AC-2023-LON-002171 - [2024] EWHC 132 (Admin)

As I explained at para 32 above, in respect of charges 15 and 16, the Appellant accepted that she had provided Patient 5 with periodontal treatment by way of a scale and polish under private contract on 11 December 2015 and that she did not record discussing the option of undergoing the treatment under the NHS or why the treatment was provided privately. The PCC accepted Dr Karpeta’s evidence that Patient 5’s records showed that this treatment was necessary and that it was available on the NHS.

Dr Imani’s original case in response to this charge was that she had not provided any periodontal treatment privately. However, when she gave evidence and was cross-examined she indicated that she might have provided Airflow treatment for cosmetic stain removal (which would only be available privately), but omitted to record it.

However, the PCC found:

“The Committee noted the FP17DC forms, which showed that on three separate occasions (14 November 2014, 24 July 2015 and 12 February 2016) you had provided private periodontal treatment to Patient 5. The Committee could see no evidence in the records that you offered to provide this treatment on the NHS.

The Committee found your evidence that the patient had wanted this treatment privately to be vague and not based on any recorded discussion with the patient about this. Further, the Committee finds your explanation that, as Patient 5 had signed the FP17DC forms, this in itself showed that he had decided to have private treatment implausible.

.....

The Committee is not critical of Airflow being provided as an additional cosmetic private treatment, but finds that because this patient’s BPE scores indicated that periodontal disease was present the patient should have been offered the available treatment on the NHS. The Committee considers that there is no satisfactory evidence that you did this.

Accordingly, the Committee found it proved that you did not offer Patient 5 the option of undergoing periodontal treatment under the NHS.”

After referring again to the Ivey test, the PCC concluded:

“...on the balance of probabilities, that as an experienced general dental practitioner, who had been working under an NHS contract since 2006, you would have been aware at the time that the treatment was available on the NHS. The Committee determined that the three separate FP17DCs, dated 14 November 2014, 24 July 2015 and 12 February 2016, evidenced that you had provided on these occasions private periodontal treatment, without the patient being offered the treatment on the NHS. The Committee considers that signing the FP17DCs evidences the patient may have been aware of the £65 charge but not that he could have had the treatment on the NHS but opted to have it privately instead.

The Committee determined that the use of Airflow was not documented in the clinical records to prompt the receptionist to charge for Airflow. The Committee finds it implausible that your receptionist, rather than you, decided that the patient should pay the £65 charge.

Looking at the evidence in the round, the Committee decided, on a balance of probabilities, that despite being aware that this patient was entitled to NHS treatment, you decided to charge him privately, without making him aware that the treatment was available on the NHS and that you did this most likely for personal gain. The Committee concluded that ordinary and decent people would view your actions of seeking to obtain private payment for this treatment, when the patient could have had the treatment provided on the NHS, as dishonest.”