What sort of profession are we? If you believe the recent advert in the Daily Telegraph, which was placed by the General Dental Council (GDC), we are clearly failing our private patients so badly that they need to be reminded to complain and enable the dentists concerned to be subject to sanction.
The placing of this advert only a few days after the announcement by the GDC of a consultation over an increase in the ARF of 64%, has been like a red rag to a bull, provoking outrage amongst the profession and anxiety to those at the beginning of their career over the costs of professional practice, whilst at the same time facing high levels of debt coupled with the well known difficulties of obtaining a foundation training place. The costs include the spiralling professional indemnity subscriptions and also act as a barrier to those working part-time, either through family commitments or those close to retirement.
The phrase: 'The beatings will continue until morale improves' seems particularly apt in dentistry at the moment. Those working within the NHS have seen pay cuts due to the failure of funding to match the ever increasing costs of providing care. The regulatory burden has seemed to grow almost exponentially in recent years and so to many, the GDC proposals are the last straw that breaks the camel’s back.
Rise in complaints
The reason for the proposed GDC fee rise is due to the large rise in complaints about dentists that require investigation by the GDC. This rise has been apparent for some years, and so it is worth considering whether the GDC might have been able to anticipate this trend and examine why.
It’s not hard to see some of the reasons at least. Local resolution of complaints was the norm for many years. The practice was the first point of contact, and, within the NHS, complaints were firstly dealt with at practice level and only moved to a further stage if resolution was not achieved. That next stage was the PCT (Primary Care Trust), and the aim of the process was to achieve resolution, and onward referral for disciplinary action or to the GDC was only necessary in a small number of cases.
It seems that efforts at local resolution are no longer the norm and the result is that more cases are being taken through the fitness to practise procedure than actually represent a need to protect the public.
Unfortunately, there are other forces at play that place dentists in jeopardy. There is lack of clarity in what the NHS will provide, and the NHS itself is inconsistent in its interpretation of how the charge banding system should be applied. Disagreement with the NHS version can lead to accusations of dishonesty and the threat of a visit to the GDC has tragically placed some dentists under so much stress that they have taken their own lives. It is to be hoped that contract reform will make it easier for dentists to avoid these problems.
In the last 30 years, society seems to be losing trust in professionals. This has been apparent, not just in dentistry, but across all professions. It is important that the GDC regains its objectivity in dealing with our profession. It is vital that questions of fitness to practice issues are those where there is a real risk to public safety or the confidence of the public is seriously undermined. Trivial cases should not begin their life in Wimpole Street.
The vast majority of the profession act professionally and put the interests of their patients first. The profession needs to have confidence in the GDC, which has huge powers over our livelihoods. It’s not just the NHS that needs reform.
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