An orthodontal dental practitioner who had an unblemished career spanning 30 year appealed to the Administrative Court against his suspension with a review, imposed three years after his retirement from practice.
Transcript
The dentist had never before had an allegation of poor performance made against him.
Her Ladyship dismissed each ground of appeal concerning the heads of charge as being wrong, unjust or due to serious procedural or other irregularity.
In its determination on impairment, the PCC observed that the misconduct included multiple non-clinical and clinical failings and failings of a basic and fundamental nature, and there had been resultant harm caused to the patient. Nevertheless, it considered that the identified shortcomings were capable of being remedied.
It also observed that the appellant had taken steps towards remediation which illustrated “a degree of insight” albeit that there had been a “late realisation … of a number of problems in the treatment of [the patient].”
The PCC referred to Professor Wilmot’s very positive view of the appellant’s efforts at remediation through Continuing Professional Development and reflection and described his activities as “commendable” given his retirement.
However, it was concerned that the appellant had been out of clinical practice for almost three years and took into account that the issues in the case related to matters of clinical assessment, clinical technique, record keeping and patient communication. It had received little or no independent assurance that the remediation undertaken had made any difference to the appellant’s day to day clinical practice.
It considered that public confidence in the dental profession would be seriously undermined if a finding of impairment were not made in these circumstances. Furthermore, such a finding was required to promote and maintain proper professional standards.
Dismissing the appeal against a finding of impairment, the Court considered that the PCC was best placed to determine where the balance lay between the competing positions advanced by the parties on the impairment issue, not least because the matters in issue reflected misconduct constituted by a failure to reach proper standards in treating patients, not matters such as dishonesty or sexual misconduct, and an assessment of what the public interest required.
In respect of sanction, the committee concluded that given that the appellant had retired from clinical practice, it could not see how it could formulate a set of conditions that would protect the public and address wider public interest considerations such that conditional registration in the circumstances of this case would not be practical or workable.
It determined that a six month suspension followed by a review was the appropriate sanction as it marked the seriousness of the misconduct found and would afford the appellant the opportunity to address the concerns raised by the PCC while ensuring the public was adequately protected.
On appeal it was argued that by imposing a period of suspension the PCC was posing the appellant an impossible task: he was being denied the very opportunity the PCC had purported to afford him to address its concerns (ie a return to practice, through which he could evidence embedded learning opportunity to address concerns identified by the PCC); a more appropriate sanction would have been the imposition of conditions on his registration.
The Court found that the PCC correctly directed itself to the relevant guidance on sanctions and properly considered them in increasing order of gravity.
It was entitled to conclude, based on the lack of evidence of the appellant having the necessary structure and support network, that conditions were not, yet, practical and workable in this case.
The PCC was therefore entitled to consider that a suspension with review was the appropriate sanction, bearing in mind the twin purposes of protecting individual patients from risk and the wider public interest.
The sanction imposed was appropriate and necessary in the public interest and was not excessive and disproportionate such that the Court should interfere.