April was a busy month in Fitness to Practise. Unlike March where there was something for everyone, April saw mainly dentists and dental nurses on the proverbial naughty step. Of these 21 had their favourite things taken away from them, 29 were put into time out, and 2 were sent to their rooms indefinitely. Drilling down into the outcomes further, the final statistics for April were as follows:
Interim Orders held 20 new hearings and 15 review hearings resulting in:
- 18 suspensions or suspension extensions;
- 12 conditions orders or conditions orders extensions;
- 4 no orders and;
- 1 adjournment.
14 registrants were not present +/- not represented at their IOC hearing, and were mostly suspended with a couple kept on conditions.
Practice committees held 29 new hearings and 9 review hearings resulting in:
- 2 erasures;
- 6 new suspensions, 1 suspension extension and 1 suspension being revoked;
- 8 new condition orders, 1 extension of conditions orders and 3 conditions orders being revoked;
- 1 reprimand;
- 3 postponements and 2 adjournments;
- 1 case concluded (the incident was historic and there was no current impairment);
- 1 no impairment;
- 2 registration appeals (1 granted, 1 refused);
- 1 restoration hearing (refused);
- 4 health related hearings with all registrants kept on suspensions and;
- 1 no case to answer
By registrant type, dentists were the clear sinners with 57, followed by 15 dental nurses and a single dental technician.
Cases of interest in April
The restoration hearing heard in April was refused for the second time due to a lack of insight by the registrant into why note tampering is serious misconduct rather than a silly mistake. The GDC request to indefinitely suspend any further applications due to the costs involved, was not upheld by the panel who, like a Buddhist monk in meditation, felt that insight might be obtained at some point, and directed the erased registrant towards obtaining representation and taking relevant courses into ethics and personal responsibility before making any future applications. Said registrant will no doubt benefit from such wisdom and gain mindfulness as a result of the teaching!
Not long after, a dental nurse who was not engaging in her on-going hearing relating to failures in decontamination procedures, was kept on suspension by the panel. She had not turned up again; perhaps having realised that she could earn as much if not more as a domestic cleaner given the average wage of a dental nurse, with the added bonus of not having to be answerable to a regulator. I need to do some further reading into whether the Fitness to Practise Rules have any mechanism to bring an on-going cycle of hearings for the above scenario to an end. Let us not forget there is no statutory limit to the amount of money that can be collected from registrants to be spent on Fitness to Practise hearings.
Interim Orders met to discuss keeping a registrant who was in prison for fraud and false accounting on a suspension. If this is not a waste of everyone’s time and money I am not sure what is, unless there is scope for him to be employed as a prison dentist without an interim sanction.
My other conundrum this month with Interim Orders is in their role of risk assessment and the concept of innocent until proven guilty. By putting the allegations against a dental nurse as a statement of fact (‘misappropriation of funds’ into a personal account including the practice name, the exact amount of money and number of patients involved) into the public domain is she going to be able to have a fair hearing? It rather reads like the IOC have accepted her guilt, yet there is no mention of any admission or criminal conviction for this alleged theft in the public determination.
Experts were on good form throughout April. When we thought we’d seen the last of them after Dental Protection’s reassurance that there is no legal or regulatory requirement for it, the dreaded failure to record LA batch numbers were back, making it into a charge sheet via GDC expert witness Conor Mulcahy. Perhaps someone can point him in the direction of this useful position statement for any future cases: http://www.dentalprotection.org/uk/publications-resources/updates/briefing-documents/2015/11/09/local-anaesthetic-batch-numbers
Aside from the batch numbers of local anaesthetics, sadly there were no other particularly curious or intriguing charges put forward this month. There were however, some thought-provoking conditions in one case which restricted the registrant from sending abusive or offensive communications. One of the erased registrants was in jail having been convicted of fraud and deception, and the other was voluntarily not present but faced a raft of serious clinical deficiencies which were found proved, including using a block of bone that had dropped on the floor on a patient.
In the ‘No case to answer’ case, expert witness Robert Bland scored an own goal and had his evidence set aside by providing superficial evidence, changing his mind at a late stage on fundamental matters relating to the case, and most importantly exhibiting a ‘lack of impartiality’ by failing to include ‘evidence that was potentially exculpatory’ to the registrant. This registrant and his wife are seriously considering leaving the profession despite the no case to answer verdict; this is exactly why the GDC must be taken to task for the style and method of its prosecution of cases over many years, and for the failings in its expert witnesses. I’d also like to make the point here that pathologist Alan Williams who failed to disclose potentially exculpatory evidence in the Sally Clarke cot deaths case, was later found guilty of serious professional misconduct and banned from court work for 3 years. The past 12 months have now seen 3 cases slung out because the experts appointed by the GDC have shown a lack of impartiality. Experts also need to remember they are not immune from a civil lawsuit, and frankly it is probably only a matter of time until one is sued, or sanctioned.
Whilst I am on the subject of bias, it also isn’t appropriate for experts to advertise themselves in a manner that suggests they are employed by, or otherwise working as an expert witness purely on behalf of the GDC. You cannot be impartial if you only do work for one side and I am amazed that this has not yet been picked up on and challenged by any registrants’ legal teams.