Uncertainty and terror: a tale of fitness to practise

Eddie ScherEddie Scher reveals the story behind the harrowing first-hand experience of his fitness to practise hearing to Guy Hiscott and asks: how does this protect patients?

In many ways, Eddie Scher is exceptional.

He is a visiting professor at Temple University Philadelphia. He is a past president, founder, and life member of the Association of Dental Implantology. He comes from a long line of successful dentists, counting deans of dental schools in his family heritage.

But in other ways, he is less remarkable. He loves his patients. He thrives on working with colleagues, on providing an exceptional end result, and on practising evidence-based dentistry.

And he is not immune to the gaze of the General Dental Council’s fitness to practise (FtP) processes.

One morning, Eddie received the ‘private and confidential’ letter that every dentist dreads – informing him that the GDC had received a complaint about him, and that FtP proceedings had begun.

‘I was horrified,’ admits Eddie. ‘It felt like the sky was falling on me. It appeared totally out of the blue. I felt frightened. I felt ashamed, even though I knew I had done nothing wrong.’

He would go on to be totally exonerated of the charges, but not before going all the way to a hearing, and enduring two years of uncertainty and terror.

Against the backdrop of the GDC’s very public recent difficulties, his personal story presents a fascinating insight into how these problems impact on the profession it regulates – and the patients it is supposed to protect.

Wheels in motion

For anyone unfamiliar with the vagaries of the FtP process, perhaps the most concerning aspect of his case is how it evolved over time.

The initial complaint came from a patient who claimed to be suffering from acute pain, ostensibly an allergic reaction to the metal used in her temporary restoration.

The metal in question is an alloy specifically recommended for use in patients with a nickel allergy. There have been 125 million uses of it without an allergy complaint; there is even a $5 million insurance policy in place (cited on the manufacturer’s website) that claims to cover any dentist or technician using it against an allergy developing.

The patient started experiencing pain shortly after the website mentioning the insurance policy was discussed with her.

After the patient’s provisional bridgework had been changed to plastic, she stopped attending the practice, and registered her complaint directly with the GDC.

‘The GDC letter arrived while we were still sending her recall letters, which was the only indicator we had that she had a problem with us,’ Eddie recalls.

A second letter arrived soon after the first, though this was nothing to do with the GDC. Instead, it was a letter from the patient, directly demanding compensation – just under £100,000 as a bill for the ‘pain and suffering caused by the allergic response’. Paying this was out of the question, of course – but by that point it was already too late. The wheels were in motion.

The claim was passed to Dental Protection, which dealt with the patient directly, denying liability on Eddie’s behalf.

Twists and turns

Edwin ScherSo how did a complaint about an allergic response to bridgework end in a hearing where it was being argued that implants were placed without consent?

After the complaint was registered, and the initial caseworker decided it warranted further investigation, it was sent to a National Clinical Assessment Service (NCAS) dentist for a clinical review of the complaint and the records submitted by Eddie.

In spite of the very low level concerns identified by the NCAS clinical reviewer, Eddie’s case was referred by the Investigating Committee for a full hearing in front of the Professional Conduct Committee.

The patient was interviewed by the GDC’s solicitors tasked with preparing the case, and the patient gave a witness statement. Following that, a new allegation – of not obtaining valid consent – emerged.

But now the allegations went even further: if consent had been obtained, it was obtained after the patient had been given intravenous sedation. The patient claimed not to remember signing the form, but did claim to have been asked to sign something just after the anaesthetist began administering the sedation.

There was a dark irony in that the patient, who attended Eddie’s implant practice seeking a replacement for her ‘hated’ denture, was now at the centre of a consent case because she had not been offered dentures as a treatment option.

Things had turned from allegations that Eddie and the team at Dental Protection knew were straightforward to deal with, as there was no evidence to support them, to something far more serious than they first anticipated.

It had become a different case, and the stakes had risen terrifyingly high.

‘It’s a severe accusation,’ Eddie acknowledges. ‘Placing implants under sedation without consent; you could, and perhaps should, be struck off for that.

‘And not only that – acquiring her signature in that manner would have been disgusting. It would be a totally despicable way of practising. If I had done it I would completely agree with being struck off; it’s a really awful accusation.

‘When the case changed in that way it completely pulled the rug out from under my feet. Especially when I had a treatment plan, signed…I had everything. I had consent, and she was saying none of it ever happened.’

Yet at the hearing, the charges completely fell apart. A day and a half into the five-day hearing, the case was dismissed with ‘no case to answer’.

The panel accepted that the patient’s evidence in the hearing itself – that consent was in fact dealt with before the sedation – was correct, and contrary to the written evidence submitted during the two-year investigation. That helped cement the unreliability of the prosecution’s case.

In effect, the case was thrown out of court before the defence had to give its argument.

Weathering the storm

Ignore, for a moment, the impact that cases like this have on the dental professional who goes through them.

For many observers, the fact that a case can make it so far through the FtP process only to be summarily dismissed raises equally serious questions about how far the GDC is succeeding in its oft-quoted aim of protecting patients.

Because despite the heartache, the worry, and the sleepless nights, Eddie still worries about what the ordeal was like for his erstwhile patient.

‘I actually feel sorry for her,’ Eddie says. ‘By the time we got to the hearing, everything about nickel allergy had been dropped from the GDC’s allegations. But not for the patient – that was still her issue. She was confused; even when she testified she found it difficult not to bring it up.’

The charges had evolved so far from the patient’s original complaint that it seemed to undermine the whole case, particularly when it came to the hearing.

‘She was caught out under questioning because she didn’t have the facts,’ Eddie explains. ‘And because of that…there’s no other way to put this: she looked confused and frustrated on the stand.

‘That is completely wrong; it was unfair to put her through that. She couldn’t own this complaint on the witness stand because it was not her complaint to begin with. So when questions were asked there were gaping holes in her testimony – she didn’t know what to answer.’

Valuable lessons

GDC reform red_4With such an unequivocal result, the question remains: was the outcome ever in doubt?

Eddie believes the strength of the determination belies the superb work done by his legal team, including the barrister Dental Protection appointed, and the support of his wife Belinda.

Without that backing, the outcome could have been very different, he explains.

‘After a detailed discussion I accepted Dental Protection’s recommendation because I realised that I needed an expert in GDC cases. They were so fair, and they deserve every credit for how they handled the case.

‘But without that choice of barrister, and without Belinda’s help, I wouldn’t have won the case. It’s as simple as that.

‘The panel at the hearing was very fair in its judgement – yes, there were record keeping issues that cropped up. You can never make enough notes! But the panel recognised that the case should never have been brought to them.

‘But would they have the chance to be that fair had the barrister not helped us show the holes in the patient’s testimony? Without all those things then the outcome could have been very different.’

Time to change

Eddie’s journey through the eye of the GDC needle has left him in no uncertainty that the regulator’s processes must change.

He continues: ‘Does my case represent the norm? I couldn’t believe that the charges changed so dramatically over the course of the proceedings. It doesn’t seem possible to me that the patient who kept returning to me for months after I had placed the implants suddenly started claiming that I did so without consent.

‘But Dental Protection weren’t surprised that this happened – they’ve seen it happen before.

‘How does this help the patient? Was my case really in the best interests of someone who feels they have a problem with their treatment?’

Despite everything, Eddie is a staunch advocate of the need for regulation – he still argues vehemently about the importance of the GDC in dentistry.

‘I’m not critical of regulation’, he says. ‘I am critical of the regulator. I am critical of the process, and of how the current regulator has been operating. The hearing itself was fair but it should never have gotten that far. I don’t believe the fact that it did was in the best interests of the patient, or me.’

Hindsight has given him ample opportunity to consider where things can be improved for the benefit of the patient and the profession.

The first item on the list is absolutely clear. Eddie explains: ‘I would like to see a senior member of the dental profession as chair of the GDC. The current chair is a layperson and I believe it should be a dentist.’

Beyond that, the suggestions get more complex but no less pressing: ‘The proposed plans for more comprehensively trained case examiners have to happen. And those individuals must be given the power to recommend arbitration – the GDC has the Dental Complaints Service and their role is to resolve complaints.’

The possibility of arbitration or mediation would also help the GDC to be much more proportionate, he argues – particularly in cases where there are record keeping issues but where the patient has come to no harm. The dental community could do more in its own way too, he believes.

‘We could do better as a profession to support our colleagues going through FtP,’ Eddie adds.

‘Not to provide legal advice, but to simply be there as a friend or mentor. So many dentists are going through similar experiences, and it is devastating. I really believe that more support could make all the difference.

‘I had a lot of support from the places you would expect – Dental Protection, the solicitor and barrister, my staff. But nobody dares tell anyone else about these things, so there’s nothing at ground level, from someone who’s been through it.

‘I only realised how important that was once the hearing was set and my name appeared on the GDC website. The moment that happened I had many calls from colleagues who simply rang to say how sorry they were that I was going through it, and wished me well. It made all the difference.

‘Patients don’t always realise how serious this is for the dentist; I don’t think they know that dentists could be struck off – it’s not just a case of a slap on the wrist. There are repercussions and I don’t think patients realise that.’

Gone but not forgotten

It is now nearly a year on from the hearing, and the sleepless night are gone, but not forgotten.

‘The investigation has left its mark on me,’ Eddie admits.

‘It took two years – two years where my life felt like it was put on hold. Once the case was finished I realised I felt like I had been holding my breath all that time.

‘When you hear of it happening to others, I used to think “there but for the grace of God”…but then it happened to me, and I learned the hard way that grace has nothing to do with it.’

It is evident that the experience has cast a long shadow but typically, for Eddie it is about moving on and trying to improve things rather than dwelling on the past.

‘I actually believe that much of what the GDC does is very good, and most of what the CQC does is very good. The CQC seems to be coming round to the idea that it initially made some mistakes, and that it needed to put those right. The GDC needs to do the same.

‘Instead of taking one in 10 dentists and putting them through a trial because of their record keeping, maybe we should be spending that money on educating dentists to do it better. Surely that’s more constructive than spending so much money on hearings?

‘I worry that there is no trust left in the relationship between dentists and their regulator, and that is not a healthy outcome for us or our patients.

‘Possibly the most annoying and disturbing aspect of this whole saga is that the GDC insisted on informing all interested parties: the three universities I work for, the journal I am editor in chief of, and so on. But did it inform them of the outcome? Of course not – which underlines the lack of respect that the GDC has for the people it regulates.’

With the case firmly behind him, Eddie is looking to the future – and trying to offer support to other dentists going through the same thing. Next month he starts lecturing about his experiences on top of his usual commitments to his practice and teaching across the globe. He is in the process of putting together a year-long series on treatment planning in his journal Implant Dentistry Today for the same reason.

But no matter where his return to normality carries him, it is safe to say that he takes his new favourite phrase with him wherever he goes: ‘No case to answer.’       


  1. 1

    This is very similar to what my husband is going through as I type; the verdict to be heard tomorrow. I am astounded as to the actions & procedures of the GDC against some of Britain’s most dedicated professionals. Reading this has been very helpful. Thankyou for sharing.

    • 2
    • 3

      Good luck for tomorrow, I know neither of you will sleep tonight but know that you have the backing of your colleagues.
      How can it be in the best interest of patients to have good and dedicated dentists who are distressed or prevented from working? I have a friend who has just had his suspension ended who still cannot get back to his patients because it’s now taking ages to sort his indemnity, he’s also had to apply for a VT number even though he’s been practicing for 30 years!
      He had a petition with over 400 signatures from patients begging not to erase him in the first place which can surely attest to his character.

  2. 4

    Hi Eddie
    I have been privileged to be a fellow ADi member with you for more years
    than I care to remember and am so glad your case has been resolved. I have
    a very similar case coming up, I do hope I have the same outcome.
    I share your views at the end of your piece entirely, and I also feel sorry for
    the patient because the GDC does not inform them what they are letting
    themselves in for ie to be cross examined by a barrister whose brief is to
    defend your career.
    So much for informed consent by messrs Moyes et al.

  3. 5

    There is only way to stop this. I advise Eddie and other dentists who had similar problems to get together and build a case against GDC specialy because of:
    -many cases are investigated by nurses. We could question how competent are they to evaluate cases like this.
    -the stress , concern snd depression caused.
    – the 2 years process and the consequences of this.
    -compare with GMC cases. Completly different. They look for the overall treatment. Not if a Doctor wrote on the notes :”verbal consent given to take blood tests”.

    This will only stop once GDC has to pay the first compensation. Please get together and take action against GDC. I am sure plenty of dentists will help u .

    • 6

      I am afraid it won’t stop after GDC has to pay the first compensation. What I think will happen is that GDC would simply raise the ARF yet again to compensate for the compensations they will have to pay if someone successfully challenges them.

  4. 7

    I have had the pleasure of hearing Eddie speak and it is sad that the petty pedants in the GDC are blind to the bigger picture when looking into complaints.
    I would happily contribute to funding some kind of action against the GDC , unfortunately even the government could not get them to refund the increase in our fees whilst acknowledging that it was unfair .

  5. 8
  6. 9

    Congratulation to Eddie for getting through this ordeal with his professional reputation intact.
    I wonder if a lesser known merely mortal GDP accused of similar “misconduct” would have received the same “no case to answer” verdict ! Somehow I doubt it.

    The only way to put a stop to this is “crowd funding” and suing the GDC to force change or accept the risk of being bullied and humiliated for the rest of your carrier.

  7. 10

    There is a difference between regulation and prosecution. Regulation implies impartiality, and legitimate prosectution implies a predetermined judgment based on the facts.

    The GDC/GMC lawyers prosecute the case within the MPTS, which is funded by the regulator, through the registrants. So from the outset there is a conflict of interests and bias in all prosecutions, which could be deemed unsafe.

    A prosectutor does not operate within the same terms of reference as a regulator. In an adversarial system, the prosectution’s objective is to secure a conviction, and if they are working for the Regulator, this implies that the Regulator’s objective is also to secure a conviction. Evidence presented by the prosectution is biased to secure a conviction. This has no place in effective regulation, and it lends the system to be used to underpin the admitted targeting of doctors by NHS Trust Employers in particular.

    Testimony, in a FTP hearing, is based on Statements of Truth, and is not sworn testimony. This means that perjury can never happen in an FTP / MPTS hearing. However, if statements of truth are demonstrated to be untrue e.g. in a Court of Appeal, this could be interpreted as contempt of court, and potentially result in a custodial sentence for the offender.

    One of the really interesting issues at the moment relates to the concept that the Regulators may be subject to a Statutory Duty of Candour. Lord Hunt has suggested as much in his speech about the GDC and PSA report. The importance of this concept lies in a breach of duty of candour, which is a criminal offence. It will be argued that the GDC GMC and other regulators are subject to a duty of candour as they are contracted to provide clinical regulation as a service for patients, and as such they are involved in the clinical care of patients, through their regulation of clinicians. If this argument is accepted, this means that they, and most importantly their agents, (prosecution lawyers) can be subject to criminal investigation of any such breach of duty of candour.
    So where does this place the prosecuting lawyers? Well, it could be argued that knowingly witholding evidence that would oppose the case for conviction, is a criminal offence. This might include altered evidence, missing evidence, fabricated evidence, lost notes, (so common in NHS Trust Cases) attempts to discredit and denigrate doctors and other prosecution “techniques”.

    The consequences of such a scenario would be game changing.

    The Indemnity Societies have long struggled with a “passive defensive approach” in the defence of their members, who have to take all complaints on the chin with no right of redress. This injustice is just one reason why malpractice cases are soaring to the point of unsustainability. Some of this indemnity burden has been reduced in hospital practice by indemnity through the NHS Litigation Authority, but this indemnity does not cover the defence in FTP hearings. Many cases can be settled with the complete ignorance of the clinician in question who has no opportunity to defend him/her self.

    Complaints against practitioners can be made with impunity by any third party. There is no inherent right of redress under the Indemnity Umbrella, which is primarily concerned with defence and not redress/justice for the Member. This has to change if indemnity societies are to survive.

    The time has come to make Professional Regulation accountable under existing laws, to address real issues of patient safety and not to play legal games with the lives of patients and the clinicians who care for them.

    Unsubstantiated complaints should never get as far as an FTP Hearing and would not get as far as an FTP hearing if we had peer group professional regulators. Vexatious complaints for gain , and attempts to pervert the course of justice, should be dealt with in the criminal courts.

    And most important of all those patients who do have a legitimate claim should be treated with courtesy respect and humility by the profession and its regulators.

    Dental Regulation is now a lottery and has appropriately a new interim CEO/Registrar, Ian Brack, who ran the National Lottery in a previous life. With the greatest of respect this is not what the doctor ordered. We need a professional regulatory system that is clinically peer based.

    The time has come to challenge this in court.

  8. 11

    I am shocked by what I read in this article. It is plain to me that certain elements within the GDC are prepared to lie and cheat.
    This was an attempt by the GDC to coach a witness through a legal process with a false testimony in the hope it would damage the career and reputation of our most respected dental colleague.
    This is clear evidence that the hierarchy of the GDC (Moyles&Co) are prepared to use dishonest and malicious tactics in order to destabilise our profession. No one is safe!
    They are no longer protecting the public, as can be seen in this case. In fact, they have demonstrated here that they have no interest in the welfare and rights of the public. They are quite prepared to exploit the public to fulfil their own agenda.
    I must thank Eddie in sharing this story and showing the resolve and dignity in coming through this ordeal. I very much doubt that I could.
    It is time for the profession to unite in the call to reform the GDC so it gets the respect of the profession and the confidence of the public.

  9. 12

    Thank you Eddie in sharing your story. I had a friend she suffered a lot for two years also. I cannot explain now how this has turned. The other day I was so surprise how in the cover of one of the famous magazine the topic was “Are you enjoying dentistry?” relating to the ways to move to another career or another way of living. I do love my career, I do love the way I could treat people and help them. But definitely I really hate how is this turning I hate the way I feel when patient is unhappy just because of the threat of the complaint could you further, and I hate to work in a defensive way just in case complaints, this deviates my attention from the patient itself. We should do something to change it, I am concerned that my career is one of the most stressful careers in the world and with high rate of suicide. I won´t like to see in future how this rates increases because of this. Most of my colleagues are so lonely and so frustrating. I hope it changes

  10. 13


    Emigrate (to another country where sanity still prevails) if you can.
    You will start to enjoy your life and your profession again. You will be respected by your patients.

  11. 14

    No other profession is hounded to this extent. The BDA is both self-serving and impotent and is not fit for purpose. I would not recommend dentistry as a profession to anyone!!

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