I found it interesting that when looking at the General Medical Council website, I noticed its annual retention fee is between £185-£315 per year. Why then, as dentists, are we being asked to pay more than three times that of our medical colleagues? One would imagine that you could do much more wrong to a patient as their doctor then as the humble family dentist. Have dentists become the easy targets of the complaining and litigious world?
I fully accept that patients have the right to make a complaint about their dental treatment to the GDC (General Dental Council), in the same way as the dentist has the right to present their defence. It is no shame on the profession that we have made our practice complaints protocols more freely available to patients. Gone are the days when the complaints policy was stuck somewhere between the Yellow pages and an old newspaper! Perhaps the looming inspections of the CQC (Care Quality Commission) have made us display them more proudly.
The role of the GDC should surely be to deal with a complaint in a manner that is fair to both the dentist and the patient in a timely fashion. Unfortunately, with the increase in the sheer number of complaints, the GDC has clearly struggled to cope with its enhanced workload. I see the scenario of the GDC in the same terms of an NHS dentist, being asked to do more and more for the same financial remuneration. Except, in the case of the dentist, the Department of Health will not pay any more despite the requests. We as dentists have to work within our budgets, so why should the GDC be any different? I believe to ask for a 64% increase is unreasonable, the GDC claims that it needs the money to meet its financial needs. Yet as practice owners we are expected to be satisfied with the less than inflation 1% increase we received.
Recently there has been calls for the GDC to be disbanded, personally I don't agree with this. There needs to be some form of regulation and discipline available. The recent case of a dentist being struck off for treating a patient in a branch of McDonald's is clearly evidence of this. The GDC has, however, somewhat lost its way. Spending a small fortune on a newspaper advert to encourage complaints, when there is an opportunity to promote this on social media for free, clearly shows a lack of business sense. Even the GDC's own regulator, the Professional Standards Authority for Health and Social Care, has highlighted numerous failings in the fitness to practise program. I know a dentist where it took the GDC over two and a half years, following a complaint being made, to find that the case should be closed without any action being taken against the dentist. Followed by the GDC sending a questionnaire asking for feedback on how well it did! Clearly it is neither in the interest of the dentist nor of the patient for these cases to be taking so long.
I firmly believe the following reforms would help lead the GDC into a brighter future:
- More clinical dentists working alongside the case workers from the start, to help filter out complaints that are clearly unfounded. This would speed up the initial process
- Patients needing to have first made a complaint to the practice providing the treatment, prior to making a complaint to the GDC. This is case with other bodies such as the Parliamentary Health Service Ombudsman. This would give the practice the ability to deal with the complaint first and perhaps satisfy the patient
- Greater fines for those who carry out illegal dentistry, the proceeds of which can be used by the GDC to cover its running costs
- It should be made clearer to patients that making a complaint to the GDC won’t lead to the patient getting any form of financial compensation
- Reduction in the legal and professional fees paid for fitness to sit hearings. Recent figures showed a cost of £20,000 per day (with the average hearing being four days)
- An annual practising fee, rather than a retention fee, which is structured to reflect the individual status of the dentist. In the same way as our indemnity providers charge different amounts depending on the number of years post qualification.
The discussion that the ARF consultation has sparked has been very positive. Many opinions and thoughts have been expressed that could lead to lasting change. My only hope is that the GDC consultation is not just paying lip service to an already forgone conclusion, and they will act on the feedback received from the consultation process.
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