HEARING HEARD IN PUBLIC McKINNON, Jemma Anne Registration No: 260669 PROFESSIONAL CONDUCT COMMITTEE SEPTEMBER 2017 - JANUARY 2019* Most recent outcome: Fitness to practise no longer impaired. Suspension revoked. *See page 9 for the latest determination Jemma Anne McKINNON, a dental nurse, SQA L3 Dental Nursing & PDA Dental Nursing SQA 2014, was summoned to appear before the Professional Conduct Committee on 28 September 2017 for an inquiry into the following charge: Charge (as amended on 28 September 2017) That being registered as a dental care professional: 1. From an unspecified period, up to and including at least 21 April 2017 you advertised and/or offered to provide tooth whitening services. 2. Amended to: From an unspecified period, up to and including at least 21 April 2017 you provided tooth whitening services. 3. The dental services at 1 and/or 2 above were outside your scope of practise as a dental nurse. 4. Your conduct in relation to allegations 1 and/or 2 was: a. misleading; and/or b. dishonest in that you knew that the tooth whitening services you offered and/or provided were outside your scope of practise as a dental nurse. And by reason of the facts alleged, your fitness to practise is impaired by reason of your misconduct. On 28 September 2017 the Chairman made the following statement regarding the finding of facts: Ms McKinnon, This is the Professional Conduct Committee s inquiry into the facts which form the basis of the allegation against you that your fitness to practise is impaired by reason of misconduct. At the start of the hearing Mr Jamieson, Counsel on behalf of the General Dental Council (GDC) made a submission under Rule 13(2) of the General Dental Council (GDC) (Fitness to Practise) Rules 2006 ( the Rules ) that there has been proper notice in this case. He submitted that the notification for this hearing dated 11 September 2017 fell short of the statutory 28 days specified in Rule 13(2). He informed the Committee that this was as a result of your request for a prompt hearing. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -1/11-
Rule 13(2) provides: The notification of hearing shall be sent to the respondent no later than 28 days before the date fixed for the hearing, unless the respondent has agreed in writing to an earlier hearing date. The Committee noted the email dated 8 September 2017 from Mrs Preston acting on your behalf in which she explicitly stated that you accept short notice of this hearing. The Committee therefore determined that in the circumstances, service had been properly effected in this case. Amendment to the Charge Mr Jamieson then made a second application under Rule 18 of the Rules to amend paragraph 2 of the charge. He submitted that there was no injustice caused by the proposed amendment as it was aimed at correcting a typographical error. The application was not opposed. The Committee accepted the advice of the Legal Adviser. It determined that the amendment could be made without injustice and granted the application. The amended charge was then incorporated into the record without being read, with the agreement of both parties. Admissions Mrs Preston on your behalf entered admissions to paragraphs 1, 2, 3 and 4(a) of the charge. The Committee deferred making a final decision on your admissions until all the evidence had been received. Background The GDC received information from an anonymous source on 11 January 2017 that you were providing tooth whitening services to members of the public. As a result of this information the GDC instructed an investigator to determine whether you were advertising and providing teeth whitening to members of the public through your Facebook page Pro White Dental. The investigator contacted you on Facebook and engaged you in a private conversation using a pseudonym. The transcripts of the conversations between you and the investigator were exhibited before the Committee. Witnesses Mr Jamieson made an unopposed application for the witness statements of Mr White, the GDC s investigator, to be read into the record. The Committee acceded to the application. Decision on the facts The Committee bore in mind that the burden of proof is on the GDC to prove the facts alleged to the civil standard, namely on the balance of probabilities. You are not required to disprove the Council s case. The Committee carefully considered all the evidence before it. It also took account of the submissions made by Mr Jamieson and those made by Ms Preston. The Committee accepted the advice of the Legal Adviser. In accordance with that advice it considered each charge separately. In relation to the allegation of dishonesty, the Committee was advised to apply the test set out in the case of R v Ghosh [1982] QB 1053 first of all decide whether according to the ordinary standards of reasonable and honest members of the profession what was done was dishonest. If it was not dishonest by those standards, that is the end of the matter and the prosecution falls. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -2/11-
If it was dishonest by those standards, then consider whether you yourself knew on a balance of probabilities that what you were doing was by those standards dishonest. The Committee s findings are as follows: 1. From an unspecified period, up to and including at least 21 April 2017 you advertised and/or offered to provide tooth whitening services. Admitted and found proved by your admission and the evidence before the Committee. 2. From an unspecified period, up to and including at least 21 April 2017 you provided tooth whitening services that were outside your scope of practise as a dental nurse. Admitted and found proved by your admission and the evidence before the Committee. 3. The dental services at 1 and/or 2 above were outside your scope of practise as a dental nurse. Admitted and found proved by your admission and the evidence before the Committee. 4. Your conduct in relation to allegations 1 and/or 2 was: 4 (a) misleading; and/or Admitted and found proved by your admission and the evidence before the Committee. 4 (b) dishonest in that you knew that the tooth whitening services you offered and/or provided were outside your scope of practise as a dental nurse. Not admitted but found proved You did not give evidence on oath to the Committee. The Committee gave such weight as it could to the submissions made by Mrs Preston and the documentary evidence you had provided taking account of the fact that it was not tested by cross-examination or Committee questions. The scope of practice for Dental Nurses clearly states that dental nurses can construct mouth-guards and bleaching trays to the prescription of a dentist. Dental nurses can apply fluoride varnish either on prescription from a dentist or direct as part of a structured dental health programme. The GDC s publication titled Considering tooth whitening? What you need to know before committing to treatment published in June 2014 also clearly states Tooth whitening is the practice of dentistry. By law, dentistry must only be carried out by dental professionals who are registered with us A dentist should always assess you before carrying out tooth whitening to confirm whether treatment would be right for you. Registered dental hygienists, dental therapists and clinical dental technicians can also carry out tooth whitening on the instructions of a dentist. In relation to the objective test for dishonesty, the Committee found that your actions were dishonest by the ordinary standards of reasonable and honest MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -3/11-
professionals. In considering whether you realised that what you were doing were by those standards dishonest, the Committee noted the submissions by Mrs Preston that you started tooth whitening following a period of financial hardship. It also noted that you engaged in agency working as a dental nurse and as such there was insufficient continuity in any one practice for training and support. The Committee is aware that working as a dental nurse in a general dental practice environment is markedly different from developing an internet business for tooth whitening to be delivered distinct from that routine dental environment. In Mrs Preston s submission, the Committee heard that you had been advised by previous managers on what to do and where to buy the gel although no evidence of who these managers were or their qualifications was offered. Furthermore, she informed the Committee that you had researched websites and had found that there was a lot of misinformation out there. The Committee was of the view that at some time in this research process you would have been sign-posted to the official guidance on websites such as the GDC and the British Dental Association (BDA). Indeed, you offered up screenshots of the BDA website, the Dental Protection website and a Mori Survey for the GDC 2016. These documents submitted by you in evidence clearly set out the legal position on tooth whitening. The Committee did not accept that you were not aware that you were acting beyond your scope of practice. The Committee saw documentary evidence of your Facebook page that you advertised yourself as a dental nurse, qualified to provide tooth whitening. This gave people accessing your Facebook page false assurance that you were qualified to deliver tooth whitening as a dental professional, with the security that attaches to such assurance. The Committee concluded that, on the balance of probabilities, you must have realised that what you were doing was by the standards of reasonable and honest professionals, dishonest. We move to Stage Two. On 28 September 2017 the hearing adjourned part heard and resumed on 14 December 2017. On 14 December 2017 the Chairman announced the determination as follows: Ms McKinnon: This is the resumed hearing of your case which, following the completion of stage 1, went part heard in September 2017. Mr Jamieson, Counsel, represents the General Dental Council (GDC) and you are participating at this hearing via Skype, as is Mrs Preston, who is representing you, albeit she is not legally qualified. The Committee has had regard to the submissions made by Mr Jamieson, on behalf of the GDC, and those made by Mrs Preston, in accordance with Rule 20 of the Fitness to Practise Rules 2006. It has accepted the advice of the Legal Adviser. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -4/11-
Mr Jamieson confirmed that you have no fitness to practise history. He submitted that each charge found proved against you is serious and amount to misconduct. Mr Jamieson invited the Committee to conclude that your fitness to practise is currently impaired by reason of that misconduct and said that such a finding was necessary in the wider public interest so as to declare and uphold appropriate standards of conduct amongst dental professionals. He submitted that the appropriate disposal of this case would be that your registration be subject to an order of suspension, with a review hearing to take place before the expiry of the order. Mr Jamieson also submitted that it was open to the Committee to consider the sanction of erasure, particularly if the Committee is of the view that you have not demonstrated sufficient insight into some of the matters that brought you before the GDC. Mrs Preston submitted that you have shown great remorse for the matters that led to your referral before the GDC and that you are now aware of your role and professional responsibilities in not advertising and/or providing tooth whitening services. She said you have ceased providing tooth whitening services to members of the public and you have removed all references to your business activities from your Facebook page and Instagram. She said that you are fully supported in your role as lead dental nurse at your current workplace and that you will not repeat your mistakes again. You respectfully asked the Committee to conclude this case with a reprimand. Misconduct The Committee has first considered whether the facts found proved amount to misconduct. In so doing, it has had regard to all the evidence before it, including the bundles of documents. It also had the benefit of hearing your oral evidence at this stage of the proceedings. Throughout its considerations the Committee has kept in mind the relevant case law regarding the meaning of misconduct within the context of regulatory proceedings. It has also had regard to the GDC s Standards for the Dental Team (September 2013). The Committee has accepted the advice of the Legal Adviser. The facts of this case are that from an unspecified period, up to and including at least 21 April 2017 you advertised, and you offered teeth whitening services to members of the public through your Facebook page. During that time, you also provided tooth whitening services. Your actions in this regard were outside the scope of your practise as a dental nurse. The Committee found proved that your conduct was misleading and dishonest in that you knew that tooth whitening services you offered and/or provided were outside the scope of practise as a dental nurse. The GDC s Scope of Practice for Dental Nurses states clearly that dental nurses can construct mouth-guards and bleaching trays to the prescription of a dentist. Dental nurses can apply fluoride varnish either on prescription from a dentist or direct as part of a structured dental health programme. The GDC s publication titled Considering tooth whitening? What you need to know before committing to treatment published in June 2014 states: Tooth whitening is the practice of dentistry. By law, dentistry must only be carried out by dental professionals who are registered with us A dentist should always assess you before carrying out tooth whitening to confirm whether treatment would be right for you. Registered dental hygienists, dental therapists and clinical dental technicians can also carry out tooth whitening on the instructions of a dentist. The Committee takes a serious view of the findings against you. By offering and/or providing tooth whitening products to patients without their having been assessed by a dentist, you were placing such patients at potential risk of harm. You were also carrying out an illegal act. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -5/11-
In your evidence you told the Committee that you were concerned about the safety of the patients you were offering to treat and that you always asked them about their oral health. However, you accepted that you were not qualified to assess the risks and benefits in the way that a dentist would be able to do. The Committee also takes a serious view of your dishonest conduct. Being honest and acting with integrity is a fundamental tenet of the dental profession. Your actions carried a risk of direct harm to the public. Your conduct was misleading and dishonest in relation to these matters The Committee is of the view that your conduct breached the GDC s Standards for the Dental Team (September 2013) as follows: Standard 1.3 Standard 1.7 Standard 1.9 Standard 7.2.1 Standard 9.1 Be honest and act with integrity. Put patients interests before your own or those of any colleague, business or organisation. You must find out about laws and regulations that affect your work and follow them. You must only carry out a task or a type of treatment if you are appropriately trained, competent, confident and indemnified. Ensure that your conduct, both at work and in your personal life, justifies patients trust in you and the public s trust in the profession. In addition, the Committee has had regard to your breach of the GDC s Scope of Practice guidance. The Committee considers that each of the findings against you is sufficiently serious to amount to a finding of misconduct, and in particular the proven finding of dishonesty. Moreover, when viewed as a whole, the Committee it is satisfied that all of the findings against you are serious and amount to misconduct. Current impairment The Committee next considered whether your fitness to practise is currently impaired by reason of your misconduct. In so doing, it has had regard to the submissions made by both parties. The Committee has accepted the advice of the Legal Adviser, who reminded them of the relevant cases of Cohen v General Medical Council [2008] EWHC 581 (Admin) and Council for Healthcare Regulatory Excellence v Nursing and Midwifery Council and Grant [2011] EWHC 927 (Admin). In your evidence you say that you regret your actions in offering to provide tooth whitening services and that you are now aware of your responsibilities to your patients and colleagues. You explained that as soon as you received notification from the GDC concerning the complaint against you you removed all pages relating to your tooth whitening business from social media and you have deleted all contacts from your phone. You have assured the Committee that you understand your scope of practise and you said that you have completed Continuing Professional Development (CPD) courses on relevant areas, including ethics. The Committee heard that you have recently been promoted to lead nurse and that you wish to develop your career further by training to become a dental hygienist. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -6/11-
The Committee acknowledges that you have taken some steps to address the concerns identified in this case, including removing any advertising material relating to the provision of tooth whitening services. It accepts your assurances that you have discontinued your teeth whitening business. However, the Committee has concerns as to your level of insight into your dishonest conduct. When asked by Mr Jamieson about this Committee s factual finding that your conduct was dishonest, you maintained that your conduct was not dishonest. While the Committee acknowledges that you have shown remorse for your actions, it is concerned that you do not understand or accept that your conduct was dishonest. In the Committee s view, it is not satisfied that you have addressed the underlying attitudinal issues that gives rise to a finding of dishonesty in this case. This therefore raises the risk, albeit slight, of repetition and therefore a finding of impairment is necessary for the protection of patients. The Committee has also had regard to the wider public interest, which includes the need to declare and uphold proper standards of conduct and behaviour among dental professionals, so as to maintain public confidence in the profession. The Committee has found that you have acted dishonestly in the context of your professional practice, which is serious. Such conduct undermines public confidence in the profession and amounts to a breach of one of the fundamental standards of being a registered dental nurse. Accordingly, the Committee considers that public confidence would be undermined if a finding of impairment were not made, given the findings against you. Having regard to all of these matters, the Committee has determined that your fitness to practise is currently impaired by reason of your misconduct. Sanction The Committee next considered what sanction, if any, to impose on your registration. It recognises that the purpose of a sanction is not to be punitive, although it may have that effect, but to protect patients and the wider public interest. The Committee has taken into account the GDC s Guidance for the Professional Conduct Committee, including Indicative Sanctions Guidance (October 2016). It has applied the principle of proportionality, balancing the public interest with your own interests. In considering the issue of sanction, the Committee has taken into account the mitigating and aggravating factors in this case. In mitigation the Committee has noted: You have no fitness to practise history Your admissions to most of the charges at the outset of the hearing as well as your engagement in these proceedings; Your expressions of regret and remorse; You took action to close down your tooth whitening business on notification of the complaint by the GDC; The supportive references from professional colleagues. The aggravating factors identified by the Committee include: The serious nature of the findings against you, including your offer to work beyond your scope of practice and your dishonest conduct; The dishonesty was premeditated, involving the setting up of a tooth whitening business, from which you received financial gain; MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -7/11-
Your lack of insight into your dishonest conduct. The Committee has considered the range of sanctions available to it, starting with the least restrictive. It has determined that in the light of the gravity of the misconduct found, to conclude the case with no further action would not be sufficient for the protection of patients and public confidence in the profession. For the same reasons, the Committee has concluded that a reprimand is inappropriate and insufficient. The Committee then considered whether a period of conditional registration would adequately protect patients and uphold confidence in the profession. The Committee has reached a finding that you acted beyond the scope of practice while running a business outside of your day job as a dental nurse as well as a finding of dishonesty in this regard. In the Committee s view, given the seriousness of the matters in this case, the imposition of conditions would not be sufficient to reflect the gravity with which it views your misconduct. Furthermore, appropriate conditions could not be devised that would be workable. The Committee has therefore determined, pursuant to Section 36P(7)(b) of the Dentists Act 1984, as amended, to direct that your registration as a Dental Care Professional be suspended for a period of 12 months. In deciding on the period of 12 months, the Committee has had regard to the need to maintain public confidence in the profession. It has concluded that 12 months is sufficient and proportionate to mark the seriousness with which the Committee views your misconduct, with particular regard to the finding of dishonesty. The Committee considered carefully whether this is a case where an order of erasure is necessary for the wider public interest. Notwithstanding the finding of dishonesty, the Committee considers that this sanction would be disproportionate given the circumstances of this case. The Committee has also had regard to the testimonials that speak very positively as to your abilities as a dental nurse who is regarded as a valuable member of staff. It is aware that one element of the public interest is that an otherwise good dental nurse should not be lost to the profession. It considers that this is not a case where your behaviour is fundamentally incompatible with being a dental professional. The Committee is therefore satisfied that an order of suspension is appropriate. A Committee will review your case at a resumed hearing to be held shortly before the end of the period of suspension. That Committee will consider what action it should take in relation to your registration. You will be informed of the date and time of that resumed hearing. This Committee considers that it would be helpful for a Committee reviewing your case to receive written evidence of further reflection on the matters that have been identified in this case, especially with regard to the dishonesty. Furthermore, the Committee would expect to see evidence of ongoing CPD. The Committee now invites submissions as to whether your registration should be suspended immediately. Ms McKinnon: Having directed that your registration be suspended, the Committee has considered whether to make an order for the immediate suspension of your registration in accordance with Section 36U(1) of the Dentists Act 1984 (as amended). In so doing, it has had regard to the submissions made by both parties, as well as the advice of the Legal Adviser. Mr Jamieson, on behalf of the GDC, submitted that an order for immediate suspension is necessary for the protection of the public and is otherwise in the public interest in the light of MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -8/11-
the Committee s findings. Mrs Preston submitted that you do not pose a risk of repeating your misconduct and that following consideration of your case before the GDC s interim order committee, you were permitted to practise without any restrictions on your registration. In accordance with Section 36U(1) of the Dentists Act 1984 (as amended) the Committee has determined that it is necessary for the protection of the public and is otherwise in the public interest to order that your registration be suspended forthwith. Given its reasons for finding current impairment, including the risk of repetition identified, and directing that your registration be suspended, the Committee is satisfied that it would be inconsistent to allow you to continue to practise during the 28 day appeal period or, if an appeal is lodged, until it has been disposed of. The effect of this direction is that your registration will be suspended immediately. Should you exercise your right of appeal, this immediate order for suspension will remain in place until the resolution of any appeal. That concludes the case. At a review hearing on 3 January 2019 the Chairman announced the determination as follows: Miss McKinnon You are participating in this resumed hearing of the Professional Conduct Committee (PCC) via Skype and telephone. You are not represented. Ms Vanya Headley of the GDC s Legal Team appears for the General Dental Council (GDC). Purpose of hearing The purpose of today s hearing is to undertake a review of a substantive suspension order imposed on your registration for a period of 12 months by the PCC on 14 December 2017. The hearing is being held in accordance with Section 36Q (1) of the Dentists Act 1984 (as amended) ( the Act ). The substantive suspension came into effect on 16 January 2018 and is due to expire on 15 January 2019. Existing order In September and December 2017 the PCC held a hearing to consider allegations that had been raised about your conduct as a dental care professional (DCP). It was alleged, and the PCC found proved, that you advertised, offered to provide, and provided tooth whitening services outside of your scope of practice as a dental nurse. The Committee found that such conduct was misleading and dishonest. You made admissions to the facts, save for the allegation that your conduct was dishonest. The Committee went on to determine that the facts that it had found proved amounted to misconduct. Although that Committee noted that you had expressed regret for your actions and had taken some steps to reduce the prospect of a repeat of such conduct, the Committee considered that you had not demonstrated sufficient insight into your dishonest conduct and that there therefore remained a risk to patients. The Committee also considered that your dishonest conduct required a finding of impairment in order to maintain public trust and confidence in the profession. The Committee determined that the appropriate sanction was one of suspended registration for a period of 12 months, with a review hearing to take place prior to the expiry of the suspension. It falls to this Committee to conduct that review. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -9/11-
Submissions In your oral evidence to the Committee you stated that your proven conduct arose out of your fear of losing your job. You stated that you admit the misconduct that was found proved and that you have done all the continuing professional development (CPD) required of you. You stated in particular that you accept that your conduct was dishonest. In your closing submissions you stated that there is no prospect of the conduct that precipitated these proceedings from happening again. On behalf of the GDC Ms Headley submitted that you have not provided the information which was suggested by the previous Committee as being of potential benefit at the review hearing, namely written evidence of your further reflection on the matters identified in this case, with particular regard to your dishonest conduct. Ms Headley submitted that your fitness to practise remains impaired as you have not shown sufficient remediation of or insight into the misconduct that has previously been identified. Ms Headley submitted that, although you have today acknowledged that your conduct was dishonest, you have not provided a sufficiently detailed analysis of why you have come to that view. Ms Headley submitted that it would be appropriate to extend the period of suspension for a further period of three months. Committee s determination This Committee has carefully considered all the information presented to it, including the written documentation and submissions provided by Ms Headley on behalf of the GDC and those provided by you. The Committee has also heard oral evidence from you. The Committee has accepted the advice of the Legal Adviser. In its deliberations the Committee has had regard to the GDC s Guidance for the Practice Committees, including Indicative Sanctions Guidance (October 2016). Impairment The Committee has considered whether your fitness to practise remains impaired by reason of your misconduct. In doing so, it has exercised its independent judgment. Throughout its deliberations, it has borne in mind that its primary duty is to address 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 has determined that your fitness to practise is no longer impaired. The Committee finds that the information that you have presented is sufficient for it to conclude that you now have appropriate and sufficient insight into your misconduct, including your dishonesty, and that you have demonstrated adequate remediation of those shortcomings. The Committee therefore considers that the risk of a repetition of the behaviour which precipitated these proceedings is now low, and that you no longer pose a risk to the public. In your oral evidence and submissions to this Committee you expressed your regret and remorse for the conduct which brought you before the PCC. You spoke with clarity and conviction about the sorrow that you feel for how you acted. Your oral reflections were not limited to the impact that your conduct, including your dishonest conduct, has had on you and your family, but also on the effect that your conduct may have had in a wider context. The Committee also attaches weight to your continued engagement in these proceedings and in your participation in today s hearing. You now accept that your conduct was dishonest, and you were sincere and candid in explaining why it is that you have come to that conclusion. Although the Committee notes that your written reflective statement is not MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -10/11-
especially detailed, it considers that your statement, when taken together with your oral evidence and submissions, is sufficient for it to conclude that you have developed and demonstrated sufficient insight into your dishonest conduct, and that a risk of any repetition is now low. You have also demonstrated good knowledge of your scope of practice as a dental nurse, with a detailed understanding of what duties you are, and are not, entitled to perform within the specified parameters. You have also put a great deal of effort into identifying and undertaking targeted CPD. Although you have not provided evidence of CPD in the area of ethics, the Committee considers that you have demonstrated a commitment to your ongoing professional learning and development and that your insight is sufficient for it to determine that you have remedied your misconduct. It is clear to the Committee that you value your position as a dental nurse, and the Committee is satisfied that you would be able to return to practise without posing a risk to patients. Having taken into consideration all the information presented to it, the Committee considers that a repetition of the shortcomings that led to your suspension is highly unlikely, and that your fitness to practise is no longer impaired. In reaching its decision the Committee has also had regard to the wider public interest. It has considered whether this requires a finding of impairment for the purposes of declaring and upholding professional standards and maintaining public confidence in the profession and the GDC as regulator. The Committee is mindful that the previous Committee found that your failings constituted misconduct, and also found that you had acted in a dishonest manner. The previous Committee also considered that a finding of impairment was required for public interest purposes. However, the Committee considers that a reasonable and informed member of the public would note the steps that you have taken to address and remediate the attitudinal deficiencies that had been identified, and that you have demonstrated sufficient insight into the matters that precipitated these proceedings. The Committee considers that the earlier finding of impairment, as well as the direction that your name be suspended from the register for a period of 12 months, have sufficiently marked the seriousness of these matters and that a further finding of impairment is not required for public interest considerations. The Committee has therefore determined that your fitness to practise is no longer impaired. Your suspension is hereby terminated forthwith. That concludes this case. MCKINNON, J A Professional Conduct Committee Sept 2017-Jan 2019 Page -11/11-