bell - General Dental Council by liuqingyan


									                             GENERAL DENTAL COUNCIL


                                 July 2009 – May 2010

                                   Bell, George David

                                Registration No: 65076

On 28 May 2010, the Chairman of the Professional Conduct Committee announced the
determination as follows:

     “Mr Bell,

     There are 2 matters before this Committee:

     -     a finding of Serious Professional Misconduct in relation to clinical matters
           occurring between November 2005 and February 2006; and

     -     a postponed judgement on a conviction case concerning events in 2004.

     The background to both cases includes your diagnosed condition of Asperger’s
     Syndrome. The Committee considered whether there should be a referral to the
     Health Committee under rule 19(a) of the General Dental Council Professional
     Conduct Committee (Procedures) Rules Order 1984. The Committee noted that
     your case was referred to the Health Committee previously, and that Committee
     determined on 30 March 2009 that your fitness to practise was not seriously
     impaired by reason of your physical or mental health. Although the Committee has
     had additional evidence about your health, it is not satisfied that there is sufficient
     cause to refer the case again to the Health Committee. The Clinical Psychologist,
     Dr Janine Robinson told the Committee that your fitness to practise is not impaired
     by reason of your Asperger’s Syndrome.

     The Committee considered first the misconduct case. The Committee made
     findings of fact on 7 January 2010 and found on 8 January 2010 that those matters
     amounted to Serious Professional Misconduct.
On Sunday 20th November 2005 you provided a dental restoration to a 14-year old
girl under conscious sedation. You provided this treatment outside normal working
hours and without a Dental Surgery Assistant present. You failed to provide written
pre-operative and post-operative instructions and you did not obtain the written
consent of the patient’s mother to administer conscious sedation.            Following
treatment you discharged the patient before she had adequately recovered and
you failed to make an adequate clinical record of the treatment provided.

Between about January 2004 and February 2006 you routinely provided dental
treatment to patients in the evenings and at the weekend without a Dental Surgery
Assistant or other third party present. Root canal treatment was provided without a
rubber dam in place in these circumstances.

In respect of each of four patients, the Committee received evidence that you had
failed to make an adequate record of treatment provided. You admitted that your
records were “woeful” in respect of these patients.

The Committee regarded the matter of treatment under sedation as the most
serious. You appear to have acted from good motives although your actions were
not in fact in the best interests of your patient. It is aggravated by the incidents of
failure to make proper records, failure to take appropriate radiographs and the
occasions of working without a Dental Surgery Assistant present. It is fortunate that
there is no evidence of any patient having suffered permanent harm.

The evidence establishes that you are, technically, a skilled and competent dentist.
However, your Asperger’s Syndrome creates difficulty in oral communication.
Detailed evidence has been presented by Dr Janine Robinson, a Clinical
Psychologist with expertise in that condition. She told the Committee that sufferers
are unable to appreciate the full effect of their behaviour on other people, and have
difficulty in communication.

In considering the appropriate sanction the Committee has taken into account that
you were at that time working in a practice where there were inadequate protocols
and you did not have the support you needed. The Committee had to balance this
against your own professional responsibility to ensure that you practise safely.
You are now working as a dentist in a practice where you do not do any out-of-
hours work and you always have the assistance of an experienced registered
dental nurse. She is able to intervene and help in communicating with patients.
You have presented evidence that in this practice you have the support which you

Through your Counsel you have proposed to give undertakings to the Committee
in respect of your future practice. You have submitted a form of proposed
undertakings in writing to the Committee to address the shortcomings identified by
the Committee in its findings on Serious Professional Misconduct on 8 January

In considering its decision on sanctions the Committee first considered the least
serious sanction available to it under the old rules which apply in this case. The
Committee was satisfied that it would be right to accept your undertakings with
some minor modifications. Taking into account your undertakings, the Committee
has decided to conclude this part of the case with an admonition.

The undertakings which the Committee accepts in respect of this part of this case
are as follows:

I, GEORGE DAVID BELL, do hereby agree to abide by the following undertakings;

1.   I will notify the GDC promptly of any professional appointment I accept and
     provide the contact details of my employer and PCT on whose Dental
     Performers List I am included;
2.   At any time I am employed, or providing Dental services which require me to
     be registered with the GDC, I will place myself and remain under the
     supervision of a workplace supervisor, nominated by my Dental Practice
     Advisor, and agreed by the GDC;
3.   I will allow the GDC to exchange information with my employer, or any
     organisation for which I provide dental services, and any individual involved in
     my supervision;
4.   I will advise the GDC of the full contact details of a professional colleague
     (who will be working at the same practice as me) and who would be prepared
      to keep my condition under review and will report every 6 months to the GDC
      on my fitness to practise. I will advise the GDC of the name of any new
      professional colleague, within 14 days of any change;
5.    I will inform the GDC of any formal disciplinary or criminal proceedings taken
      against me, from the date of this determination;
6.    I will keep my professional commitments under review and limit my dental
      practice in accordance with my workplace supervisor’s advice;
7.    I will not engage in clinical dental practise for more than ten sessions per
      week. A session is defined normally as a maximum of three and a half hours
      duration. I must not engage in single handed dental practice and shall only
      work at premises where another dentist or dentists are working at the same
      time as I am working.
8.    I will permit any other member of the dental team at my practice to contact
      my General Medical Practitioner immediately if they are concerned about my
      fitness to practise;
9.    I will always be assisted by a registered dental nurse when working;
10.   I will refrain from all forms of dental sedation;
11.   I will abide by any undertakings given to the High Court;
12.   I will inform the following parties that I have entered into these undertakings
      with the GDC listed at 1-11 above;
      a.    Any organisation or person employing or contracting with me to
            undertake dental work,
      b.    Any locum agency or out of hours service I am registered with or apply
            to be registered with (at the time of any such application),
      c.    Any prospective employer (at the time of application),
      d.    The PCT in whose dental performers list I am included, or seeking
            inclusion (at the time of application);
13.   I permit the GDC to disclose the above undertakings 1- 12, to any person
      requesting information about my registration status.
14.   I will register with and remain under the care of a General Medical
      Practitioner and / or consultant psychiatrist and inform them that I am subject
      to supervision by the GDC, and of these undertakings;
15.   I will cease work if so advised by either my General Practitioner and / or
      Consultant Psychiatrist;
The second part of this case concerns your convictions on 2 November 2004 and
25 January 2005 at South Lakeland Magistrates’ Court of offences of sending a
letter and telephone messages which were indecent or grossly offensive. This
behaviour was part of a campaign you were conducting against Somerset County
Council in order to obtain what you regarded as appropriate services for your
children. When this matter came before the Professional Conduct Committee on 13
January 2006, that Committee said that it disapproved strongly of your actions
“which caused fear and distress to a number of individuals and reflected very badly
on your profession.”

That Committee concluded that the public interest was best served by postponing
judgement and said that it regarded its determination “as curative rather than
preventative and one that affords you the possibility of rehabilitation. It therefore
offers you the chance to show that you can avoid the behaviour which was the
subject of the complaint. … A repetition of this behaviour would almost certainly
impact upon your registration. In coming to its decision, the Committee has heard
your evidence that these actions were prompted by your Asperger’s Syndrome and
a reaction to the personal pressure you and your family were experiencing at that
time. However, you must recognise that this behaviour is inexcusable in a

Under rule 16(1)(c) of the General Dental Council Professional Conduct Committee
(Procedure) Rules Order of Council 1984, this Committee received evidence
concerning your conduct since that case was postponed.

The GDC called witnesses and presented written evidence concerning numerous
contacts between you and Somerset County Council from 2007 to 2009. A list of
allegations was prepared and presented to the Committee which was marked C12.
The full list was as follows:

1.    In or about March 2007 you began to make repeated telephone calls to the
      offices of Somerset County Council.
2.   On 13 March 2007, you telephoned the offices of Somerset County Council
     on about 28 occasions.

3.   You persisted after March 2007 in making repeated telephone calls to the
     offices of Somerset County Council despite being informed in a letter dated
     15 March 2007 that you should make only one call each week.

4.   On 18 April 2007, you:

     (a)    telephoned the offices of Somerset County Council and said that,
            unless the Chief Executive called you before 10.30am, you would make
            45 calls to different people and report to the Ombudsman each person
            who did not speak to you;

     (b)    proceeded to make repeated calls to the offices of Somerset County
            Council, some of which you terminated without speaking once the call
            was answered.

5.   On 23 May 2007, you telephoned the offices of Somerset County Council on
     about 60 occasions, often terminating the call without speaking once the call
     was answered.

6.   On 24 May 2007, you telephoned the offices of Somerset County Council on
     about 35 occasions, speaking on only about 3 occasions.

7.   In June 2007, you:

     (a)    made repeated calls to the offices of Somerset County Council which
            you terminated without speaking once the call was answered;


     (c)    told a Council employee that it was a good thing that Keith Brelstaff did
            not own racehorses because he would find a horse’s head in his bed.

8.         At a Special Educational Needs (“SEN”) Tribunal in December 2007, you
           attempted to trip up Keith Brelstaff as he entered the room.
9.    At a SEN Tribunal in December 2007, you approached Keith Brelstaff after
      the hearing and suggested going “outside to settle this” in a threatening

10.   On 6 December 2007, you telephoned the offices of Somerset County
      Council and falsely claimed that Keith Brelstaff had touched your wife in an
      inappropriate manner, and said “it was all I could do to stop myself from
      knocking his bloody head off”, or words to that effect.

11.   On 16 November 2007, you telephoned the offices of Somerset County
      Council on at least 125 occasions, terminating most calls without speaking
      once they were answered.

12.   On 12 December 2007 you spoke to a member of staff at the County Council
      and referred to one member of staff as a “child abuser” and two others as


14.   Between about 3 December 2007 and 9 May 2008, you made about 700
      telephone calls to officers and members of Somerset County Council.

15.   On 22 May 2008 you spoke to an employee of Somerset County Council by
      telephone and asserted that Keith Brelstaff had been accused of child
      molestation and made threats about doing “something” to County Hall.

16.   On 10 October 2008 you telephoned the child care team in the legal
      department of Somerset County Council on more than 100 occasions,
      frequently terminating calls without speaking once they were answered.

17.   On 19 January 2009 you sent an email to Keith Brelstaff in which you
      threatened to sue Haygrove School if he attended an annual review on 29
      January 2009.
18.   On 29 January 2009, you telephoned Haygrove School and informed a
      receptionist that you would effect a citizen’s arrest on Mike Turner if he
      attended the annual review.


20.   In 2008 and 2009 you made repeated telephone calls to the home of
      Councillor Gloria Cawood, some of which you terminated without speaking
      once they were answered, despite the fact that you had been informed by her
      that she could not do anything to assist you and had been advised not to
      accept your calls in view of the telephone protocol.

21.   In 2008 and 2009 you made repeated telephone calls to the home of
      Councillor Patrick Parker, often late at night.

22.   In about February 2009 you telephoned Councillor Parker at home at about
      10.30pm and informed him that your son could drown over the weekend and
      you referred to the possible imprisonment of Councillor Parker for perjury.

You admitted that the majority of these incidents had occurred as alleged but the
Committee was obliged to make findings of fact upon the following allegations. The
Committee applied the criminal standard of proof:

      - 7(c) The Committee accepted your evidence that your words were intended
       as a joke, although the Committee found it to be in bad taste, and it was not
       a threat to Mr Brelstaff.

      - 8. The Committee was not satisfied to the necessary standard that this
       allegation was proved.

      - 9. The Committee was satisfied that this event occurred as alleged and that
       your manner was threatening. However, the Committee did not think it likely
       that you intended physical violence.

      - 12. You admitted that you referred to a member of staff at Somerset County
       Council as a “child abuser”, and to two others as ”abuser”. The Committee
       found that your comment was made in the context of the refusal by
       Somerset County Council to provide services to your child. You knowingly
       used inappropriate language to provoke a reaction.

     - 15. The Committee accepted the evidence of Ms Dawson and her note of
       the telephone conversation. In particular, the Committee found that the
       word “molestation” was used. It could not accept your suggestion that the
       reference to “something” meant at that time that you would be pursuing
       legal proceedings against the County Council. The Committee was not
       satisfied that you would have been likely to cause criminal damage to
       County Hall.

This continuing campaign of provocation against Somerset County Council is a
repetition of exactly the type of behaviour which the PCC referred to in January
2006. That Committee warned you that repetition would almost certainly impact on
your registration.

The Committee appreciates that sufferers from Asperger’s Syndrome may tend to
pursue a cause in an obsessive manner without fully appreciating the effect which
their words and behaviour have on other people. The Committee has received
evidence    that     sufferers   from   Asperger’s   Syndrome   have   an   ability   to
compartmentalize areas of their lives, so that your campaign against Somerset
County Council did not impact upon the care of your patients. However, you were
warned by the Magistrates’ Court and by the PCC of the GDC, and yet you
persisted in this provocative behaviour.

The public has a higher expectation of the way in which a professional person
should behave. The public may well be prepared to make allowances for someone
with a Asperger’s Syndrome, but will not expect that a dentist can break the law
and flout decisions of his professional regulatory body.

The Committee notes that you have fully complied with orders to pay fines and
compensation. It appreciates that you have experienced personal and professional
difficulties. Nevertheless this matter is too grave to conclude at this stage with or
without an admonition. It would not be appropriate to postpone judgement again.
The Committee is satisfied that the only proportionate sanction, to maintain public
confidence in the profession, is an order of suspension.

Having regard to all the mitigating circumstances, the Committee has concluded
that the appropriate period of suspension is 4 months.

The Committee has decided that it is not necessary to order a review at the end of
this period of suspension.

The combined effect of these 2 orders is that, unless you appeal, your registration
will be suspended 28 days from today, for a period of 4 months. At the end of that
period your name will automatically be restored to the Dentists Register and you
will be permitted to practise subject to the undertakings which you have given to
this Committee.

The Committee is not minded to order immediate suspension.

That concludes the case.”

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