The GDC has recently hit the dental profession with a bit of a double blow. Not only have they increased the ARF by 64 per cent, but on July 5, 2014 they published an advert in The Telegraph that has caused something of a furor amongst the profession.
The ARF increase has created such consternation because the perception is that the rise is completely against our interests as professionals; the GDC charging us more so they can continue to sanction and persecute us. I’m not wholly convinced I take such a defensive line. Sure, I resent the idea of the fee increase; that money would be much better off remaining in my pocket thank you very much, but part of the issue arises because of a general lack of understanding surrounding the GDC.
The role of our regulator is the protection of our patients. Some cynical and pessimistic professionals have been quoted as saying, “They’ve honestly made me feel like chucking the towel in. Even our professional body is against us”. Now I can certainly sympathise with this poor dentist, but they have forgotten that the GDC exists to be antagonistic to the profession, standing up for our patients’ rights, not ours.
My criticism of the GDC comes from its downstream approach to the current problem. There seems to be little or no benefit to sinking more money into the fitness to practise process whilst simultaneously ignoring the issue of why there is such an increase in complaints in the first place. In my view, it is a product of the society that we live in, more and more we are becoming more rights focused and any real or perceived infringement upon these gives us cause for complaint, regardless of the harm suffered. For example, take the scenario where a patient isn’t given smoking cessation advice and then decides to complain about this. Sure, they should have been given the advice, but if we stop and ask ourselves about the harm caused by
not doing this or the likelihood of there having been a change in behaviour on the patient’s behalf had this been done, we see there isn’t really a case to answer, yet a patient may still feel their right to be informed on such a matter has been violated. If we take the test for a breach of duty in civil law, the Bolam test, there would be a reasonable body
of professional opinion that agrees with my opinion. Where I worry with the GDC is that it will decide to re-interpret
the law and lower this legal standard. I will explore this further with reference to their recent advert advertising the
Dental Complaints Service.
One of the main issues with the advert has to be the choice of language. The use of the word completely in the title line, “Not Completely Happy with Your Private Dental Care?” This is poorly chosen and in my view shows that the GDC holds itself as superior to the Bolam test standard mentioned earlier. The Bolam test was defined by McNair J, stating that: “A doctor is not guilty of negligence if he acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art. Putting it another way round, a doctor is not negligent if he is acting in accordance with such a practice merely because there is a body of opinion that takes a contrary view.” Therefore, the reasonable standard we are legally held to is that of our peers. We do not have to be perfect and patients need to be aware that we cannot be expected to deliver perfection each and every time we carry out a procedure. The GDC seems to be setting itself up to demand more than the reasonable standard for the profession and looks in the advert to be fostering unrealistic expectations in our patients.
I actually quite like the GDC’s Dental Complaints Service. Unlike the GDC, it exists as an independent mediator between patients and dentists so that issues can be resolved. I actually had a conversation with a manager there recently who told me that she and the other members of staff had been surprised at how well dentists had responded to the service and how well dentists and patients worked together to resolve problems with very little
involvement of the service. This has to be seen as a triumph and one questions why the GDC cannot take the success of the Dental Complaints Service and expand it into other areas. I have no issue with the GDC advertising the Dental Complaints Service because it is helpful to us and, more importantly, to our patients; it works to help them seek a remedy to whatever complaint they have. I hope that the result of the advert will be that more people
recognise the existence of the service and use it to gain redress rather than going to see lawyers or end up going through the GDC’s fitness to practise process. Where the advert may fail is that many patients are unlikely to distinguish between the GDC and the Dental Complaints Service. At the end of the day it comes to this; the GDC is out there to give patients protection from us should they need it. The fitness to practise process actually does little to offer patients redress, all it does is sanction the dentist involved. I accept that occasionally this needs to happen, but surely the majority of the GDC’s work should be acting as a mediator rather than as judge, jury and executioner.