imposed on the respondent, suspending her registration as a nurse. On the information before me, it is apparent that the respondent has been duly served not only with the papers in this case but also with notice of today's hearing. She has not appeared. I am informed that those representing her have no instructions and have confirmed as recently as yesterday that they would not be appearing on her behalf for that reason. In those circumstances, I consider it appropriate to proceed to consider this application.

The factual background can be summarised for present purposes very briefly. On 17 January 2013, the applicant received a referral from an independent psychiatrist who had had to examine the respondent in a very different context to do with Family Court proceedings. However, the referral raised serious concerns about the respondent's mental health. It is unnecessary to go into the details of health matters; suffice to say that I have read the material which relates to that.

In due course, after investigation was carried out by the applicant's relevant Committee, the matter came before the applicant's Health Committee. There was some suggestion in the evidence before me and in the very helpful skeleton argument filed in support of this application that there might be the possibility that the case might go back to the Conduct and Competence Committee of the applicant Council. However, I have been informed by Mr Jeffs, who appears on behalf of the applicant this afternoon, that on instructions that is no longer contemplated. For that reason, the period of extension sought today is not as long as was indicated in writing, when a 6-month extension was being sought; rather, Mr Jeffs has confirmed at this hearing that in the circumstances all that is felt to be necessary is an extension of 4 months.

There is power in the 2001 Order for an interim order to be made and for it to be extended where certain criteria are satisfied. The last such extension was earlier this year and the current extended period is due to expire on 16 August 2015, i.e. next week. It is for those reasons that the application has come before the court at this stage.

I have been considerably assisted by the skeleton argument filed by Mr Jeffs in which he reminds this court of the criteria in the order which have to be considered by this court before deciding whether to extend an interim order in a case like this. He has also reminded me of the decision of the Court of Appeal in GMC v Stephen Chee Cheung Hiew [2007] EWCA Civ 369, a case concerned with a similar regulatory regime in the context of the General Medical Council. As the Court of Appeal there said, relevant factors in considering whether to grant an extension include the gravity of the allegations, the seriousness of the harm, the risk of harm to patients, the reasons why the case has not been concluded and prejudice to the practitioner if an interim order is continued.

In the circumstances of this case, I am satisfied, on the material before the court, that a nurse suffering with the sort of health issues that this respondent appears to have could seriously compromise patient safety, particularly in circumstances where she was working with vulnerable patients. The reason why the matter has not concluded so far is that a hearing was commenced but it was not possible to complete it within one day. It is anticipated that matters can now be concluded realistically within the 4-month extension period sought. There is some prejudice no doubt to a person in the respondent's position who will not for the time being be able to practise her profession as a nurse. Nevertheless, I am satisfied, for the reasons which are more fully set out in the evidence before this court, that any prejudice caused to her is outweighed by the public interest in ensuring patient safety and maintaining public confidence in the profession.

For the reasons which I have given, I conclude that it does remain necessary in order to protect the public and is otherwise in the public interest for this interim order to be extended for a period of a further 4 months. That is the order that I now make.

Shall I sign the draft order that you have kindly handed up?

MR JEFFS: My Lord, I am very grateful. There is one other matter I should properly raise, if I may. My Lord did indicate, of course based on my submissions, that it is not the intention of the applicant to transfer this matter back to the Conduct and Competence Committee; those are my instructions. Of course, the regulatory legal team would have no control should the Health Committee decide to do that of its own volition, but it is certainly not a course that they are going to be invited to take.

MR JUSTICE SINGH: Thank you for pointing that out very fairly to me, Mr Jeffs. I note that, but it does not affect the decision that I make.

MR JEFFS: I am grateful.

MR JUSTICE SINGH: In the draft order, what is the date that I therefore need to insert in paragraph 1?

MR JEFFS: My Lord, I think it would now be 16 December.

MR JUSTICE SINGH: Yes. That would take us 4 months from now. I think that is the only change I need to make; otherwise I will sign this so the court has the endorsed version. Is there anything else?

MR JEFFS: No, my Lord. I am very grateful. Thank you.

MR JUSTICE SINGH: Thank you very much for your considerable assistance.