The High Court has found that NHS regulations do not forbid ‘top-up’ fees, after the GDC struck off a dentist.
The High Court of Justice has revoked the GDC’s decision to erase a dentist.
Lucy Jane Williams, the dentist, was charged with professional misconduct allegations, including charging ‘top-up’ private fees in addition to NHS charges. She had provided three patients with an NHS crown and offered a ceramic crown for an additional top-up.
The GDC’s Professional Conduct Committee argued that NHS regulations did not allow such mixing, that she had behaved ‘contrary to a fundamental tenet’ of NHS charging, and that she was dishonest. As a result, she was erased from the register.
After Williams appealed, the High Court confirmed that ‘top-up’ fees were permitted by the NHS regulations, and that mixing NHS and private treatment was allowed – and on the same tooth.
As a result, the judge found her erasure to be wrong and ‘procedurally unfair’. He also found the NHS regulations to be ‘not at all straightforward’.
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This case has sparked concern across the dental profession, with some questioning the GDC’s fitness to practise protocols as well as the NHS regulation changes.
Neel Kothari, a practice owner in Cambridge, said: ‘There has been little to no support for registrants who are placed in the most impossible position of having to wade through a myriad of incoherent regulations, doing what they can to make a flawed system work, but risking their registration in the process of doing so.
‘This is simply not good enough and will no doubt force many dentists to ponder – is it too risky to work within the NHS?’
Clarity needed from NHS England
The BDA has stated ‘there is no doubt that dentists can mix on the same tooth’ and that ‘this has been the case since 2006’.
It also stressed that NHS England officials must ‘provide clarity on multiple fronts’ and that dental professionals should familiarise themselves with the relevant regulations in the meantime.
Head of BDA indemnity, Len D’Cruz, said: ‘Lucy Williams has faced lengthy and traumatic regulatory court processes.
‘Lawyers engaged by both sides in the original GDC hearing failed to recognise regulations removing “same tooth” mixing landed in 2006. It might well have saved much anguish and a significant amount of heartache, not to mention cost, for everybody concerned had they done so.
‘The GDC must now reflect on every [fitness to practise] case and erasure from the last 17 years that did not acknowledge these changes.
‘Judges have recognised that dentists shouldn’t be left out of pocket when providing a private crown alongside other NHS treatment on this, and that this is closer to the spirit of free dental services. That’s progress.’
Damage to wellbeing
The British Association of Private Dentistry (BAPD) published a statement regarding the case.
It said: ‘The British Association of Private Dentistry fully supports all dental professionals in all aspects of UK dental practice and in their expectation to be treated fairly and with due accuracy, as a fundamental tenet in any fitness to practise proceeding initiated by the General Dental Council.
‘Of particular concern to us is the damage to individuals’ mental and physical wellbeing when this process continues to not only take significantly longer than it should, but is then found to be flawed.’
It also said: ‘The GDC should not be surprised at the number of professionals disillusioned with practising dentistry in this country. The BAPD stands with the whole profession in calling for urgent reform to the GDC fitness to practise processes, as well as a fundamental shift in the approach of all involved in these processes.
‘Changes need to be put in place swiftly, with action also demanded from the Secretary of State to remedy systemic failings that are seemingly written in stone and with little hope of improving the morale and mental health of dental professionals in the UK.’
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