IN THE FAMILY HEALTH SERVICES APPEAL AUTHORITY
Mr G T Carney – Chairman
Dr J N Chope– Professional Member
Mrs J Alderwick – Member
B E T W E E N:
DR SAPNA CHANDU
(GDC Regn No.80442)
POOLE PRIMARY CARE TRUST
DECISION WITH REASONS
1 This is an appeal against Poole Primary Care Trust’s (“PCT”) decision to conditionally include Dr Sapna Chandu on their Supplementary Dental List.
2 Both parties have agreed in writing pursuant to Section 38(1) of the Family Health Services Appeal Authority (Procedure) Rules 2001 that the appeal can be determined without an oral hearing on the basis of the papers submitted by them.
3 On the 6 November 2003 Dr Chandu applied to be included in the Supplementary Dental List of the PCT as an assistant.
4 On the 5 December 2003 The Dorset Family Health Services Agency wrote to Dr Chandu on behalf of the PCT informing her that her application was approved subject to the following conditions, as provided for under regulation 8 of the National Health Service (General Dental Services Supplementary List) and (General Dental Services) Amendment Regulations 2003 (“the Regulations”):
· That Dr Chandu would agree not to work in a single handed practice;
· That Dr Chandu should work only under the supervision of at least one other principal or associate dentist;
· That Dr Chandu’s inclusion will be reviewed after a period of six months at which time she would have to produce a satisfactory reference from the NHS Dentist(s) with whom she had been working.
5 The letter of the 5 December 2003 went on to say:
“Before imposing the above condition on inclusion the Poole Primary Care Trust took into account the remarks received in a reference from the only NHS dentist for whom you have worked, references received from dentists in Australia and a practice manager at the above NHS Practice.”
6 On the 27 December 2003 Dr Chandu wrote to the FHSAA giving notice of appeal against the PCT’s decision to conditionally include her in its Dental Supplementary List and setting out her grounds of appeal. On the 5 January 2004 Dr Chandu again wrote to the FHSAA sending further documents to support her appeal.
7 On the 22 January 2004 the Dorset Family Health Services Agency wrote to the FHSAA giving notice on behalf of the PCT that it intended to oppose the appeal on the grounds that to admit Dr Chandu to the Dental Supplementary List without a condition would be prejudicial to the efficiency of the service. The letter went on to say:
“The grounds under which the condition was set, was in considering that admitting Dr Chandu to the Dental Supplementary List without a condition would be prejudicial to the service.”
8 In her application of the 6 November 2003 Dr Chandu provided the names of three referees who were willing to provide clinical references in accordance with Regulation 4(h) of the Regulations. In addition she provided the name of a practice manager, Mrs Mary Wittingham, as a personal referee. Dr Chandu had worked for the practice of Mr Dickerson in Newcastle Staffordshire for six weeks and Mrs Wittingham was the practice manager.
9 The PCT had obtained satisfactory references from the three clinical referees provided by Dr Chandu, all of whom were in Australia, where Dr Chandu had qualified. The PCT had also applied for references from both Mrs Wittingham and Mr Dickerson. Mrs Wittingham provided a good reference, but that of Mr Dickerson was adverse in a number of respects.
10 Dr Chandu in her letter of appeal and supporting documents states:
(1) That she had provided three clinical referees all of whom provided good references for her;
(2) That she had not given Mr Dickerson’s name as a referee because she had not worked for him for three months as required by Regulation 4 and, secondly, because of personal differences which had lead to an irretrievable breakdown in their professional relationship; and
(3) That it was therefore inappropriate for the PCT to apply for a clinical reference from Mr Dickerson.
11.1 On the 25 February 2004 the Dorset Family Health Services Agency, on behalf of the PCT, wrote to the FHSAA withdrawing its opposition to Dr Chandu’s appeal and giving the following reasons:
· The practitioner was not offered a review of the decision;
· Consideration should only have been given to the clinical reference and not to any information provided relating to general references;
· The PCT have become aware of a “personality clash” between Dr Chandu and one of the referees whose general reference was taken into consideration when the conditional inclusion was made;
· The reference in question was given by a contractor who had not worked with Dr Chandu for at least three months.
11.2 The Appeal Panel noted these reasons, but with regard to the second reason were of the opinion that a PCT could not ignore information of the nature of a general reference if provided to the PCT as part of the application procedure.
12.1 On the 25 February 2004 a letter was also written by Mr Stephen Henderson of Dental Protection on behalf of Dr Chandu in relation to her appeal. In his letter he stated as follows:
“I have seen the conditions of inclusion applied by Dr Chandu and it seems to me that none of 3.2.22, 3.2.23, 3.2.25, 3.2.29 and 3.2.31 of the Department of Health’s Guidance “Primary Care Trust Management of Primary Care Practitioners’ Lists General Dental Practitioners” is being followed.”
12.2 Some of these grounds were new grounds of appeal, but the Appeal Panel, bearing in mind the PCT’s decision to withdraw their opposition to the appeal, felt able to take account of the contents of the letter written by Mr Stephen Henderson of Dental Protection.
13 The Appeal Panel noted that the appeal was by way of re-determination.
14 The Appeal Panel having considered all the papers submitted by Dr Chandu and the PCT and their representatives decided unanimously that Dr Chandu’s appeal should be allowed and that she should be unconditionally included in the Dental Supplementary List of the Poole Primary Care Trust.
15 The reasons for their decision were:
(1) Dr Chandu had identified three clinical referees all of whom provided excellent references for her.
(2) The reference provided by Mr Dickerson should not have been taken into account because:
(i) Mr Dickerson should not have been asked for a reference because Dr Chandu did not put him forward as a clinical or general referee;
(ii) Dr Chandu had only worked in Mr Dickerson’s practice for six weeks, and for two of which Mr Dickerson was away on holiday. In these circumstances Mr Dickerson did not comply with the requirements of Regulation 4 that applicants should have worked with their clinical referees for a minimum period of three months; and
(iii) There was clearly, as evidenced in the papers before the Appeal Panel and as admitted by the PCT, personal differences between Dr Chandu and Mr Dickerson, which rendered his reference unreliable.
(3) There was no evidence on the papers before the Appeal Panel that the admission of Dr Chandu to the Dental Supplementary List without a condition would be prejudicial to the efficiency of the service.
(4) There were no grounds to justify the imposition of conditions and, further, that the imposition of conditions would be on Dr Chandu’s record and she would have to disclose those conditions in future applications which would be unfair and prejudicial to her.
16 In accordance with regulation 42(5) of the Family Health Services Appeal Authority (Procedure) Rules 2001, any party to these proceedings may have a right to appeal this decision under Section 11 of the Tribunals and Inquiries Act 1992.
G T CARNEY…………………………