Professional Standards Authority for Health & Social Care v General Dental Council & Anor  QBD (Admin)
Patient X was treated by D, a dental practitioner, over the course of three appointments for the replacement of existing fillings. Before Patient X's fourth appointment with D, Patient X went to another dental practice for an emergency appointment. During this consultation, attention was drawn to the quality of the fillings that had been done by D.
Patient X wrote to D detailing the concerns expressed by the consultant allowing D the opportunity to respond to the allegations, which D did via email. D apologised and stated that the reason the fillings were rough was because he had not completed his work and that her fillings were only provisional.
The matter was referred to the Professional Conduct Committee. The Committee found that D's email had been misleading and had intended to mislead but had not been dishonest. Part of the reasoning the Committee cited for not finding dishonesty was that D had stated that he was willing to carry out further work on Patient X and had apologised for not making it clear that her treatment was incomplete. Therefore, whilst the email was misleading it did not meet the threshold required for a finding of dishonesty to be made.
In the absence of dishonesty, the Committee imposed a sanction of reprimand. In imposing this sanction, the Committee referred to the steps D had taken to remedy his actions, his previous record and positive statements provided from other patients.
The Professional Standards Authority for Health and Social Care appealed the decision. The appellant authority concluded that to state that D's email was misleading but not dishonest was contradictory and the sanction of reprimand was unjustifiably lenient. The Council accepted that to make a finding that D had intended to mislead was inconsistent with a finding that D had not acted dishonestly. D accepted the Council’s position but highlighted that a finding of dishonesty was not the only outcome possible following a finding that he had misled.
The court held that the Committee's decision that D’s behaviour had not been dishonest was manifestly wrong and irrational. After further analysis, the court highlighted three factors the Committee had relied upon in reaching its decision as being irrelevant or supportive of a finding of dishonesty:
- It was irrelevant that D had been willing to carry out further work on Patient X in relation to determining dishonesty.
- D's apology to Patient X actually formed part of D's deceit as by apologising, D hoped Patient X would be persuaded to believe that D's work was incomplete.
- That D's good character, as provided by testimonies and past record, was irrelevant to the objective test in Ghosh as D had knowingly misled and intended to mislead.
The Committee’s decision that dishonesty had not been proved was quashed, together with its decision on sanction. The matter was remitted to a fresh Committee.