The Professional Standards Authority for Health And Social Care v General Dental Council & Anor [2021] EWHC 3230 (Admin) (01 December 2021)

The PSA successfully appeal a decision of the GDC’s Professional Conduct Committee in a case involving a dentist accused of clinically unjustified treatments.

For a period up to 22 January 2019, Mohamed Amir, the second respondent, made claims to the public via his website that asthma, ataxia, allergies, sciatic nerve pain, breathing problem, Chrohn’s disease, coeliac disease, depression and anxiety, fibromyalgia, infertility, arthritis, learning difficulties, migraine, multiple sclerosis and heart palpitations could be attributable to a dysfunctional jaw joint, a condition which, as a dentist, the second respondent was able to treat.

As a registered dentist, the second respondent was under a professional obligation to “provide good quality care based on current evidence and authoritative guidance” (paragraph 7.1 of first respondent’s Standards for the Dental Team, 30 September 2013).

The Professional Conduct Committee (“PCC”) found that there is no current evidence or authoritative guidance to support Mr Amir’s claims to be able to address those medical conditions through dental treatment.

The PCC found that this treatment was not clinically justified; and that the second respondent provided it to Patient A without performing an adequate examination of Patient A’s jaw joints; without undertaking diagnostic assessments and special investigations required for an assessment of those joints; without obtaining Patient A’s informed consent to the treatment (including by failing to provide any treatment options or explain any risks); and without making adequate clinical records.

The PCC decided to suspend Mr Amir for a period of three months, subject to a review prior to the expiry of that period.

The PSA referred the decision to the High Court on the grounds that the decision is not sufficient for the protection of the public.   The GDC adopted a neutral stance regarding the appeal. 

Mr Justice Lane, in upholding the appeal, said:

“…that the PCC was wrong and/or committed a serious procedural irregularity in failing to make any proper connection between, on the one hand, the long list of medical conditions set out on the second respondent’s website, which the PCC found he was attributing to a dysfunctional jaw joint; and the failings that occurred in respect of the treatment and care of Patient A. The evidence before the PCC, graphically confirmed by the second respondent’s written and oral submissions to me, is that the second respondent is so committed to his theories and so disparaging of anyone who disagrees with them, that he simply saw no need to go through a process that is demanded of any professional dentist.”

 

On the question of the sanction, the PSA argued that “the PCC’s decision to suspend the second respondent’s registration for a period for three months was a serious procedural or other irregularity because there needed to be an effective inquiry into the reasons why the second respondent had failed in offering proper treatment and care to Patient A, providing him with only one treatment option and failing to inform Patient A of the risks of that option.”

 Lane J commented tha:

” I agree with these criticisms. Even leaving aside the problems with the approach to charge 6, the PCC’s “compartmentalised approach”, as Mr Bradly describes it, meant it failed to afford adequate weight to the seriousness in the deficiencies of the second respondent’s treatment and care of patient A. These did not fall to be viewed in isolation but as part of the second respondent’s advertised belief that a large number of unrelated medical conditions can be attributed to a dysfunctional jaw joint. This flawed approach meant that the reasons why the second respondent acted as he did towards Patient A remained unresolved by the PCC.”

Following a discussion on the rest of the grounds of appeal, Lane J upheld the appeal and substituted the decision of the PCC to erase Mr Amir from the register.

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