Al-Nahar v General Dental Council

On a statutory appeal against a professional disciplinary sanction, the court must decide whether the committee’s reasons or decision were wrong. It must not substitute its own view merely because another committee might have imposed a different sanction.

Erasure is a sanction of last resort, but it may be proportionate where misconduct is fundamentally incompatible with continued registration. The fact that erasure may prevent an older practitioner from returning to practice does not make it inappropriate if erasure is otherwise necessary. The committee must consider sanctions in ascending order and impose the least restrictive sanction sufficient to protect patients, uphold professional standards and maintain public confidence.

The appellant, a dentist, appealed against the Professional Conduct Committee of the General Dental Council’s decision to erase his name from the register. The committee had found 56 of 66 charges proved, including inadequate or inappropriate clinical treatment, inadequate record keeping and four instances of dishonesty, three involving false insurance claims.

The appeal was limited to sanction. The appellant accepted that the realistic alternatives were suspension and erasure, but argued that suspension would sufficiently protect the public. He relied on his previously unblemished career, professional courses, engagement with the Dental Deanery and changes to his practice. The central issue was whether the committee’s decision to impose erasure was wrong or disproportionate.

1. Appeal dismissed. The court could interfere only if the Professional Conduct Committee’s reasons or decision were wrong. It was not enough that a different committee might have reached a different conclusion.
2. The committee had correctly approached the available sanctions in ascending order. It was common ground that conditions of practice were insufficient. Erasure was properly treated as the sanction of last resort, to be imposed only where lesser sanctions would not sufficiently protect the public interest.
3. The committee was entitled to conclude that suspension would not adequately protect patients, uphold proper standards or maintain public confidence. The misconduct had to be assessed as a whole. It included a substantial catalogue of clinical failings and record-keeping failures, as well as repeated dishonesty over more than 18 months.
4. The committee was entitled to attach significant weight to the dishonesty and to the appellant’s lack of insight. His continued denial of matters found proved gave the committee legitimate grounds for concern that he had not understood the seriousness of his conduct or learned from it.
5. The possibility that erasure would prevent an older practitioner from returning to practice did not justify withholding erasure where it was otherwise requisite. Nor did ceasing to undertake insurer-funded work remove the wider concerns arising from the proved misconduct.
6. The committee had considered mitigation, including the appellant’s long career, testimonials, professional development and personal circumstances. Its reasons adequately explained why suspension was insufficient and why erasure was proportionate. The appellant was ordered to pay the General Dental Council’s costs, summarily assessed by consent at £10,745.

• Professional Conduct Committee of the General Dental Council: found 56 charges proved, concluded that the appellant’s fitness to practise was impaired and directed erasure from the register.
• High Court (Administrative Court): dismissed the statutory appeal and ordered payment of the respondent’s costs.