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

A statutory appeal under section 29 of the National Health Service Reform and Health Care Professions Act 2002 is supervisory rather than a rehearing. The court may intervene where a disciplinary tribunal applies an erroneous principle or reaches a sanction outside the range reasonably open to it.

In assessing repeated sexualised or discriminatory conduct, the tribunal must consider the pattern cumulatively and in context. It must properly evaluate attitudinal concerns, the seriousness of all relevant misconduct, insight, remediation and continuing risk. It must not treat sexually motivated conduct as the only relevant sexual misconduct or apply sanctions guidance mechanically. A material failure to do so may render an otherwise protective sanction insufficient. The appropriate remedy may be remission to a differently constituted specialist tribunal.

The Professional Standards Authority appealed under section 29 of the National Health Service Reform and Health Care Professions Act 2002 against a decision of the General Dental Council’s Professional Conduct Committee concerning a registered dentist.

The Committee found repeated inappropriate, sexualised and discriminatory conduct towards colleagues, including junior female staff, together with racist remarks and inappropriate conduct towards patients. It found impairment but imposed six months’ suspension with review. The GDC supported the appeal, while the registrant resisted it.

The issues were whether the Committee had erred in characterising the conduct, whether the case had been under-prosecuted by omitting a specific harassment charge, whether the sanction reasoning adequately addressed cumulative seriousness and attitudinal concerns, and whether suspension was sufficient to protect the public and maintain confidence in the profession.

1. Appeal allowed. The Committee’s six-month suspension with review was insufficient to meet the statutory objectives of public protection, public confidence and proper professional standards.
2. The appeal under section 29 was supervisory. The court was required to respect findings of primary fact and evaluative judgments, but could intervene for an error of principle or where the sanction fell outside the range of reasonable responses.
3. The Committee had approached the allegations too compartmentally. It should have assessed the conduct as an escalating and repeated course of behaviour, including unsolicited sexualised interactions with junior female colleagues, discriminatory and racist remarks, and the professional power imbalance.
4. The Committee erred in concluding that a comment about a female patient’s chest was not sexual in nature. In its context, the only reasonable inference was that it formed part of the wider sexualised pattern.
5. The Committee also erred in treating unsolicited questions about colleagues’ sex lives, explicit-image remarks and sexual ranking comments as not sexually motivated. The alternative explanation that the conduct was merely provocative or an assertion of authority did not adequately engage with its inherently sexual character.
6. The under-prosecution ground failed. Although a harassment charge could have been framed, the allegations and evidence sufficiently placed the substance and gravity of the conduct before the Committee. The absence of statutory harassment terminology did not cause material procedural unfairness.
7. The Committee inadequately analysed its own description of the behaviour as attitudinal, including whether it evidenced the deep-seated attitudinal problems identified in the sanctions guidance as potentially supporting erasure. It also gave undue weight to limited insight and remediation despite incomplete understanding and continuing risk.
8. The matter was remitted to a differently constituted Committee to reconsider sanction on the existing findings, subject to the conclusions in this judgment. The Committee must assess the gravity of the misconduct as a whole, attitudinal concerns, insight, remediation and risk of repetition. No order for costs was made against the GDC.

• General Dental Council Professional Conduct Committee: found most allegations proved, determined that the registrant’s fitness to practise was impaired, and imposed six months’ suspension with review.
• High Court (Administrative Court): the appeal was allowed under section 29 of the National Health Service Reform and Health Care Professions Act 2002; the sanction decision was remitted to a differently constituted Committee for reconsideration.