Booth v General Dental Council

On a statutory appeal from a professional disciplinary tribunal, the court must decide whether the tribunal’s decision was wrong. It must not interfere merely because another conclusion was possible. Findings based substantially on the tribunal’s assessment of oral evidence should stand unless the appellate court can identify error. Financial motivation may consist of intentionally putting the professional’s financial interests before the patient’s best clinical and financial interests; conduct need not be deliberate, repeated, organised or highly profitable in order to satisfy that description. Where serious clinical failures are accompanied by dishonesty and financial exploitation of a vulnerable patient, erasure may be proportionate even if the clinical failings are remediable and the dishonesty concerns a single transaction.

The appellant, a dentist, appealed under section 29 of the Dentists Act 1984 against findings by the General Dental Council’s Professional Conduct Committee. He challenged findings that his failure to record a £3,000 advance payment was dishonest and that his admitted failures concerning defective or inappropriate treatment were financially motivated. He also challenged the sanction of erasure from the register.

No procedural unfairness, inadequacy of reasons or other procedural irregularity was alleged. The central issue was whether the Committee’s findings and sanction were wrong.

1. The appeal was dismissed on all grounds. The applicable question was whether each challenged decision of the Professional Conduct Committee was wrong. If it was not wrong, the court was not entitled to interfere.

2. The Committee was entitled to find dishonesty in the failure to record the £3,000 payment. The evidence contained unexplained omissions, inconsistencies about the purpose and scope of the payment, and uncertainty about why implants and an advance payment had been proposed when recent examinations had recorded no abnormality. The Committee had heard Mr Booth’s oral evidence, which the appellate judge had not, and its conclusion that the omission was probably deliberate and dishonest was open to it.

3. The finding of financial motivation was also open to the Committee. The expression meant putting the practitioner’s own financial interests before the patient’s best clinical and financial interests, and the Committee’s interpretation was not challenged. The conduct need not be deliberate, repeated, large-scale, highly organised or highly profitable. The evidence that treatment had repeatedly failed, fees had been charged again, and approximately £7,000 should have been refunded but was not, justified the finding.

4. Under section 27B(6) of the Dentists Act 1984, the Committee had considered the hierarchy of sanctions. Erasure was proportionate in view of the catalogue and duration of the clinical failures, the dishonesty, the financial motivation, and the exploitation of an elderly and vulnerable patient. The fact that the clinical failings were remediable, and that the dishonesty concerned a single transaction, did not make erasure wrong.

The judgment records a statutory appeal from the Professional Conduct Committee of the General Dental Council. The Committee had made findings against the appellant and ordered erasure from the register. The High Court dismissed the appeal.