Serious failings in Court for GDC

Once again, the GDC is in the courts and on the wrong end of criticism for the way it has conducted itself in legal proceedings Baz v General Dental Council [2025] EWHC 643 (Admin) (20 March 2025). At the same time, serious failings have been identified in the effectiveness of the non-executive Council by external consultants.

The Baz case is complicated, with multiple legal cases in the background, and arises from a decision to erase a dental nurse which was made by the Professional Conduct Committee of the GDC on 18.1.24. It is worth setting out the key dates in the case to illustrate the hopeless delays that happened within the GDC. The PCC decision was confirmed to Ms Baz on 1.2.24. Here is a link to the determination BAZ, Umut The hearing was unexpectedly challenging for the panel, and questions might be asked as to why the hearing was not adjourned to seek a health assessment. There is no doubt that the GDC staff faced a tremendous challenge dealing with this person to the point that the Court had previously imposed a General Civil Restraint Order (GCRO) which required Ms Baz to seek the permission of the Court to issue any new proceedings involving the GDC.

Briefly, the GDC has not only tried every trick to try and prevent Ms Baz exercising her statutory right to make an appeal against the PCC decision, it also demonstrated a serious lack of urgency in responding to the legal case and a fundamental failure to follow the Civil Procedure Rules by not including Ms Baz in its legal correspondence with the Courts.

Ms Baz needed permission to appeal because the GCRO was still in place during the 28-day window to make her appeal. Ms Baz made her application for permission to make an appeal on 7.2.24. The GDC was given the chance to put in reasons why the permission should be refused by the Judge, with a deadline of 15.3.24. The GDC either chose not to put in any response or failed to put in a response through incompetence. Either way, the Judge decided that the GDC had missed its opportunity to say why the application should be refused because it was “frivolous or vexatious”. Permission to lodge the legal claim was given on 28.3.24 and Ms Baz lodged her legal papers on 3.4.24. She told the GDC that the claim had been sent to the Court on 5.4.24. The GDC had been notified on 28.3.24 that the Court had given Ms Baz permission to issue proceedings but inexplicably it waited until 5.8.24 to make an application to set that decision aside.

Unfortunately, there were delays in the Court process and the GDC was not notified about the claim by the Court until 3.7.24. Ms Baz had sent a copy of the claim to the GDC via post, with proof of posting as soon as she heard from the Court that the claim had been successfully lodged on 16.5.24. The GDC corresponded directly with the Court and for some reason, did not include Ms Baz in the correspondence, which it should have done.

The conclusion of the case is that Ms Baz now has the opportunity to have her appeal heard in the High Court. At this point this Court has deliberately not considered the merits of any appeal, it has just dealt with the GDC’s attempts to have Ms Baz’ case struck out. In that it has spectacularly failed. This is the second case in six months where the conduct of legal claims could be considered hopeless General Dental Council v KK & Anor [2024] EWHC 3053 (Fam) (25 November 2024).

These cases cost large amounts of money, money that is collected from registrants as the only significant source of income for the Council. What scrutiny is in place making sure that registrants fees are not being incompetently wasted by a legal team that seems not to learn from its mistakes? The GDC will point to the relatively low sums spent on external legal costs, but that conveniently hides the huge amount of time (which has a real cost) used up internally by the in-house legal team which is not visible on a case-by-case basis as those costs are not attached to individual cases.

At its recent Council meeting, the GDC received a “Board Effectiveness Review” carried out by external consultants (Item 10 p57-91  Public-Council-Meeting---28-February-2025-(Final-Pack) (2).pdf ) It is telling to read that the GDC Council has not been spending too much time on “Risk”. The ghost of the Post Office incompetence hovers again. Here are a couple of choice paragraphs:-

It is evident to all observers that no-one at the GDC is really interested in dealing with the hard choices within the FTP process. The Executive team offers platitudes to the Council about its performance, carefully burying the data that shows that a case takes one year to pass from Rule 4 observations to a case examiner decision. All that needs to be done in that time is to collate a bundle. The number of cases at that stage of the process is not significant, so it is hard to see what warrants a delay of a year. It is old news that people under investigation make more mistakes, not to mention the impact upon their mental health while the sword of Damocles dangles.

Both the outgoing Chair of the GDC and the new Chief Executive have been keen to stress the importance of transparency, rebuilding relationships with the profession, improving fitness to practise procedures and abolishing the culture of fear. They have been let down again by the failing legal team that does not appear to appreciate that the Civil Procedure Rules that govern legal proceedings, apply to the GDC. What is the Executive team doing about the desperate and unacceptable delays in the FTP process and spectacular failings in the way legal proceedings are conducted?

Once again questions must be asked about the level scrutiny of the executive team by the Council. Even the external consultants spotted this, noting that some on the Council were more concerned about typos in the papers than the subject matter.

The GDC’s “lamentable ignorance” of the confidential nature of Family Court proceedings has led to a brutal judgment of its conduct during the investigation of the fitness to practise of a dental registrant. General Dental Council v KK & Anor [2024] EWHC 3053 (Fam) (25 November 2024)

There have been many episodes I’m sure we all know about where a colleague has done something that has been their eventual professional downfall. Examples like the well publicised cases of Joyce Trail and Desmond D’Mello are a demonstration of how a professional has destroyed their own career and reputation through their actions, whether it be an illegal act, or a dangerous one.

But none is more worrying then the Case of Bawa-Garba. I am sure you are all aware of this, but if not, very briefly this involved a junior paediatrician being charged and found guilty of gross negligence manslaughter due to the tragic death of one of her patients whilst under her care. However, what is unusual about this sentence is that it was not only a very short one, but also suspended; something that very rarely happens in a case like this. As is then the usual route of action, the doctor was referred to the GMC for the associated disciplinary hearing that comes with a conviction. The tribunal found that her fitness to practice was impaired, but allowed her to stay on the register. However, the GMC appealed this decision, and she was subsequently struck off by the High Court last week. Interestingly, an interim orders committee of the GMC suspended the doctor initially, which was overturned on appeal by the high court who ruled that even a serious criminal charge did not always mean that suspension was necessary or appropriate to protect the public.

As someone with a conviction for manslaughter, then one could always argue that a professional actually should not be allowed to practice their art on the public again, but there is case law that supports the more subjective approach that was taken in this case initially. But this case (without going into even more detail) is as much, if not more, of an indictment of the systematic failings of leadership and organisation inherent in the environment Dr Bawa-Garba was working in. That the tribunal found no impairment was significant, as the doctor had engaged in insight, and had placed her reflections on the tragic event on her e-portfolio.

And that is the problem.

By honestly reflecting on the events and committing them to the permanent record of her E-Portfolio, this allowed the GMC to use this reflection against Dr Bawa-Garba, and subsequently was part of the case that was successful against her. In effect, by complying with the requirements of the GMC, she has committed professional suicide by recording her reflections as required. It is fine to record ones reflections to show insight, but to then have them used against you is surely unfair. You would have to trust the regulator implicitly when committing your reflections to a permanent record, and the actions taken by the GMC will have served to destroy any trust that our medical colleagues would have had in their regulator. Given that the GMC has always seemed to be to be a more considered and pragmatic regulator than the GDC of late, then once can only wonder just what manner of jeopardy we will have to place ourselves under as a result of this ruling.

In one fell swoop, the GMC have removed the chance for professionals to show they have learnt from their mistakes and develop in a no (or low) blame environment (as indeed occurs in the aviation industry) and installed a culture of fear that I think even the GDC at its worst a couple of years ago would have struggled to create so effectively. However, with the new GDC rules on CPD and reflective analysis requirements that we now have, is there anyone amongst you that thinks that the same couldn’t possibly happen to dentists? Once a regulator has set a precedent, it is likely that they will all act in the same manner.

I suspect the GMC realise there will be a problem with personal reflection now, and given the release of a blog by the GMC on this issue at the weekend, this might be seen to confirm it. The amount of internet noise coming from the medical profession over this matter is significantly higher than anything we have been able to generate, and as a result one must hope that there is a higher likelihood of something significant developing over the next few weeks and months as a result of this case, something which hopefully will roll down to the GDC as well. Even Jeremy Hunt has raised concerns about this case and its unintended consequences.

Once cannot forget the tragedy of the death of a child in the case, but there has to be consideration of the bigger picture of how a ruling such as this will now probably affect the analysis of mistakes in healthcare that are needed to protect the public.  Furthermore, unless the use of reflective writing is somehow protected, the use against us of our own insightful learning could be our eventual downfall.

Image credit - James Cridland  under CC licence -  modified.