If the statements released by the General Dental Council were to be believed, there’s very little wrong within the dentistry profession in the UK. Okay, maybe there seems like there’s a few too many hearings into dentists conduct but, judging by what the regulator is saying, everything is going quite well.
Their reaction to the Professional Standards Authority’s publication of their annual report on health service regulators in the UK is one such example. Titled “General Dental Council focused on patient-first regulation”, the GDC welcomed the report’s findings. Chief Executive, Evlynne Gilvarry, said: “The PSA report recognises much of the excellent work being done by the GDC on a daily basis.”
When Gilvarry and her colleague, Chair Bill Moyes, appeared before the Health Select Committee for an accountability hearing, a GDC statement said they “welcomed the opportunity to attend the hearing” as well as indicating that the committee “welcomed the GDC setting out the need for reform.”
For dentists, however, statements such as these are laughable, if not downright insulting. Dentists have been subjected to so much inadequate behaviour by the GDC: from the ARF hike, to the Telegraph advert encouraging patients to complain, to the constant fear of being brought before an unfair Fitness to Practise process. Many have lost total faith in the GDC and feel that it consistently treats dentists unfairly, with the ability to strike them off the register based on an “arbitrary” judgement as well as putting them under severe emotional and financial pressure with their FtP process.
As a disillusioned profession has realised that no real change will happen at the GDC without Government intervention, we caught up with two dental professionals who are doing their bit to help their colleagues through the difficulty and hardship of enduring FtP hearings and vexatious claims.
First and foremost on the mind of most dentists in regard to the GDC is the state of their current fitness to practice process. Duncan Scorgie, a practising dentist working in Scotland, summed it up quite well. He said: “Dentists are held to an extremely high standard which is unachievable and unfeasible within general practice. Not only that, these rules are arbitrarily applied.” This arbitrary application of these rules means that a dentist could find themselves before a hearing where their very livelihood is at stake over an arbitrary application of quite excessive rules.
As well as that, to bring clinical cases before a Fitness to Practise may be, in most cases, missing the point entirely, according to Duncan. “So many FtP cases are about shortcomings that can be remedied with appropriate mentoring,” he said. “There’s no need for them to end up before an FtP hearing.” Where FtP is necessary, it should be due to a matter of questioning the integrity of the dental professional in question. “There is a massive separation between clinical shortcomings and integrity, and the current process treats them as the same”, Duncan added.
Keith Hayes, who has retired as a practising dentist but remains a registrant with the GDC, is similarly disillusioned with this and many other aspects of the GDC’s conduct. Highlighting that they were “the worst performing regulator”, he echoed the feeling across the profession that the GDC is “not fit for purpose.” He said all the GDC had done in recent times was to “confirm [his] opinion that they do not act with proportionality or fairness and do not uphold the same principles they expect from registrants. They seem to have little insight into the degree of trauma they inflict on a young professional who has been accused of actions which almost certainly have never taken place.”
The recent case of Jasbinder Singh was a particularly unsettling development. The GDC’s own Professional Conduct Committee (PCC) said that the GDC’s conduct “was so egregious that the Committee’s sense of justice and propriety is offended.” Duncan points out that since the GDC’s own misconduct in pursuing this case only came to light when investigated by the PCC, it begged the question of how many other cases are pursued in this manner featuring “multiple, repeated and very serious failings.” Furthermore, Keith pointed out that “the GDC cannot conduct a prosecution in this way whilst, at the same time, maintaining the confidence of the professionals it regulates or that of the wider public.”
And it’s certainly not only the profession that views the GDC in such a poor light, as Keith highlights: “The profession has also had to come to terms with the regulator facing a House of Commons Committee and a Health Select Committee hearing and recently being described as the worst performing regulator for the second year by the PSA.”
The Fight Back
The views of the dentists in question are clear, concise and their expectations aren’t all that unrealistic. Duncan Scorgie has networked with colleagues who’ve suffered from damaging, vexatious claims and it inspired him to begin a crowd funding project to help dentists pay the legal costs associated with these cases. He has set up a website www.fairnessfordentists.com which will help to support dental professionals who find themselves on the end of a fictitious or vexatious claim, in order to help them seek redress for the enormous emotional or financial toll that these proceedings can take.
He explained: “Vexatious claims have a hugely negative impact on dentists. So many cases where damaging claims were found to be untrue… they cause incredible emotional stress. I’ve had many dentists come to me and describe their experiences with these hearings. One told me that she’d ‘cried for weeks’ in the run up to the hearing and was unable to work.”
Keith has also been canvassing the experiences of dental professionals who’ve been put under the GDC’s microscope and, with a view to legal proceedings, believes that the gross conduct of the GDC has been morally inadequate. He said: “We hope to bring to public attention the actions of the GDC in relation to a young professional which we believe further illustrates the conspicuously reprehensible behaviour of the GDC in this case.”
To that end, Keith is using his own business which specialises in helping practices prepare for CQC inspections, RightPath4, to help support dentists looking to cover the cost of tackling the GDC. “Because use of this system will also help safeguard against some aspects of the GDC,” he described, “I felt it was entirely appropriate to offer this package to as many practices as possible and to donate 40% of the proceeds towards supporting dentists to bring pressure upon the GDC where is has been grossly disproportionate… We now have hundreds of practices using our system and this has contributed over £10,000 in the past 3 months.”
Taking the battle further
Both men have received a positive response across the dental community, with many recounting similar stories and experiences at every turn. The need to reform the GDC is clear and urgent. The problem, however, is that while these kinds of steps are unfortunately necessary to help protect dental professionals in the current climate, offering these alone will not make the GDC change how they operate. That responsibility lies squarely at the feet of the Government, with hopes that they implement real change to the way the industry is regulated in this Parliamentary session.
Keith is feeling quite positive that, finally, the tide may be turning against the GDC. He said: “I have spoken with my MP, Greg Clark and he is as dismayed as I am about the behaviour of the GDC. Recently we have been joined by a number of MP’s who are similarly disenchanted and willing to use Parliamentary Privilege to ensure that the GDC is answerable for its failures and behaviour which falls way below the standards we should expect of a Regulator. Politicians are now well aware of these failings and it can surely only be a matter of time before the Secretary of State for Health feels compelled to call time on the current GDC leadership.
“The profession is united in a way I have never seen before and much of what we need to show comes from us all voicing our concerns with a very loud voice. Of course there are many who are already trapped in the GDC quicksand and also those who feel intimidated to speak out. However there are now sufficient numbers of enraged professionals like myself who are mobilised to take action.
“Although I have often described the GDC ability to shake off mud like a Teflon coated rhino; I believe that the time has surely come when Jeremy Hunt cannot ignore this a moment longer.”
Duncan, however, is not as hopeful. While acknowledging that the profession is doing a great deal to fight the GDC, it remains very difficult. “The only real way to see change is for Governmental steps to be taken. Really shocking cases where there was literally no more that dentist could have done gets brought before FtP.”
Hope for the future
Duncan certainly sees how the GDC could instantly begin to remedy some of its most deep-rooted problems. He said: “They’re not protecting the public. What they’re currently doing is not good for patients and not good for dentists. They need to work with the profession, not against them.” Keith envisages that, as the profession unites more and more, this may begin to become a reality: “As we enjoy greater successes from our challenges, it will become easier to ensure we have a more proportionate and fair response from the regulator.”
And how to fix the GDC? Again, dentists are not simply arguing against the status quo, they are also offering alternatives as to how the GDC could become a more efficient regulator, for patients and professionals, alike. “It’s very important to focus more on local resolution, so cases don’t end up at FtP,” Duncan proposed. “As well as that, there should be more accountability for corporates.”
Keith had similarly effective proposals: “It is inconceivable that the GDC can improve without having a leader who has the real experience of delivering dental care… I would like to see somebody who the profession can trust as a safe pair of hands who understands the standards and who has demonstrated an ability to deliver them. I can imagine that if Nairn Wilson had taken the time to call me on a matter, I would very definitely have sat up and taken note. I can’t imagine the same from the present incumbent. We could do far worse than engaging someone like Prof Nairn Wilson to oversee this turnaround at the GDC.”
Both men, also, would like to see a reform of compensation claims. Duncan believes it is disproportionate that “patients are compensated for the cost of private treatment even where they have chosen NHS treatment. What this means is that they have (often unknowingly) gone into a limited system, where the dentist is limited in what can be achieved, but then held accountable to a standard that isn't achievable in NHS practice.” Keith meanwhile would like to see a system with “less blame and more gain.” He added: “A clear path for patients to complain and be compensated without the engagement of lawyers where it is possible to defend cases that are mistakes not negligent and where the patient is suitably rather than extravagantly compensated and the professional learns from the experience rather than dismissed.”
We approached the GDC and asked if they had any response to this article. They declined to comment.