GDC Commence Court Case Over “Top Up” Fees

GDC Commence Court Case Over “Top Up” Fees

In June 2022 in the High Court, Mr Justice Ritchie overturned the GDC decision to erase a young dentist. It was the second time in three years that a decision by the Council’s Professional Conduct Committee (PCC) had been overturned in the High Court.

The dentist who had been erased as a result of the PCC decision, has been restored to the register following Justice Ritchie’s judgement. Now, on their website, in a news feature headlined “GDC seek clarity on interpretation of NHS regulations” the Council have announced that they intend to appeal the High Court decision. The GDC do state that, “we are not seeking to appeal the sanction imposed” but that they are concerned about the way in which the NHS Regulations were interpreted. It is the GDC’s contention that the only way that clarification can be achieved is through the Courts. The appeal, the GDC say “will clarify how the regulations should be interpreted for dental professionals, dental practices, NHS bodies in England, and for the purposes of our own regulatory activities”

At the erased registrants appeal, Justice Ritchie described the original decision as “Disproportionate and unnecessary.” In what is generally agreed to be a complex case, with a hearing lasting 27 days and involving 16 witnesses, there was a long list of allegations. These included ones related to record keeping, failure to diagnose and treat caries, failures in X-ray reporting, and inappropriate claims. The dentist did not appeal all of these, with most of the appeal regarding the findings of dishonesty. These related to the dentist having offered patients the option of “top up fees” when having NHS treatment.

Some dental figures have expressed concern that the registrant, a recent UK graduate, who had presumably completed a foundation year and was working in NHS practice, was not familiar with the regulations, and in particular that private top ups for NHS items of treatment were very much a no go area. However, Justice Ritchie observed that there were inconsistencies between the NHS charges and contract regulations, and Business Service Authority guidance. He also noted that the registrant had been in a very busy practice seeing up to 50 patients a day, had experienced difficulties in her relationship with the practice owner, and had not been given a contract there.

In his conclusion Justice Ritchie allowed the appeal against the PCC decision in relation to the top up charges and related findings of dishonesty. He went on to quash the PCC’s sanction of erasure and instead substitute a 9 month suspension. He added that in the event that a higher court found him wrong in overturning the dishonesty charges, that he wished it recorded that he would have increased the suspension to one year for all the charges.

Lastly, Justice Ritchie stated that, “no further sanction may be imposed for the matters covered by the investigations considered by the PCC.” This would suggest that the GDC’s comment that, “we are not seeking to appeal the sanction imposed” was not so much a benevolent gesture, as the acknowledgement of a ruling that they would have no choice but to abide by.

Original case report: https://www.gdpuk.com/news/latest-news/4352-high-court-quashes-gdc-erasure-decision-as-mixing-comes-under-the-spotlight

GDC announcement: https://www.gdc-uk.org/news-blogs/news/detail/2022/12/19/gdc-seeks-clarity-on-interpretation-of-nhs-regulations

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