HEARING HEARD IN PUBLIC

Transcription

1 HEARING HEARD IN PUBLIC PEZESHKI, Peyman Registration No: PROFESSIONAL CONDUCT COMMITTEE FEBRUARY - MAY 2017 Most recent outcome: Suspension extended for 12 months (with a review) ** ** See page 12 for the latest determination. Peyman PEZESHKI, a dentist, BDS Lpool 2004, was summoned to appear before the Professional Conduct Committee on 6 February 2017 for an inquiry into the following charge: Charge (as amended 6 February 2017) That, being registered as a dentist, Peyman Pezeshki s fitness to practise is impaired by reason of misconduct, in that: 1. On or around 30 April 2015 you sent s to representatives of NHS England containing the following statements: a. Please dont be difficult because i will complain and will do a lot of damage for you and your colleagues"; b. I did not threaten your staff you. your staff is incompetent. stop the application and send back all my documents asap. You are not half as intelligent as i thought you would be. 2. On or around 5 August 2015 you attended a meeting with representatives of NHS England and behaved in an aggressive manner. 3. Your conduct was threatening in respect of: a. 1a above; b. 2 above. 4. Your conduct was unprofessional in respect of: a. 1a and / or 1b above; b. 2 above. 5. Between 24 September 2015 and 24 November 2015 you failed to adequately cooperate with an investigation conducted by the GDC in that you did not provide information in a timely or adequate manner regarding: a. Your employers details; b. Your indemnity provider or insurance cover arrangements. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -1/14-

2 6. You did not maintain a correct and up to date address with the GDC from an unknown date after 31 December 2014 to on or around 1 January Mr Pezeshki was not present and was not represented. On 7 February 2017 the Chairman announced the findings of fact to the Counsel for the GDC: Decision on service Mr Pezeshki was neither present nor represented at the Professional Conduct Committee (PCC) hearing of his case. Mr Daniel Mansell appeared on behalf of the General Dental Council (GDC). In Mr Pezeshki s absence, the Committee first considered whether the GDC had complied with service of the Notice of Hearing in accordance with Rules 13 and 65 of the GDC (Fitness to Practise) Rules Order of Council 2006 (the Rules). The Committee took into account the submissions made by Mr Mansell on behalf of the GDC. It accepted the advice of the Legal Adviser. The Committee had sight of a copy of the Notification of hearing, dated 6 January 2017, which was sent to Mr Pezeshki s registered address by way of Special Delivery and First Class Post. The Committee was satisfied that the letter contained proper notification of this hearing, including its time, date and location, as well as notification that the Committee has the power to proceed with the PCC hearing in Mr Pezeshki s absence. The Notification of Hearing also contained a copy of the charge against Mr Pezeshki. A copy of the Notification of Hearing was also sent to Mr Pezeshki via on the same date. The Committee also had sight of a Track and Trace receipt which confirmed delivery on 7 January 2017 and was signed for in the printed name PEZESHKI. The Committee was satisfied that the notice of this PCC hearing was served on Mr Pezeshki in compliance with the rules. Decision on proceeding in the absence of Mr Pezeshki The Committee then considered whether to exercise its discretion under Rule 54 to proceed with this PCC hearing in Mr Pezeshki s absence. The Committee bore in mind the submissions made by Mr Mansell on behalf of the GDC. It accepted the advice of the Legal Adviser. The Committee was mindful that this was a discretion that must be exercised with the utmost care and caution. It also had regard to the need for fairness to both parties, as well as the public interest in the expeditious disposal of the hearing. Mr Pezeshki had been sent notification of this hearing. The Committee was provided with evidence of numerous attempts made by the GDC to contact Mr Pezeshki in relation to this hearing. The Committee had regard to all the responses from Mr Pezeshki and noted that he had confirmed on a number of occasions that he would not be attending the hearing. In particular, it noted that in an response, dated 25 January 2017, Mr Pezeshki had answered a number of questions regarding the case and confirmed that he would not be attending the hearing. It also took into account that Mr Pezeshki had been notified that he could provide documentary evidence to the Committee and that he had done so. The Committee was therefore satisfied that he was aware of today s hearing and that he had chosen to voluntarily absent himself. It took into account that Mr Pezeshki had not requested PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -2/14-

3 an adjournment of this hearing. The Committee considered that it had no evidence before it to suggest that an adjournment would secure Mr Pezeshki s attendance at a future date. The Committee bore in mind the potential inconvenience to a number of witnesses who had made arrangements to attend the hearing. Taking all this into account, having weighed the interests of Mr Pezeshki with those of the GDC and the public interest in the expeditious disposal of this hearing, the Committee determined to proceed in his absence. Preliminary matters Mr Mansell, on behalf of the GDC, made an application pursuant to Rule 18 to amend charge 5a. The proposed amendment was for the word employer s to be changed to employers. The Committee took into account the submissions from Mr Mansell and it accepted the advice of the Legal Adviser. The Committee was satisfied that the proposed amendment could be made without any injustice to either party and therefore acceded to the application. Mr Mansell then made a further application under rule 57 for Witness C to give her evidence via Skype. He submitted that Witness C is currently out of the country and unable to attend the hearing in person. He referred the Committee to an , dated 4 February 2017, from Mr Pezeshki confirming he had no objection to the application. The Committee accepted the advice of the Legal Adviser. The Committee considered that there was a good reason for Witness C not attending the hearing in person. It noted that Mr Pezeshki had confirmed that he had no objection to the witness giving evidence via Skype. In considering all the evidence before it, the Committee concluded that it could accede to the application without any injustice to either party. The Committee therefore granted the GDC s application for Witness C to give evidence via Skype. Background to the case and summary of the allegations In March 2015, Mr Pezeshki applied to re-join the NHS Dental Performers List after a period of working in Australia. On 20 August 2015 concerns were raised by NHS staff about Mr Pezeshki s behaviour. This matter was referred to the GDC and the initial complaint, and subsequent GDC investigation, forms the basis of the charge against Mr Pezeshki. It was alleged that Mr Pezeshki sent s to representatives of NHS England which were threatening in nature and unprofessional. It was further alleged that on or around 5 August 2015 Mr Pezeshki attended a meeting with representatives of NHS England and behaved in an aggressive manner. It was alleged that in relation to this his conduct was threatening and unprofessional. It was alleged that between 24 September 2015 and 24 November 2015 Mr Pezeshki failed to adequately co-operate with an investigation conducted by the GDC in that he did not provide information in a timely manner regarding his employers details and his indemnity provider or insurance cover arrangements. It was also alleged that he did not maintain a correct and up to date address with the GDC from an unknown date after 31 December 2014 to on or around 1 January Evidence The Committee heard oral evidence from Witness A and Witness B who gave evidence in person, and Witness C, who gave evidence by Skype. It considered that all three witnesses provided their evidence in a clear, concise and credible manner. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -3/14-

4 The Committee was also provided with documentary material in relation to the heads of charge, including: a witness statement from Witnesses A, B, C, D and E who produced associated exhibits, correspondence documents between the Medical Defence Union (MDU) and the GDC and a number of correspondence documents from Mr Pezeshki to the GDC. Committee s findings of fact The Committee took into account all the evidence presented to it. It considered the submissions made by Mr Mansell on behalf of the GDC and the written representations made by Mr Pezeshki. The Committee accepted the advice of the Legal Adviser. The Committee reminded itself that the burden of proof lies with the GDC, and considered the heads of charge against the civil standard of proof, that is to say, on the balance of probabilities. In accordance with that advice it has considered each head of charge separately. The Committee s findings of fact in relation to each head of charge are as follows: 1. On or around 30 April 2015 you sent s to representatives of NHS England containing the following statements: 1. a) Please dont be difficult because i will complain and will do a lot of damage for you and your colleagues"; Found proved. The Committee had before it a copy of the , dated 30 April 2015, which was sent from Mr Pezeshki to representatives of NHS England. It also took into account the witness statement of Witness A who also made reference to the . Further, a copy of the detailing the above wording was also contained in the documentation provided by Mr Pezeshki. In light of these reasons the Committee found this charge proved. 1. b) I did not threaten your staff you. your staff is incompetent. stop the application and send back all my documents asap. You are not half as intelligent as i thought you would be. Found proved. The Committee had before it a copy of the , dated 30 April 2015, which was sent from Mr Pezeshki to representatives of NHS England. Further, a copy of the detailing the above wording was also contained in the documentation provided by Mr Pezeshki. In light of these reasons the Committee found this charge proved. 2. On or around 5 August 2015 you attended a meeting with representatives of NHS England and behaved in an aggressive manner. Found proved In considering this charge the Committee took into account the evidence of Witness B and Witness C who had conducted the meeting with Mr Pezeshki. In Witness B s oral evidence, she stated that Mr PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -4/14-

5 Pezeshki s behaviour started off relaxed but then his body language changed and he raised his voice. She went on to state that Witness C had shortly afterwards ended the meeting. She explained to the Committee that NHS England have a zero-tolerance policy on shouting, bullying and threatening behaviour. Witness B also detailed this in her written statement. She stated He went from being perfectly polite to a raised voice accusing NHS England staff of being incompetent. Further, in Witness C s oral evidence she confirmed that she had ended the meeting before it could escalate. In Witness C s witness statement, she said His voice was raised and he seemed to me to be aggressive. Both Witness B and Witness C stated that they had been shocked by Mr Pezeshki behaviour and that they felt it was appropriate to end the meeting early. Taking all this into account the Committee concluded that Mr Pezeshki had acted in an aggressive manner during the meeting. It therefore found this charge proved. 3. Your conduct was threatening in respect of: 3. a) 1a above; Found proved. In considering this charge the Committee was satisfied that an ordinary meaning of a threat is one in which a person indicates by word or action that if another does not do what they want they, in turn, will do something disadvantageous to the other. The Committee considered the wording of Charge 1a and concluded that this clearly amounted to threatening conduct; requiring the recipient of the to facilitate his application to join the Dental Performers List, or else to be the subject of a complaint and damage. Furthermore, it took into account the evidence of Witness A who stated both in oral evidence and in her written witness statement that she considered the wording to be threatening. She informed the Committee that she referred the to her manager who subsequently ed Mr Pezeshki on 30 April 2016 saying I would politely ask you to refrain from making threats to my staff who are just trying to do their job in accordance with the GDS Regulations. Taking all this into account the Committee considered that on a balance of probabilities the sent from Mr Pezeshki on 30 April 2016 was threatening. It therefore found this charge proved. 3. b) 2 above. Found proved. The Committee took into account that both Witness B and Witness C had separately stated that during the meeting they felt Mr Pezeshki had changed his body language and begun to raise his voice. In particular, it noted that Witness C had stated in her witness PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -5/14-

6 statement that she felt Mr Pezeshki was acting in an aggressive, unacceptable and unpleasant manner. Witness C also stated that she had ended the meeting early as she wanted to prevent the situation from escalating. Taking all this into account, the Committee considered that Mr Pezeshki had acted in a confrontational manner during this meeting and that this constituted threatening behaviour. It therefore found this charge proved. 4. Your conduct was unprofessional in respect of: 4. a) 1a and / or 1b above; Found proved. Whilst the Committee took into account Mr Pezeshki s written submissions and that he clearly appeared to be frustrated by the slow process of his application by NHS England it did not consider that this excused his actions in sending the s. The Committee took into account that dental professionals should treat all patients, colleagues and members of the public with respect and dignity. It also took into account that it found Mr Pezeshki s conduct at 1a above to be threatening. The Committee further noted that Witness A had referred the to her manager and that her manager had ed Mr Pezeshki asking him not to continue speaking to her staff in this manner. In light of these reasons the Committee concluded that Mr Pezeshki s conduct at 1a and 1b above was unprofessional and it therefore found this charge proved. 4. b) 2 above. Found proved. The Committee took into account that both Witness B and Witness C had stated that they were shocked by Mr Pezeshki s actions during the meeting. Witness B also stated that she had never experienced another professional acting in this manner before. Witness C stated that she had ended the meeting before it escalated. The Committee concluded that attending a meeting with a professional body and acting in an aggressive manner would be considered unprofessional. It noted that dental professionals occur a position of trust and that they should treat all patients, colleagues and members of the public with dignity and respect. Taking all this into account the Committee considered that Mr Pezeshki s actions in acting in an aggressive manner during the meeting on 5 August 2015 was unprofessional and it therefore found this charge proved. 5. Between 24 September 2015 and 24 November 2015 you failed to adequately co-operate with an investigation conducted by the GDC in that you did not provide information in a timely or adequate manner PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -6/14-

7 regarding: 5. a) Your employers details; Found not proved. The Committee noted that it is not disputed by either party that Mr Pezeshki did not provide the required employment details to the GDC between 24 September 2015 and 24 November However, the Committee noted that the head of charge relates to Mr Pezeshki failure to cooperate with the GDC s investigation by not providing his employers details. The Committee noted from the documentation before it that Mr Pezeshki had stated that he was abroad during the two-month period and that he had limited access to the internet during this time. It also noted that some of the documentation sent by the GDC was downloaded in Iran. The Committee had various correspondence documents between Mr Pezeshki and the GDC during this period. The Committee concluded that as Mr Pezeshki had been responding to the s sent by the GDC during this period that it could not be satisfied on a balance of probabilities that his cooperation was professionally inadequate. It therefore found this charge not proved. 5. b) Your indemnity provider or insurance cover arrangements. Found not proved. The Committee had before it an dated 10 November 2015 from Mr Pezeshki to the GDC providing the name of his indemnity provider and a copy of his indemnity insurance. The Committee concluded that Mr Pezeshki had not failed to adequately cooperate with the investigation conducted by the GDC in a timely or adequate manner regarding his indemnity provider as it had evidence of Mr Pezeshki providing details of his indemnity provider to the GDC during this period. It therefore found this charge not proved. 6. You did not maintain a correct and up to date address with the GDC from an unknown date after 31 December 2014 to on or around 1 January Found proved. The Committee noted that in an from the MDU, Mr Pezeshki previous defence representatives, they had stated There is no doubt that Mr Pezeshki did not provide the GDC with up to date information regards his address for purposes of registration. They went on to state There was an oversight in provision of his practising address. He can say no more than that. Of course, he apologises for this oversight. The Committee took into account the evidence of Witness E that Mr Pezeshki s registered address had been in Australia from 31 December 2014 until 31 December However, Mr Pezeshki confirmed in his note dated 27 February 2016 that he had returned to the United Kingdom in February It therefore found this charge proved. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -7/14-

8 The hearing will now proceed to stage 2. On 8 February 2017 the Chairman announced the determination as follows: Having announced its findings on all the facts, the Committee heard submissions on the matters of misconduct, impairment and sanction. Submissions In accordance with Rule 20 (1) (a), Mr Mansell informed the Committee that Mr Pezeshki does not have any previous fitness to practise history. In his submissions, Mr Mansell, on behalf of the General Dental Council (GDC), outlined the specific issues identified in line with the standards, which in his submission, have been breached. Mr Mansell submitted that facts found proved against Mr Pezeshki amount to serious departures from the standards expected of a registered dentist, particularly in relation to his conduct in sending a threatening and acting in a threatening, aggressive and unprofessional manner during a meeting with NHS England staff. He submitted that Mr Pezeshki s conduct fell far below the standard expected of a registered dentist and that the facts found proved against Mr Pezeshki clearly amount to misconduct. Mr Mansell next addressed the issue of current impairment. He submitted that the Committee may think that Mr Pezeshki s conduct represents deep-seated attitudinal issues. He addressed the Committee on the factors that it must consider, including Mr Pezeshki s level of insight, whether his failings are remediable and whether they have been remedied. He submitted that Mr Pezeshki had consistently acted in an unprofessional manner and had on occasions acted in an aggressive and threatening manner. He submitted that this conduct is not easily remediable. He submitted that Mr Pezeshki has not taken any steps to remedy his failings and that he has no insight into his failing in light of his recent correspondence to the GDC. He submitted that in light of the lack of remediation and insight that the was a risk of repetition in this case. Mr Mansell also addressed the Committee on the need to have regard to protecting the public and the wider public interest. This includes the need to declare and maintain proper standards and maintain public confidence in the profession and in the GDC as a regulatory body. Mr Mansell then addressed the Committee on the matter of sanction. He referred it to the GDC s Guidance for the Practice Committees, including Indicative Sanctions Guidance (October 2016) (the GDC s sanctions guidance). He submitted that the appropriate and proportionate sanction is one of suspension for a period of six months. Committee s considerations The Committee carefully considered all of the information placed before it. The Committee bore in mind the submissions from Mr Mansell on behalf of the GDC and the written submissions from Mr Pezeshki. The Committee accepted the advice of the Legal Adviser. In its deliberations, the Committee had regard to the GDC s Guidance for the Practice Committees, including Indicative Sanctions Guidance (October 2016). Decision on misconduct PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -8/14-

9 The Committee first considered whether the facts found proved amount to misconduct. In considering the matter, the Committee exercised its own independent judgement. The Committee reminded itself of the extent and nature of the findings made against Mr Pezeshki. The Committee s reasons for its findings have been set out in full in its determination on the facts. When determining whether the facts found proved amount to misconduct the Committee had regard to the terms of the relevant professional standards in force at the time. The Committee concluded that Mr Pezeshki s conduct was in breach of the Standards for the Dental Team (2013) as set out below: You must treat colleagues fairly and with respect, in all situations and all forms of interaction and communication. You must not bully, harass, or unfairly discriminate against them You must treat all team members, other colleagues and members of the public fairly, with dignity and in line with the law. The Committee appreciated that whilst the above breaches do not automatically result in a finding of misconduct they are serious, fundamental to the integrity of the profession and capable of seriously undermining public confidence in the profession. The Committee considered Mr Pezeshki s conduct in sending a threatening , sending more than one unprofessional s and acting in an unprofessional, threatening and aggressive manner during a meeting with NHS staff, was particularly serious. It took into account that Mr Pezeshki had acted in an unacceptable manner on more than one occasion. It concluded that Mr Pezeshki s conduct fell far below the standards expected of a registered dentist. It considered that public confidence in the profession would be undermined if it did not conclude that Mr Pezeshki s actions constituted misconduct. Taking all these factors into account, the Committee was in no doubt that the facts found proved amount to misconduct. Decision on impairment The Committee next considered whether Mr Pezeshki s fitness to practise is currently impaired by reason of Mr Pezeshki s misconduct. In reaching its decision on impairment, the Committee exercised its own independent judgement. It bore in mind that its duty was to consider the public interest, which includes the protection of patients, the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour. The Committee noted that the case does not involve matters of clinical practice or patient care and that there has been no criticism of Mr Pezeshki s clinical ability. In considering the failings in this case, the Committee noted that they are behavioural and attitudinal in nature. The Committee accepted that by nature attitudinal failings are more difficult to remedy than clinical failings. However, it considered that the failings in this case are capable of being remedied. Whilst the Committee considered that the failings could be remedied it had no evidence before it that Mr Pezeshki had taken any steps to remedy them. The Committee considered whether Mr Pezeshki had demonstrated sufficient insight into his failings. In this regard, the Committee noted the documentary evidence provided by Mr Pezeshki. It also noted the most recent correspondence s from Mr Pezeshki to the GDC regarding the GDC s investigation. In an , dated 18 February 2016, Mr Pezeshki PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -9/14-

10 stated With respect to your recent Hilarious accusations. We would like to know if you are going ahead with this case. I am planning to go abroad shortly so you have to say say it. In either case I would like compensation from you. Further, in an dated 17 March 2016 Mr Pezeshki stated My DDU membership is expired. I don t intend to renew it because I am not planning to work in the UK. With respect to the hearing I couldn t care less about the outcome. The Committee had before it no evidence to demonstrate that Mr Pezeshki has developed any insight whatsoever into his conduct. The Committee concluded that, in light of the lack of evidence of any remediation or developed insight from Mr Pezeshki, the risk of repetition of similar conduct was high. The Committee bore in mind that its primary function is to protect patients. It also took into account the wider public interest. It had regard to the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour. The Committee concluded that to make a finding of no current impairment would send a message to the public and the profession that Mr Pezeshki s conduct was acceptable. The Committee took into account that Mr Pezeshki had on three occasions breached a fundamental tenet of the profession by not treating the individuals, namely NHS staff members, with respect and dignity. It concluded that trust and confidence in the profession and in the GDC as the regulator would be seriously undermined if a finding of impairment was not made. The Committee had regard to the serious nature of the issues identified in the circumstances of this case when reaching this decision. The Committee therefore finds that Mr Pezeshki s fitness to practise is currently impaired. Decision on sanction Having determined that Mr Pezeshki s fitness to practise is currently impaired by reason of his misconduct, the Committee considered what sanction, if any, to impose on his registration. It reminded itself that the purpose of a sanction is not to be punitive, but to protect patients and the wider public interest. In reaching its decision the Committee again took into account the GDC s Guidance for the Practice Committees, including Indicative Sanctions Guidance (October 2016). The Committee considered the range of sanctions available to it, starting with the least serious. It applied the principle of proportionality, balancing the public interest with Mr Pezeshki s own interests. In considering the matter of sanction, the Committee considered the mitigating and aggravating factors. The Committee considered that the evidence before it of Mr Pezeshki s previous good character was a mitigating factor. In relation to aggravating factors, the Committee considered Mr Pezeshki s lack of remediation and insight. In light of its findings, the Committee determined that it would be inappropriate to conclude this case without taking any action in respect of Mr Pezeshki s registration, given the serious and repeated departures from the standard expected of a registered dentist. It also considered that taking no further action when it had found a real risk of repetition would be insufficient. The Committee reached the same conclusion in respect of a reprimand. The Committee noted that Mr Pezeshki has demonstrated no insight, nor has he provided any evidence of PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -10/14-

11 any corrective steps. It concluded that the serious nature of the conduct that it has found, raising as it does significant concerns about public trust and confidence, as well as the standing and reputation of the profession and the regulatory process, means that some form of restriction must be imposed. The Committee next considered whether a period of conditional registration would be appropriate and proportionate. The Committee determined that, given the serious findings that it has made in respect of allegations which are not clinical in nature, there are no conditions that could be formulated which would prove to be workable, measurable or enforceable, or which would address the significant public interest concerns engaged in this case. Further, it had no evidence before it to indicate that Mr Pezeshki would be willing to comply with conditions. The Committee next considered whether a period of suspension would be appropriate in this case. Whilst the Committee accepts that Mr Pezeshki was experiencing frustration with the length of the process of his application to be included on the Dental Performers List, it does not consider that this provides any excuse for his repeated departures from the expected standard of a registered dentist. The Committee took into account that it had no evidence before it of any remediation, remorse or insight on Mr Pezeshki s part. Taking all these factors into account and the risk of repetition in this case, the Committee concluded that the concerns in this case would not be protected by any lesser sanction than one of suspension. The Committee took into account that the effect of this order is that Mr Pezeshki will be prevented from working as a registered dentist and that this could result in financial hardship to him. However, it has had no information before in this regard. In applying the principle of proportionality, the Committee determined that Mr Pezeshki s interests were outweighed by that of the public in this regard. Accordingly, the Committee determined that the appropriate and proportionate sanction was one of suspension. The Committee did consider erasure but concluded that it would be disproportionate in the circumstances of this case. It considered that both the shortcomings and the wider public interest concerns could be addressed by a short period of suspension. The Committee determined that Mr Pezeshki s registration should be suspended for a period of three months. It considered that this period of time is necessary in view of the gravity of the matters identified in this case and to mark the importance of maintaining the standards expected of a registered dentist and send a message to the profession that Mr Pezeshki s conduct is not acceptable. It also considered that this period is sufficient for Mr Pezeshki to develop his insight, to start the process of remediation, and to meet the wider public interest concerns engaged. The Committee further directs that Mr Pezeshki s suspension should be reviewed before its expiry. Although the Committee in no way wishes to bind the reviewing Committee, it considered that that Committee may be assisted by being provided with evidence of Mr Pezeshki s engagement with the GDC and with a reflective statement from him. The Committee now invites submissions on whether an immediate order should be imposed. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -11/14-

12 Having directed that Mr Pezeshki be suspended from the register, the Committee considered whether to impose an order for his immediate suspension in accordance with section 30. (1) of the Dentists Act 1984 (as amended). The Committee took into account the submissions of Mr Mansell on behalf of the GDC. It accepted the advice of the Legal Adviser. In its deliberations, the Committee had regard to the GDC s Guidance for the Practice Committees, including Indicative Sanctions Guidance (October 2016). The Committee bore in mind its reasons for making an order suspending Mr Pezeshki s registration. For those same reasons the Committee determined that it was in the public interest to impose an immediate order, in order to uphold and maintain public confidence in the profession and the GDC as its regulator. The Committee was satisfied that it would be inconsistent with its reasons as to why a suspension order was the only appropriate and proportionate sanction in this case not to make an immediate order. If, at the end of the appeal period of 28 days, Mr Pezeshki has not lodged an appeal, this immediate order will lapse and will be replaced by the substantive direction of suspension for a period of 3 months. If Mr Pezeshki does lodge an appeal, this immediate order will continue in effect until that appeal is determined. That concludes this case for today. On 24 May 2017, at the review hearing the Chairman announced the determination as follows: Ms Headley Service of Notice of Hearing Mr Pezeshki was not in attendance nor was he represented at this review hearing today. The Committee saw a copy of the Notification of Resumed Hearing dated 25 April 2017 that was sent to Mr Pezeshki s registered address via Special Delivery, and to a previously supplied address. The download receipt for the confirmed that the had been opened. It saw a printout from the Royal Mail Track and Trace website service which stated that the item was passed on to overseas postal services for delivery to the registrant s address on 25 April The Committee was satisfied that notification of the hearing had been made in accordance with Rules 28 and 65. Proceeding in the absence of Mr Pezeshki The Committee then considered whether to exercise its discretion to proceed in the absence of Mr Pezeshki. It bore in mind that its discretion to proceed had to be exercised with the utmost care and caution. It balanced the interests of Mr Pezeshki against the public interest in the expeditious disposal of this matter. It is aware that the order will expire on 12 June Mr Pezeshki ed the GDC on 19 May 2017 stating that he was not going to attend today s hearing. It is apparent from the papers that the GDC has made attempts to keep Mr Pezeshki informed of the progress of his case and has sought his engagement with matters PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -12/14-

13 at every stage. Mr Pezeshki s contact with the GDC has been limited to s dated 11 February 2017 and 19 May The Committee had regard to the information before it indicating that the GDC had made contact with Mr Pezeshki regarding this hearing. It noted that he ed on 19 May 2017 simply stating he would not be attending the hearing today. Mr Pezeshki has not requested an adjournment. The Committee was satisfied that Mr Pezeshki had been furnished with all of the relevant information to enable him to participate in the hearing. It was satisfied that he was afforded the opportunity to be present and has chosen voluntarily to absent himself. It determined that there was a pressing public interest in proceeding, bearing in mind the imminent expiry of the order. The Committee concluded that an adjournment of this hearing would serve no useful purpose and therefore determined that it was fair and reasonable to proceed with the hearing notwithstanding Mr Pezeshki s absence. Background This is a review of a suspension order imposed upon Mr Pezeshki s registration on 8 February 2017 for a period of 3 months. At the substantive hearing on 8 February 2017 the PCC considered allegations relating to whether Mr Pezeshki s fitness to practice was impaired by reason of misconduct. At that hearing the following was found: The Committee considered Mr Pezeshki s conduct in sending a threatening , sending more than one unprofessional s and acting in an unprofessional, threatening and aggressive manner during a meeting with NHS staff, was particularly serious. It took into account that Mr Pezeshki had acted in an unacceptable manner on more than one occasion. It concluded that Mr Pezeshki s conduct fell far below the standards expected of a registered dentist. It considered that public confidence in the profession would be undermined if it did not conclude that Mr Pezeshki s actions constituted misconduct. The PCC on 8 February 2017 found that Mr Pezeshki s fitness to practise was impaired and imposed an order of suspension for 3 months with a review. Decision on review Today this Committee has undertaken a review. It took account of the submissions on behalf of the GDC and all of the material before it. It accepted the advice of the Legal Adviser. Impairment The Committee considered whether Mr Pezeshki s fitness to practise remains currently impaired by reason of his misconduct. It was found at the substantive hearing, that Mr Pezeshki s conduct in sending a threatening , sending more than one unprofessional s and acting in an unprofessional, threatening and aggressive manner during a meeting with NHS staff, was particularly serious. It was noted that Mr Pezeshki had acted in an unacceptable manner on more than one occasion. It was concluded that Mr Pezeshki s conduct fell far below the standards expected of a registered dentist. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -13/14-

14 At this review, the onus is on Mr Pezeshki to demonstrate that he has addressed the concerns identified. The Committee notes that Mr Pezeshki submitted a reflective statement dated 11 February 2017, some 3 days after the initial PCC hearing. The Committee considers that the reflective statement provided does not demonstrate evidence of current insight or reflection into his conduct. Having been given an opportunity to develop his insight, start the process of remediation and demonstrate reflection, there is no indication that Mr Pezeshki has taken steps to acknowledge and address the issues raised previously. The Committee therefore takes the view that there remains a risk of repetition of his misconduct. The Committee has determined that Mr Pezeshki s fitness to practise remains impaired. It has further determined that such a finding remains necessary in order to declare and uphold proper professional standards and to maintain public confidence in the profession. Sanction The Committee went on to determine what action to take in relation to Mr Pezeshki s registration. It bore in mind that the purpose of a sanction is not to be punitive, but rather to protect patients and the wider public interest. It first considered whether to revoke the order of suspension and take no further action. In light of the seriousness of the findings made against Mr Pezeshki and the fact that there remains a risk of repetition, the Committee concluded that it would be inappropriate to revoke the order and take no action. The Committee next considered whether to revoke the order of suspension and replace it with one of conditional registration. It noted Mr Pezeshki s limited engagement with the GDC in relation to this matter. It considered that no conditions could be formulated which would be workable, practicable and measurable and which would address the identified failings in this case. In particular, no conditions could assist Mr Pezeshki s development of insight and reflection upon his conduct in any meaningful way. This can only be achieved by his own efforts. The Committee has determined that an extension of the order of suspension for the maximum period of 12 months is necessary and will serve to safeguard public confidence in the profession and uphold standards. The order is imposed for 12 months from the date at which the current order would otherwise expire and will be reviewed shortly before the end of that period. This extended period will provide Mr Pezeshki an opportunity to reflect on and appreciate the seriousness of his failings. It will also allow him time to develop insight into his conduct and take appropriate steps to address these. The reviewing Committee may be assisted by Mr Pezeshki providing a reflective statement that demonstrates an understanding of how his misconduct fell below the relevant standards for the dental team and what steps he has taken to address the risk of repetition. That concludes the case for today. PEZESHKI, P Professional Conduct Committee Feb May 2017 Page -14/14-