High Court upholds decision of Professional Conduct Committee of GDC to continue conditions in the absence of evidence of full remediation.

Judgement date: 16 April 2013

B, a registered dentist, appealed against a decision of the Professional Conduct Committee (“PCC”) of the General Dental Council (“GDC”) to impose conditions on his registration.

In September 2009 the PCC had found B guilty of misconduct and his fitness to practise to be impaired. The misconduct concerned, in summary, the inadequate clinical treatment of a patient, unhygienic conditions at B’s surgery and dishonest conduct relating to paperwork.

The PCC imposed conditions on B’s registration for a period of 12 months. The conditions were reviewed and modified in September 2010, to include a requirement that B place himself, and remain, under a supervisor at any time he was employed or providing dental services (condition 10), and that he take part regularly in peer group review meetings (condition 11).

In August 2011, the PCC was not satisfied that B had complied with the above two conditions. It found that he had practised unsupervised since the 2010 review hearing and that he had only very recently begun to take part in meetings. The PCC decided to extend condition 10 for a further period of 9 months and it was that decision that was the subject of the instant appeal (condition 11 was removed, as outlined below).

B argued that there were difficulties complying with condition 10, that there was room for confusion as to its proper interpretation and that the PCC’s decision had been unreasonable and unfair.

His appeal was dismissed. HHJ Gore QC rehearsed the authorities on the High Court’s role in appeals against sanctions imposed by professional panels such as the PCC; namely that the court should be slow to interfere with the Panel’s decision on sanction, unless that decision was “clearly inappropriate” (As per Hickinbottom J in Odes v General Medical Council[2010] EWHC 552). 

He also noted the observations of Blake J in Abrahaem v General Medical Council [2008] EWHC 183, that a reviewing panel “has to consider whether all the concerns raised in the original findings of impairment through misconduct have been sufficiently addressed to the Panel’s satisfaction.”

Although there may have been some confusion about the precise ambit and construction of the conditions imposed, condition 10 was, in HHJ Gore’s view, “plain beyond any argument”. Emphasising the “persuasive burden on the practitioner” to demonstrate that he or she had addressed past impairment, he noted that a report, provided to the PCC by the final supervisor appointed to oversee B, gave scant detail about his conduct with patients.

There was, therefore, only limited evidence of B’s practice available to the PCC at the review hearing to satisfy their original concerns as to the public interest, protection of patients and the maintenance of public confidence in the profession of dentistry.  It was on that sole basis that condition 10 had been extended.

HHJ Gore QC noted that the PCC had removed condition 11 at the hearing, having acknowledged that opportunities to participate in the required meetings were in fact rare in B’s region. The conditions imposed were therefore less onerous than those originally placed upon B. Further, it was noted that it had been open to the PCC to suspend B in light of the breach of condition 10 but it had taken ’as benign a view that it is possible to take’.

This case clearly demonstrates that practitioners bear the burden of proving to a review panel that they have sufficiently addressed all aspects of the impairment found by the original panel. Where a panel has not been provided with clear evidence of that remediation, any sanction/conditions will remain. Further, difficulty in complying with a condition will not necessarily absolve the practitioner of the need to meet it, even if the difficulties are through no fault of their own.