Ghafoor Manan v General Dental Council

In a statutory rehearing appeal against professional disciplinary sanction, certified criminal convictions may be relevant to impairment and sanction where they have a clear nexus with the practitioner’s conduct in the regulatory proceedings and attitude towards regulatory requirements.

Repeated practice in breach of an interim suspension order may properly be treated as extraordinary conduct destructive of the regulator’s, profession’s and public’s ability to trust the practitioner to comply with restrictions. Erasure may therefore be proportionate even where the underlying clinical misconduct would ordinarily justify a lesser sanction, particularly where there is associated lack of candour, lack of integrity and inadequate remediation.

The Professional Conduct Committee of the General Dental Council found that Dr Manan had committed clinical and professional misconduct in treating Patient A, including failures concerning assessment, records, candour and integrity. It found current impairment and imposed erasure from the register.

The Committee also considered certified convictions for eight offences of practising dentistry while subject to an interim suspension order. Dr Manan appealed under section 29 of the Dentists Act 1984, challenging sanction only. He argued that the convictions were legally irrelevant or had been given disproportionate weight, and that conditions of practice or suspension should have been imposed instead.

The central issue was whether erasure was appropriate and necessary in the public interest, or excessive and disproportionate.

1. Appeal dismissed. The erasure sanction was appropriate and necessary in the public interest and was not excessive or disproportionate.

2. The appeal was a rehearing under section 29 of the Dentists Act 1984. The question was whether the Committee’s decision was wrong or unjust because of serious procedural irregularity. No procedural irregularity or challenge to the factual findings, misconduct or impairment findings was advanced.

3. Certified convictions were not confined to cases in which they themselves constituted a separate ground of misconduct or impairment. They could be considered in assessing impairment and sanction where there was a clear nexus between the convictions and the practitioner’s relationship with the regulator and regulatory proceedings. Here, the convictions arose from repeated practice while an interim suspension order was in force, during the same disciplinary proceedings, and were accompanied by an inaccurate explanation to the Committee.

4. The Committee was entitled to find that the eight convictions constituted conduct which was truly extraordinary and wholly unacceptable from a regulatory perspective. It was entitled to conclude that the conduct destroyed the ability of the public, the profession and the GDC to trust Dr Manan to comply with any restriction on registration, including suspension.

5. The Committee had not unlawfully ignored favourable contextual features of the underlying misconduct. Its reasoning had to be read with the detailed findings of fact delivered shortly before the sanction hearing. The absence of dishonesty, the well-meaning nature of some conduct and the lack of previous fitness-to-practise history did not prevent the failures of candour and integrity from being serious aggravating features.

6. The convictions, the lack of integrity in dealings with the patient and regulator, the attitudinal concerns and the absence of meaningful remediation justified the conclusion that conditions of practice and suspension would not adequately protect the public or maintain confidence in the profession and regulatory process. Erasure was therefore the only appropriate and proportionate outcome.

7. The appellant was ordered to pay the respondent’s costs in the agreed sum of £13,781.60 within 28 days.

• Professional Conduct Committee of the General Dental Council: On 4 October 2022, imposed erasure following findings of misconduct and impairment of fitness to practise.
• High Court (Administrative Court): The statutory appeal was dismissed and the erasure sanction upheld.