Council for the Regulation of Healthcare Professionals v General Dental Council & Anor

A professional disciplinary committee must give reasons for a penalty which demonstrate how it protects the public, maintains confidence in the profession and maintains proper standards. Where serious, longstanding misconduct is followed by the maximum period of suspension, the reasons should address training or retraining, current professional evidence and whether the deficiencies can be remedied before the practitioner returns to practice.

Failure to address those matters may constitute a serious procedural irregularity. If the court cannot assess whether the penalty protects the public, it may allow the appeal, quash the penalty and remit the case under the National Health Service Reform and Health Care Professions Act 2002.

The Professional Conduct Committee of the General Dental Council found Iain Ralph Marshall guilty of serious professional misconduct arising from extensive failings in the treatment of nine patients over approximately 15 years. It imposed the maximum available suspension of 12 months.

The Council for the Regulation of Healthcare Professionals referred the disciplinary decision to the Administrative Court under section 29 of the National Health Service Reform and Health Care Professions Act 2002, contending that the reasons for the sanction did not show how the public would be protected when Mr Marshall returned to practice. The Council no longer sought erasure directly and instead sought quashing and remittal.

1. Statutory appeal. A reference under section 29 of the National Health Service Reform and Health Care Professions Act 2002 is treated as an appeal. The review provisions in CPR Part 52 apply. The court must consider whether the disciplinary committee properly performed its task and reached a correct decision on penalty, and may dismiss, quash, substitute or remit the decision.
2. Reasons and public protection. The authorities, including Selvanathan v General Medical Council and Stefan v GMC, establish that professional disciplinary committees must give reasons for findings and penalty. The reasons need not normally be detailed findings on every fact, but they must be adequate for the issue decided. Protection of the public is central to the penalty decision. The reasons must therefore explain how the chosen sanction protects the public, maintains public confidence and maintains professional standards. They also serve the Council’s statutory oversight functions, as recognised in Threlfall v General Optical Council.
3. Finite suspension. Where misconduct is serious and longstanding, and a 12-month suspension permits the practitioner to return to practice without further safeguards, the committee must explain why the public will be protected on return. Relevant matters include evidence of training or retraining, up-to-date evidence from dentists with whom the practitioner has worked, and whether the identified deficiencies can be remedied during the suspension. The PCC’s reasons did not address those matters and it was unclear how public protection would be achieved.
4. Disposition. The failure to give adequate reasons was a serious procedural or other irregularity and a failure of process. The court could not determine whether suspension was appropriate. The appeal was allowed, the penalty was quashed and the case was remitted to the PCC. On reconsideration, the PCC was directed to consider satisfactory evidence of past or future training or retraining and current evidence from dental practitioners concerning Mr Marshall’s conduct and proficiency in New Zealand. If satisfied that suspension would protect the public, it should say so and give reasons; otherwise, erasure might be the proper penalty.

1. Professional Conduct Committee of the General Dental Council: Found Mr Marshall guilty of serious professional misconduct and imposed a 12-month suspension on 14 July 2005.
2. High Court (Administrative Court): Allowed the Council’s appeal, quashed the penalty and remitted the case to the PCC with directions.