Well done to Dentistry for initiating the GDC reform campaign. It has come too late, but better now than never.
The reason why Dentistry is initiating the campaign is because of the huge potential hike in the GDC’s (General Dental Council's) ARF (annual retention fee), not because of the problems at the GDC that have been there for at least the last three years. Since the departure of Alison Lockyer (former chair), the GDC has been in a real mess with no clear leadership or definition about what it is meant to do. There is no doubt the problems at the GDC is in part due to its organisation structure and its composition of staff. I would like to highlight some of the problems at the GDC based on my experiences with its staff and my observations on dento-legal cases concerning my dental colleagues.
The first problem is the number of complaints the GDC receives. It is due to the large number of complaints that the GDC has welcomed and subsequently processed, that there is a need to raise the ARF by 64%. Many of the complaints that are received eventually end up as Professional Conduct Committee (PCC) hearings, which are very expensive to run. The GDC has to pay solicitor firms and barristers at these hearings and their fees are not cheap. The GDC should stop welcoming all kinds of complaints and deal with complaints concerning dental treatment to patients only. It should deal with wrong dental treatment that has caused damage to patients. Other complaints such as dishonesty, fraud (unless it involves defrauding patients), practice disputes and minor criminal offences (unless the offence is committed on a patient) should all be excluded from the GDC remit because these complaints have no relation to protecting patients. Instead, these other complaints should be dealt with by other public bodies, which are already set up to do so.
The second problem is the GDC is overloaded with staff. There are six committees, of which three of them are futile. The Investigating Committee (IC) merely relays almost all cases it receives to the PCC for hearings. There are numerous IC meetings, which do not produce valuable outcomes or decisions and these meetings come at a cost. The other two committees: Health Committee (HC) and Professional Performance Committee (PPC) are barely used and almost all of the very few cases they receive are again passed to the PCC for hearings. The GDC should streamline its staff and reduce its committees by half by abolishing IC, HC and PPC. If the GDC just dealt with wrong dental treatment to patients, like it is meant to, and it reduced its committee and staff numbers proportionately, then I am sure its expenses would be reduced by at least a third.
The third problem is the fitness to practise panel, which is made of dental professionals and lay people. Obviously the dental professionals are qualified and have an appreciable understanding of the dentistry environment. What about the lay people? What qualifications do they have? What training and understanding do they have of the dentistry environment? If in-house training is provided, it is not enough. What are the criteria in appointing lay people? Are these criteria suitable? The problem with fitness to practise panels is that because their competency is below what is required, their decisions at hearings are inconsistent. This is evidenced when the GDC make contrasting determinations to the same or similar charges at hearings. Each case involving dishonesty, fraud or poor treatment (not wrong treatment) will have varied hearing outcomes, even if the charges in dishonesty, fraud or poor treatment are the same or very similar. I doubt each hearing is heard on its merits.
The fourth problem is the list of solicitor firms and barristers the GDC employs for each complaint it welcomes. Does the GDC vet the solicitors and barristers it contracts with? What are the standards deployed by the GDC in hiring these legal professionals? Just because they are registered with the Law Society and regulated either by the Solicitors Regulation Authority or The Bar Council doesn’t mean they are an automatic shoe-in to represent the GDC before and at hearings. Unfortunately there are many examples of bad practise by these hired legal professionals, who are very quick to produce trumped up charges of dishonesty and fraud against dentists with no direct evidence, only circumstantial. The GDC needs to be more transparent about selecting its legal representatives and minimise bad practise on its behalf.
I have only highlighted some of the problems at the GDC and there is much more. Everyone is calling for GDC reform, but this is not what is required. The GDC must transform because it needs a new direction, by new leadership, with streamlined staff and structure. The GDC must focus only on its core function of protecting patients from wrong treatments that have caused damage. Any change to section 60 of the Dentists Act (1984) will have very little impact on correcting the problems at the GDC.
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