High Court Overturns Professional Conduct Committee’s Suspension Of Dentist, By Imposing Erasure
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- Published: Thursday, 16 December 2021 08:13
- Written by Chris Tapper
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A High Court judge has overruled a decision made by the General Dental Council’s Professional Conduct Committee to suspend a dentist subject to review, by imposing erasure from the dental register.
The Honourable Mr Justice Lane came to his decision after hearing an appeal brought to the Queen’s Bench Division Administrative Court, by the Professional Standards Authority (PSA).
The PSA oversees the nine statutory bodies that regulate health professionals, including the General Dental Council.
The Professional Standards Authority had appealed against the GDC’s PCC decision regarding dentist Dr Mohammed Amir. The GDC was named as the 1st respondent, and Dr Amir, the 2nd respondent.
The PSA (the appellant) referred the decision to the High Court because it considered that that decision the GDC made was not sufficient for the protection of the public.
The judgement document said “For a period up to 22 January 2019, the second respondent (Dr Amir) made claims to the public via his website that asthma, ataxia, allergies, sciatic nerve pain, breathing problem, Crohn’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 (Dr Amir) was able to treat.”
The judgement document said “As a registered dentist, the second respondent was under a professional obligation to “provide good quality care based on current evidence and authoritative guidance”
The document went on “The PCC found that there is no current evidence or authoritative guidance to support the second respondent’s claims to be able to address those medical conditions through dental treatment.”
The Court heard that “Patient A had been diagnosed in 2011 with Spinocerebellar Ataxia Type 3 (“Sca3”), a rare incurable hereditary degenerative condition, the symptoms of which include loss of co-ordination and problems with movement.”
The Court was told that “The PCC had also heard evidence from consultant neurologist Dr Jonathan Rohrer that These progressively deteriorate over time and do not improve.”
By January 2016, Patient A’s condition had deteriorated and his mobility had become poor. Patient A also experienced signs of anxiety and depression and had expressed suicidal thoughts.
The court heard that when he consulted Dr Amir in December 2015, “Patient A was in a vulnerable condition.” The Court papers said Patient A told the PCC in oral evidence that he was “Very desperate at that point to find a solution for his problem.”
Dr Rohrer’s evidence said that there is no known association between Patient A’s condition and dysfunction of the temporomandibular joint.
Patient A told the PCC that Dr Amir didn’t conduct an examination inside his mouth and had informed the patient that he could help, indicating that he “Could perhaps improve Patient A’s cerebellar ataxia or stop it from deteriorating further.”
“Patient A was told by the second respondent (Dr Amir) about the cases of other patients whom the second respondent had treated.”
The Court papers said “Patient A agreed to the only treatment which the second respondent offered; namely, an appliance which the second respondent claimed would expand Patient A’s upper maxillary arch, at a cost to Patient A of £8,000.”
The PCC found that the treatment was “Not clinically justified” and that it had been provided without an adequate examination of the patient’s jaw joints and undertaking diagnostic assessments and special investigations.
The PCC also found that Dr Amir provided treatment without Patient A’s informed consent.
The High Court document said “A central element of the appeal to this court is the assertion that the PCC approached the second respondent’s (Dr Amir’s) conduct as having two discrete elements; that is to say, (i) the statements which the second respondent had made on his website and to Patient A; and (ii) the deficiencies in the second respondent’s care and management of Patient A.”
`’The appellant (PSA) says that the PCC undertook no inquiry into the relationship between these two concerns, which went to the crucial issue of the reasons why the second respondent had failed in his care and management of Patient A.``’
`’Accordingly, the PCC did not address the issue of whether the second respondent had abused his position as a dentist in relation to a vulnerable patient. That issue was, in effect, crucial to deciding upon the second respondent’s fitness to practise,” the Court papers said.
The PSA contended that Dr Amir’s misconduct amounted to widespread breaches of relevant professional standards “And was thus, very serious.”
“Since the second respondent proved incapable of demonstrating any insight into those serious deficiencies, the appellant submits that an order suspending the second respondent’s registration for a period of three months is wholly insufficient to meet the public interest in protecting patients, maintaining public confidence in the profession and promoting standards within the profession.”
The High Court document said that Justice Lane heard material and a statement prepared by Dr Amir for the High Court hearing. The material included extracts from Dr Amir’s own website, “Graphs concerning the alleged alleviation of the symptoms, as recorded by patients of the second respondent, and a document written by the second respondent, which refers to Roger Sperry, a Nobel Prize winner, who is quoted as saying that more than 90% of the energy output of the brain is used in relating to the physical body in its gravitational field.”
“The more mechanically distorted a person is, the less energy is available for thinking, metabolism and healing. This meant that “the most important treatment for any illness has to be the achievement of the symmetry of the cranial dental and skeletal complex to remove mechanical distortions.”
“The second respondent says ‘I discovered how to bring that about. Roger gets a Nobel Prize. I get suspended. This is what we call institutionalised racism.’”
Dr Amir was also said to have submitted a document after the hearing, said to have been prepared by his supporters. The document said his supporters reiterated their support for his ‘unique treatment,’ which ‘could halve the NHS budget if taken up more widely.’
Mr Ivan Hare QC who represented the General Dental Council informed the judge that the GDC adopted a neutral stance regarding the appeal, and the Queen’s Counsel made no oral or written submissions on the regulator’s behalf.
In his judgment, Justice Lane said “In his oral and written submissions, the second respondent takes issue with the findings of the PCC concerning the inadequacy of the treatment and care provided by him to Patient A.”
“The second respondent has not, however, appealed against the first respondent’s decision concerning impairment and sanction. I understood him to say that this was because he lacked the financial means to do so.
“The second respondent regards the charges as “trumped up”. They are, he says, the result of “medieval thought patterns by the existing system of dental conduct.”
The judge agreed with the PSA that the “PCC was wrong to consider that a direction for the suspension of the second respondent’s registration for a period of three months was sufficient for the protection of the public.”
“It follows from what I have already held that I am compelled to agree. Suspension for three months failed completely to reflect the gravity of the second respondent’s misconduct.”
Judge Lane went on “I am in no doubt that the only reasonable regulatory response to the facts of this case is that the second respondent should be erased from the register.”
“The position might have been otherwise, had I been in any doubt of the possibility of the second respondent achieving insight.”
“I reach this conclusion with regret. The second respondent has worked as a dentist for many decades. He has, however, brought himself to a position which is fundamentally incompatible with his continuing to be registered as a dentist.”
“The appeal is allowed. I substitute for the decision of the PCC a decision that the respondent’s name be erased.”
In 2009, the Evening Standard ran a feature feature on Dr Amir titled “How a dental brace could cure MS, migraines and paralysis.”
Written by Bella Freud, the article said Dr Amir “Has had extraordinary results treating the symptoms of MS and ME sufferers.”
“He has also helped people cure persistent migraines, irritable bowel syndrome and even paralysis.”
The full High Court case can be found here.
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