KATZ, N M Professional Conduct Committee July 2015 Page -1/6-

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1 HEARING HEARD IN PUBLIC KATZ, Neale Merrick Registration No: PROFESSIONAL CONDUCT COMMITTEE JULY 2015 Outcome: Current impairment found, reprimand issued. Neale Merrick KATZ, a dentist, registered as of Lilac cottage, 5 Winkfield Row, Bracknell, Berkshire RG42 6NE; BDS University of Witwatersrand 1986, was summoned to appear before the Professional Conduct Committee on 20 July 2015 for an inquiry into the following charge: Charge (as amended) That, being a registered dentist: 1) At all material times you were a United Kingdom registered Dental Practitioner in practice at The Appledore Dental Clinic, Binfield, RG42 4HL. 2) You failed to maintain adequate and suitable professional boundaries with Patient A when you accepted a personal loan from Patient A on 4 March ) You failed to maintain appropriate standards of personal behaviour from 4 March 2007 to 21 July 2008 by: a) failing to re-pay the agreed loan on a monthly basis; and b) providing assurances of the loan being repaid in full in May 2008 when your bankruptcy hearing was imminent. 4) Your conduct set out in paragraphs 2 and 3 was; a) unprofessional; and b) inappropriate. 5) [withdrawn] 6) [withdrawn] a) [withdrawn] b) [withdrawn] c) [withdrawn] AND, by reason of the facts stated, your fitness to practise as a dentist is impaired by reason of your misconduct. KATZ, N M Professional Conduct Committee July 2015 Page -1/6-

2 On 22 July 2015 the Chairman made the following statement regarding the finding of facts: Mr Katz, The Committee has taken into account all the evidence presented to it. It has accepted the advice of the Legal Adviser. I will now announce the Committee s findings in relation to each head of charge: 1. Proved. 2. Proved. 3.a Proved. 3.b Not proved. 4.a 4.b The Committee was of the view that, regardless of the nature and significance of any personal friendship between you and Patient A, he was nonetheless a patient. Accordingly, accepting a personal loan from him constituted a failure to maintain adequate and suitable professional boundaries. The Committee found that, as a matter of fact, you only made nine payments across a period of approximately 17 months. Further, you and Patient A made the loan arrangements in contemplation of an agreement that you would maintain regular repayments of per month until the loan was repaid. The Committee considered that you did not re-pay the agreed loan on a monthly basis and accordingly, this constituted a failure to maintain appropriate standards of personal behaviour. There was no evidence to satisfy the Committee that the bankruptcy was imminent in May 2008 when, Patient A says, you assured him that you would repay the loan in full. Proved. Proved. 5. [withdrawn] 6.a [withdrawn] 6.b [withdrawn] 6.c [withdrawn] The Committee noted that the culpable aspects of paragraphs 2 and 3(a) are virtually indistinguishable from those in paragraphs 4(a) and 4(b), on the facts of this case. It therefore found these heads of charge proved for the same reasons stated above. Paragraphs 5 and 6 of the charge were withdrawn by amendment at the close of the prosecution case. We move to Stage Two. KATZ, N M Professional Conduct Committee July 2015 Page -2/6-

3 On 23 July 2015 the Chairman announced the determination as follows: Mr Katz, The Committee has considered the submissions from Ms Horlick on your behalf, and those from Mr Hunt on behalf of the General Dental Council ( GDC ). It has had regard to all the documents placed before it, and has accepted the advice of the Legal Adviser in reaching its decisions. Background The Committee was informed that you first registered as a dentist in the UK on 30 December 1987 and for approximately ten years to date you have been in practice at the Appledore Dental Clinic. Sometime during the mid 1990s, you and Patient A became friends. The Committee heard much conflicting evidence concerning the nature and significance of your and your family s friendship with Patient A and his family, including how that friendship changed over the years leading up to the material events and your subsequent referral by Patient A to the GDC. There was no dispute that Patient A became a patient of yours in or around 2002, at your original practice in Chiswick, and later at the Appledore Dental Clinic. You encountered significant personal financial difficulties in or around Patient A, an accountant, assisted and advised you during this time. It noted that there was a dispute between you and Patient A in respect of the basis of his assistance. It was undisputed, however, that you accepted a loan from Patient A on 4 March 2007 in the sum of 12,989.16, and in doing so, entered into a loan agreement which Patient A drafted. The agreement included a term which required that Repayments will be 390 per month until the loan is repaid. It was alleged, and the Committee found proved that, you failed to maintain professional boundaries with Patient A in accepting the personal loan. It has further found that, in making only nine repayments during the period 4 March 2007 and 21 July 2008, you failed to re-pay the loan on a monthly basis and therefore failed to maintain appropriate standards of personal behaviour. Misconduct The Committee first considered whether the facts found proved amount to misconduct. In order to make a finding of misconduct the Committee must be satisfied that your actions fell below the appropriate standards and that the falling short must be serious. In reaching its decision the Committee considered the GDC publication Standards for Dental Professionals dated May 2005, which provided ethical guidance for the dental profession at the material time. The facts found proved concern the following paragraphs: 2.5 Maintain appropriate boundaries in the relationships you have with patients. Do not abuse those relationships. 6.3 Maintain appropriate standards of personal behaviour in all walks of life so that patients have confidence in you and the public have confidence in the dental profession. The Committee was of the view that your conduct contravened the above standards. In reaching its decision on misconduct, it considered, amongst other things, the oral evidence. Patient A appeared aggrieved and on occasions was evasive. Certain aspects, such as his factual evidence and recollection of the chronology were however helpful to the Committee. Witness 1, herself a dentist and your long-standing colleague, provided evidence that she KATZ, N M Professional Conduct Committee July 2015 Page -3/6-

4 considered you to be a person of integrity upon whom she could rely. She said that she had received dental treatment from you. She also stated that she would never consider accepting a loan from a patient in any circumstances. The Committee considered your own oral evidence and concluded that you were a credible witness. You gave a frank account of your actions and state of mind at the material time in order to help the Committee to understand the circumstances and the pressure you were under due to your financial constraints. Consistent with its findings of facts, in particular that your conduct was inappropriate and unprofessional, the Committee was of the view that a breach of professional boundaries was a particularly serious matter. Maintaining such boundaries are at the heart of the dentist / patient relationship, and this is a necessary safeguard to protect patients, given a dentist s position of trust. The Committee accepts that dentists frequently treat patients who are also friends and colleagues; this, however, does not mean that professional boundaries can be disregarded, as occurred in this case. Further, whilst failing to repay the agreed loan on a monthly basis could be viewed as a less serious matter, in the circumstances the Committee took the view that this was repeated on numerous occasions. This conduct is inconsistent with the duty incumbent upon dentists to maintain their integrity in their personal as well as professional dealings. The Committee concluded that you are aware that your conduct constituted culpable behaviour. When cross examined you were asked whether you accepted that you breached professional boundaries, you responded at the time, yes, but I accepted the loan from a friend. Further, you described that you had major things on my mind that clouded my judgement, referring to your adverse financial circumstances. Accordingly, the Committee determined that the facts found proved do amount to misconduct which was serious. Impairment Having found misconduct, the Committee next considered whether your fitness to practise is currently impaired. It was referred to the guidance set out by Dame Janet (Lady Justice) Smith in the 5th Report to the Shipman Inquiry which, at paragraph 25.67, sets out relevant considerations when determining whether a registrant s fitness to practise is impaired: Do our findings of fact in respect of the [dentist s] misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he: b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession [ ]. The Committee observed that the misconduct in this case falls within the scope of this test, in that your misconduct is of a kind which could damage the trust that the public places in dental professionals. It noted that you have started to undertake appropriate and targeted remedial steps. These included courses, only taken in May 2015, aimed at improving your knowledge of professional boundaries. During your oral evidence, you demonstrated some insight into the implications of breaching professional boundaries and standards of personal behaviour. The Committee noted however that, when cross examined, there were questions you were unable to answer. In particular, when asked if you had considered the dual relationship with Patient A, as a friend and a patient, when you accepted the loan, you responded, I honestly can t answer that. You have not yet developed full insight into your KATZ, N M Professional Conduct Committee July 2015 Page -4/6-

5 misconduct and your own personal shortcomings which led to it. It noted, however, that you are both willing and able to engage in remedial steps. This, combined with your remorse and contrition, has satisfied the Committee that there is a low risk that your misconduct could be repeated in the future. Next, the Committee was referred to the case of CHRE v NMC and Grant [2011] EWHC 927 (Admin) where Cox J stated at paragraph 74, In determining whether a practitioner s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances. In spite of your remedial steps and low risk of repetition, your misconduct is of a kind which requires the Committee to declare and uphold proper standards of conduct and behaviour. Given that the maintenance of professional boundaries is a fundamental aspect of the dentist / patient relationship, it would undermine public confidence in the dental profession and the regulatory process if a finding of current impairment were not made in this case. For all the reasons set out above, the Committee has determined that your fitness to practise is currently impaired. Sanction The Committee next considered which sanction, if any, was applicable in this case. It has borne in mind that the purpose of a sanction is not to be punitive, although this may be its effect. It has had regard to the principle of proportionality, and the need to balance the public interest with your own interests in the outcome of this case. The Committee first considered concluding this case with no further action. This case concerns the breach of professional boundaries, and the maintenance of appropriate standards of personal behaviour. Given the serious nature of your misconduct, concluding the matter with no further action would not be sufficient or proportionate to satisfy the wider public interest. The Committee next considered imposing a reprimand. It noted that there was no direct patient harm in this case, and there is no evidence to suggest that you would be likely to pose such a risk in the future. The GDC publication Guidance for the Professional Conduct Committee, including Indicative Sanctions Guidance dated April 2015, states at paragraph 7.2, if the case concerns an act of professional misconduct and the likelihood of repetition is felt to be very low in all future circumstances, imposing a reprimand may be more appropriate than imposing conditions. A number of positive testimonials were provided by colleagues and patients. It noted that over your career of more than 30 years, no other fitness to practise concerns have been raised. It would not be proportionate, in the particular circumstances of this case, to impose any sanction which would restrict the practice of an otherwise dedicated and well-regarded dentist. The Committee was nonetheless satisfied that it is necessary to declare and uphold proper standards of conduct and behaviour for the benefit of the wider profession, and the maintenance of public confidence in the dental profession and the regulatory process. KATZ, N M Professional Conduct Committee July 2015 Page -5/6-

6 Accordingly, the Committee has determined that it is proportionate and appropriate to conclude this case with a reprimand. KATZ, N M Professional Conduct Committee July 2015 Page -6/6-