Implications of GDC v. Williams judgment for dentists mixing private and NHS treatment

Dentists and dental lawyers have been watching the case of GDC v. Williams with interest, due to the implications for the long-held view that it is not permitted to mix NHS and private treatment by charging patients a private top-up fee in addition to the NHS charge for NHS treatment. The registrant provided three patients with a crown on the NHS, and offered a ceramic crown for an additional top-up fee (of between £35 and £65) to cover the difference in lab cost between a ceramic crown and the porcelain crown which was sufficient to maintain oral health and would therefore have been provided on the NHS. The Professional Conduct Committee held that the Regulations did not allow such mixing, that the registrant had acted contrary to a fundamental tenet of dentistry, and that she was dishonest in so doing. The registrant appealed to the High Court, and the GDC then appealed that decision to the Court of Appeal.

On 5 May 2023, the Court of Appeal handed down judgment, finding in favour of the registrant. They held that the NHS Contracts Regulations (which they noted are “unclear”) do not prevent dentists from charging a top-up fee to provide a better looking crown on the NHS, and rejected the GDC’s argument that the Regulations prevent mixing of NHS and private work on a single tooth. Of most importance to the registrant involved, who had initially been erased by the GDC’s PCC for dishonesty, the Court of Appeal held that regardless of the way in which the Regulations were interpreted, the finding of dishonesty should never have been made. Of importance to the profession, the Court of Appeal found that these top-up fees are allowed by the Regulations and indeed are much closer to the spirit of NHS dentistry than the GDC’s interpretation. The Court recognised that their decision would have implications for other GDC cases arising out of top-up fees, and we await the GDC’s comments with interest.

The Judgment can be found here: