Professional Standards Authority for Health and Social Care v General Dental Council

On a statutory appeal concerning a disciplinary sanction following a serious criminal conviction, the court must assess whether the sanction sufficiently protects the public interest, including public confidence and professional standards. A general principle that a practitioner should not resume unrestricted practice before completing a serious criminal sentence is a starting point, not an inflexible rule. It must yield to a sanction that is just, proportionate and no more than necessary. A reprimand will ordinarily be inadequate where the conviction involved imprisonment, whether immediate or suspended, unless circumstances plainly justify departure. The absence of evidence of public concern is not a proper reason to reduce the sanction. Personal mitigation has a limited role because regulatory sanctions are protective rather than punitive.

The Professional Standards Authority referred a General Dental Council disciplinary decision to the High Court under section 29 of the National Health Service Reform and Health Care Professions Act 2002. The GDC Professional Conduct Committee found that Naveed Patel had been convicted of causing death by careless driving, had failed to notify the GDC of the charge, and had misled the GDC. It found impairment by conviction and misconduct but imposed only a reprimand.

The PSA argued that the sanction was insufficient to maintain public confidence, particularly in light of the serious driving offence, the suspended custodial sentence and the principle in Fleischmann. The central issues were whether the Committee had applied the correct approach to seriousness, mitigation, public confidence and departure from that general principle, and what consequential order the court should make.

1. Appeal allowed. The reprimand was insufficient to maintain public confidence and was therefore wrong. The Committee’s decision was quashed and the matter remitted for reconsideration of sanction.
2. The appellate court should interfere with an evaluative sanction decision only for an error of principle or where the decision falls outside the range of decisions reasonably open to the tribunal. The court should respect the expertise of the specialist committee, but may assess the impact of conduct on public confidence where it is equally well placed to do so.
3. The principle in Council for the Regulation of Health Care Professionals v GDC v Fleischmann [2005] EWHC 87, incorporated into the GDC sanctions guidance, is a general starting point. It does not impose a tariff or operate as an inflexible rule. Suspension may remain appropriate even after the criminal sentence has been completed, while in other cases the circumstances may justify a different sanction.
4. An offence resulting in imprisonment, whether immediate or suspended, should normally be treated as serious for the purpose of the guidance. Suspension is the starting point unless circumstances plainly justify another course. The absence of criminal intent, lapse of time and good professional standing did not plainly justify departure in this case.
5. The Committee was entitled to make its own assessment of insight and remorse on the evidence before it. However, it gave impermissible weight to the absence of public concern, treated the criminal punishment and the practical effects of suspension as reasons against suspension, and applied factors directed principally to clinical misconduct rather than the public-confidence consequences of a serious conviction.
6. Allowing the appeal required the Committee’s decision to be quashed. On remission, the Committee was directed to consider what sanction was now required to maintain public confidence, taking account of Mr Patel’s completion of the criminal sentence. The GDC was not ordered to pay the PSA’s costs. Mr Patel was to pay the PSA’s costs, subject to submissions on assessment.

The judgment describes a referral to the High Court under section 29 of the National Health Service Reform and Health Care Professions Act 2002. The GDC Professional Conduct Committee had imposed a reprimand. The High Court allowed the PSA’s appeal, quashed that decision and remitted sanction to the Committee.