Sex, death and Dr High’s dramatic fall from grace
DENTAL BULLETIN, ISSUE 39
Dr High appeared before the PCC on the 23rdJanuary. The charges allege that, whilst employed as a Senior Lecturer at a School of Dentistry, on one or more occasions between the 1stJanuary 2013 and the 12th March 2015, he engaged in sexual activity in his office; and that this conduct was inappropriate and/or unprofessional. Secondly, it was alleged that when questioned about his conduct, he provided a false account as to his whereabouts; and therefore his conduct was misleading and/or dishonest.
On the same day four other dentists appeared before the committee facing allegations from failing to provide an adequate standard of care, poor communication and inadequate record keeping; all of which arguably could have a more direct detrimental effect on public safety. One dentist is even alleged to have offered money and free treatment to a mentally ill patient in an attempt to persuade them to withdraw their complaint to the GDC; an allegation that if proved will have extremely serious consequences. However, it is Mr High that piqued the interest of the newspapers. It is not hard to see why. The public shaming of a successful professional, with lascivious details thrown in for good measure is an irresistible mix. However, in my view from a professional conduct point of view, the inappropriate sexual conduct in the work place is arguably less damning than the dishonesty that followed.
9 Principles for Practice in Dentistry
The GDC Standards for the Dental Team sets out the Principles for Practice in Dentistry:
1. Put patients’ interests first
2. Communicate effectively with patients
3. Obtain valid consent
4. Maintain and protect patients’ information
5. Have a clear and effective complaints procedure
6. Work with colleagues in a way that is in patients’ best interests
7. Maintain, develop and work within your professional knowledge and skills
8. Raise concerns if patients are at risk
9. Make sure your personal behaviour maintains patients’ confidence in you and the dental profession
The GDC expressly states that all members of the dental team will maintain appropriate personal and professional behaviour. Of course what is appropriate is sometimes rather subjective; one man’s offence can be, within reason, another’s entertainment. But the line is certainly crossed when a dental professional is dishonest.
The Case Examiner Indicative Outcomes Guidance
In August of 2016 the GDC published the Case Examiner Indicative Outcome Guidance. It was developed for use by the case examiners when considering cases that had been referred to them by the Registrar and is intended to provide a framework for the issues that they think should be considered by the Practice Committee. The guidance states that in cases involving dishonesty or deliberately misleading behaviour and cases involving sexual impropriety a referral to the Practice Committee is likely to be appropriate.
Analysing paragraphs 13 to 15 of the guidance
However, paragraphs 13 to 15 of the guidance states as follows:
“13. Allegations of sexual misconduct encompass a wide range of behaviour, from criminal convictions for sexual assault and sexual abuse of children (including child pornography) to any form of sexually motivated behaviour involving patients and/or colleagues.
14. Sexual misconduct has the potential to undermine public trust and confidence in the profession. This is particularly so where:
(i) there has been any abuse of the position of trust which exists between a patient and dental practitioner, or between a dental practitioner and a junior colleague;
(ii) there has been abuse of children or vulnerable adults, particularly where there is also an element of grooming;
(iii) a registrant has been convicted of a criminal offence involving sexually motivated or indecent conduct, or relating to child pornography; and/or
(iv) the registrant has been required to register as a sex offender.
15. In those cases, the need to protect the public interest by maintaining public confidence in the profession, and by declaring and upholding proper standards of conduct is such that, where there is a real prospect of the facts being established, there is also likely to be a real prospect of misconduct being established and of a finding of current impairment being made by a Practice Committee.”
Does Dr High’s sexual behavior amount to professional misconduct?
When one considers Dr High’s sexual behaviour against this guidance, it is difficult to see where it falls. There is no suggestion that the woman involved was a patient, student or colleague of Dr High, and no suggestion that any inappropriate influence had been exerted over her. What he had done was arguably antisocial, but unlikely to be criminal. Dr High’s employers would certainly have cause to take disciplinary action against him, and it is unlikely that he would have an argument against dismissal for gross misconduct. But does his sexual behavior amount to professional misconduct, leaving his fitness to practice impaired? Does an academic using his office for illicit purposes undermine the public’s confidence in both him as a professional and in the profession as a whole?
Dr High continued with his inappropriate and unprofessional behaviour even following an informal warning
The GDC thought so. On the 24th January misconduct was found and he was erased from the register. The GDC committee commented that “Dr High continued with his inappropriate and unprofessional behaviour even following an informal warning. [We have seen] nothing to show Dr High has any insight into the seriousness of his actions or the potential consequences, and he has not provided any assurance that his misconduct would not be repeated.”
However, it was his behaviour thereafter which made matters much worse. During an investigation into his conduct by the University, Dr High provided various documents that supported his assertion that he had not been in the building at the time of at least one of the allegations; presumably in an attempt to discredit his accusers. However, his lie was uncovered when it became apparent that he had been logged on to the university computer system.
Analysing paragraph 24 of the guidance
The Guidance states at paragraph 24 that:
“Patients, employers, colleagues and others have a right to rely on registrants’ integrity. Important choices about treatment options and significant financial decisions can be made on the basis not only of registrants’ skill but also of their honesty….The GDC’s position is that dishonesty, particularly when associated with professional practice, is highly damaging to public confidence in dental professionals as it undermines the trust that the public are entitled to have in registrants. In that regard, the Privy Council has emphasised that:
“…Health Authorities must be able to place complete reliance on the integrity of practitioners; and the Committee is entitled to regard conduct which undermines that confidence as calculated to reflect on the standards and reputation of the profession as a whole”.”
Test for dishonesty
When considering whether a dentist has acted dishonestly the PCC will rely on a two stage test, known as the Ghosh test (taken from the legal case R v Ghosh  QB 1053) which states as follows:
1. According to the ordinary standards of reasonable and honest people, was what was done dishonest? If yes,
2. Would the registrant himself have realised that what he was doing was, by those standards, dishonest?
The PCC found that the “deliberate and calculated false account…which had the intention to mislead the investigators and undermine the allegations made against him was conduct that fell significantly below the standards expected.”
This is clearly an extreme case of poor behaviour; but a lesson none the less for practitioners. Whilst accepting one’s poor behaviour may sometimes be embarrassing and uncomfortable, a mature and contrite acceptance of wrongdoing can sometimes be the difference between an admonishment and the end of a lengthy career.
If you have any questions about the content of this article please feel free to email Julia Furley at firstname.lastname@example.org, or call her on 0207 388 1658. If you need advice on appealing a decision by the professional conduct committee please contact our expert lawyers.
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Julia Furley, Barrister
Please note that the information contained in this article was correct at the time of writing. There may have been updates to the law since the article was written, which may affect the information and advice given therein.