Key Facts
- •The General Dental Council (GDC) appealed a High Court decision that partially overturned a Professional Conduct Committee (PCC) determination against dentist Lucy Jane Williams.
- •The PCC found Williams guilty of dishonesty regarding 'top-up' payments for ceramic crowns, exceeding NHS fees.
- •The High Court judge ruled that the relevant regulations did not prohibit Williams' conduct, overturning the dishonesty findings.
- •The GDC appealed, arguing the judge misinterpreted the regulations, and that the dishonesty findings should be reinstated.
- •The Court of Appeal appointed an advocate to assist in interpreting the regulations.
- •Williams charged patients modest additional fees (£30-£65) for ceramic crowns, above the NHS porcelain crown cost.
- •The additional fees covered the higher laboratory costs of ceramic crowns; the practice was financially worse off providing ceramic crowns without the additional fee.
- •The dispute centered on the interpretation of the National Health Service (General Dental Services Contracts) Regulations 2005 and the NHS (Dental Charges) Regulations.
Legal Principles
A judge is not bound by the parties' agreed interpretation of the law if the judge believes it to be incorrect.
Zuckerman on Civil Procedure, 4th Edition paragraph 7.7
Natural justice requires a judge to warn parties if they have a preliminary view that the parties' interpretation of the law is wrong, and invite submissions on the consequences of a different interpretation.
Pantorno v R (1989) 166 CLR 466 at 473
In determining dishonesty, the tribunal must ascertain the individual's actual state of knowledge or belief, and apply the objective standards of ordinary decent people.
Ivey v Genting Casinos (UK) Limited [2017] UKSC 67; [2018] AC 391 at [74]
Regulation 22 of the Contracts Regulations prohibits extra fees for treatment 'under the contract,' while Schedule 3, paragraph 10, allows private fees for 'any part of a course of treatment'.
National Health Service (General Dental Services Contracts) Regulations 2005
Outcomes
The Court of Appeal dismissed the GDC's appeal.
The judge's interpretation of the regulations was correct; there was no prohibition on the 'top-up' fees charged; the dishonesty findings were unsustainable due to procedural unfairness and lack of evidence.
The judge's interpretation of the regulations was upheld.
The regulations permit mixing NHS and private payments where agreed by the dentist and patient, for ‘any part of a course of treatment’, even if the work relates to a single tooth.
The dishonesty findings were quashed.
The PCC's process was flawed, relying on inadmissible expert evidence about the regulations' meaning, operating on a mistaken understanding of a ‘fundamental tenet’ that wasn't in the regulations, and failing to adequately challenge the respondent's evidence regarding her knowledge and intent.