A dentist has successfully appealed against being struck off the register on allegations of dishonesty and fraud.
In Balachandra v The General Dental Council  EWHC 18 (Admin) (10 January 2024), the Appellant was a dentist providing mainly NHS services in Fareham, Hampshire from her own practice with 3-4 other dentists and support staff.
In February 2023 the Professional Conduct Committee [PCC] of the General Dental Council [GDC] erased the Appellant’s name from the register. The main reason for that decision was that the PCC found that the Appellant had made handwritten clinical notes about 11 patients long after the treatments were provided, and then sought to persuade the PCC that the notes were contemporaneous.
The Appellant denied the assertion of post event note fraud and seeks to overturn the findings made by the PCC on that alleged wrongdoing and the decision on erasure as the appropriate sanction. There were less serious charges relating to some clinical failings and poor or withdrawn billing, which the parties agreed were not central to the appeal. There were charges found proved, which are not appealed.
- More specifically, the grounds of appeal were:
- Ground 1: The PCC were wrong to refuse to stay the proceedings in relation to the Brown Cards charges.
- Ground 2: The PCC were wrong to find as a fact that the CQC report in 2013 did not refer to the Brown Cards.
- Ground 3: The PCC were wrong to conclude that each (Brown Card) charge was proven.
- Ground 4 and 5: The PCC were wrong to find as a fact that the Appellant made backdated Brown Cards and submitted them to the NHSE and GDC.
- Ground 6: The PCC were wrong to conclude that the admission of Doctor Pal’s evidence in respect of record keeping prior to and at the time of the charges would be prejudicial to the GDC’s case. His evidence was admitted at stage 2.
- Ground 7: Sanction. The PCC were wrong to erase the Appellant from the register. Suspension would have been the appropriate sanction.
- Ground 8: The PCC were wrong to impose an immediate suspension order to cover the appeal period.
Mr Justice Ritchie summarised the issues before the court as follows:
The first issue in the appeal was whether the Appellant’s application to stay the hearing or dismiss the charges in relation to the Brown Cards for abuse of process should have been granted. If this is decided in the Appellant’s favour then the Appealed Findings will be set aside, but not the Unappealed Findings.
The second issue is whether the PCC were wrong, on the evidence before them, or whether it was procedurally seriously irregular and/or unjust to make the Appealed Findings relating to dishonestly back dating the handwritten Brown Cards under the asserted frauds 1 and 2 (which I shall explain below) at all or for the reasons given.
The third issue is whether the sanction of erasure was wrongly imposed taking into account the Appellant’s 7 years of safe practise from 2016 to 2023; her otherwise good character; her CQC reports and other mitigating evidence.
Summarising the “central issue” of the case, Ritchie J commented:
“… was whether the Appellant fraudulently wrote the Brown Cards. The PCC did not define it that way but instead expressed the central issue by asking whether the Appellant delivered the Brown Cards to NHSE in June 2017. That did not quite get to the heart of the central issue. On the PCC’s issue, there was no first-hand eye-witness evidence from the GDC to rebut the Appellant’s evidence that she herself gathered the original notes for The 11 together and delivered them to the Post Office. There was no evidence of how these were sent to Darlington. There was no evidence from Capita’s Darlington staff. No copying protocol was put in evidence. So, all the GDC had to rely on was the scans taken which, on the agreed evidence, were incomplete. Many documents, including the Brown Envelopes, had not been copied on both sides. At best all the PCC could conclude from this evidence was that Brown Cards were not scanned. In my judgment there was insufficient evidence to find as a fact that no Brown Cards existed in June 2017.”
In his judgment in the particular grounds of appeal, Ritchie J commented:
Ground 1: Taking into account that law in relation to stay and abuse of process, I do not consider that the PCC were wrong to dismiss these applications for the reasons set out above in the analysis.
Ground 2: (That the PCC were wrong to find as a fact that the CQC report in 2013 did not refer to the Brown Cards). There was no sufficient evidence one way or the other to uphold this ground of appeal.
Ground 3: (That the PCC were wrong to conclude that each (Brown Card) charge was proven). In my judgment, this ground was made out in the appeal for the reasons set out in the analysis. There was inadequate evidence to draw the inferences the PCC drew. In addition, the PCCs stated reasoning was flawed, and no adequate reasoning was provided to justify the findings.
Grounds 4 and 5: In my judgment, the PCC were wrong to find as a fact that the Appellant fraudulently made back dated Brown Cards and submitted them to the NHSE and GDC. There was inadequate evidence to draw the inferences the PCC drew. Further, I find that the PCCs stated reasoning was flawed and there was no adequate reasoning provided to justify the findings. I will be setting aside the findings on the following charges with all of the sub-charges: 1-11, 16, 17, those parts of 21 relating to Brown Cards and 22-24.
Ground 6: (Doctor Pal’s expert evidence as to the Appellant’s record keeping at stage 1.) His evidence was admitted at stage 2. I have read the transcript and there was no application to rely on his evidence at stage 1. His report was dated June 2022 so did not exist when Stage 1 took place. The Appellant did not proceed with this ground at the hearing.
Ground 7: Sanction. (That the PCC were wrong to erase the Appellant from the register. Suspension would have been the appropriate sanction). Because I have set aside many of the most serious charges, I consider that this case should be remitted to the PCC for reconsideration of the sanction.
In the final point, Ritchie J ruled:
“Therefore, the immediate suspension ceases from this determination of the appeal. I consider it is determined by the handing down of this judgment. If I am wrong about the date of the automatic ending under S30, then I specifically terminate the order for immediate suspension on the date of handing down pending the remission to the PCC for sanction because, on the evidence put before the PCC, the Appellant practiced reasonably safely for 7 years between 2016 and the sanctions hearing in 2023.”
Disclaimer: The accuracy and information of news stories published on this website is accurate on the date of publishing. We endeavour to update stories if information change. You can contact us with change and update requests. Where possible, we will link to sources. Content on this website is for guidance purposes only. We cannot accept any responsibility or liability whatsoever for any action taken, or not taken. You should seek the appropriate legal advice having regard to your own particular circumstances.