CQC –What lessons can we learn?
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| Not since the transitional days of the new contract have I known such anger amongst the colleagues that I meet in various capacities. |  |
There is not a meeting I attend where voices do not get raised when the topic of the CQC reaches its point on the agenda. The sheer frustration with conflicting advice and the worry that come the 1st April , your practice may not be able to operate, causes anxiety in the best informed of individuals.
This frustration is compounded by the inability to slow down, never mind halt the rolling out of the process, and the time scales dictated by the CQC on the journey towards registration.
The Law is the Law, be it good or bad, once made it has to be complied with. One could question if living in a society means obeying the “laws of the land” or do we owe it to our fellow citizens to obey or defy laws that are unjust or wrongheaded? The over turning of the Community Charge legislation with the Poll Tax riots some 20 years ago and more recently the Hunting Act of 2004 and the opposition show what effect civil disobedience may have. Can one really expect professionals to behave in such a manner, despite their anger?
The option offered to the BDA by a recent open letter from an editor of a dental magazine, was for the BDA to stop assisting members to comply with requests from an organisation it says is incapable of operating without such help. This advice is clearly inappropriate; the CQC is struggling having had manpower cuts and a time frame unrealistic to their tasks. But, it would hardly be appreciated by many BDA members who wish to comply with the law, if their professional organisation did not help them in such matters.
John Milne as Chair of GDPC was given a clear message by the LDC Conference when their motion stated “this Conference calls for the new Government to save money and support patient care by withdrawing the requirements for dental practices to register with the Care Quality Commission before the beginning of the registration process in October.”
John used his opportunity of delivering that message to Lord Howe when he met him shortly after the election but just two days before the White Paper “Liberating the NHS” was released. This reinforced and enhanced the strength of the CQC, and hence John received no opportunity of convincing the new Minister, who was unable to exempt dentistry from the CQC process.
When BDA advisors had members alerting them to conflicting advice from the CQC helpdesk, to that on the BDA website, it prompted Susie Sanderson and John Milne to write to Cynthia Bower seeking an urgent meeting. The advice line for the CQC is manned by staff using an algorithm, leading them to give apparently appropriate advice, but this is not reliable when terms such as provider can be interpreted so differently between caller and advisor. It would seem that despite the BDA asking for a delay in implementation, legislation was again utilised by the CQC to enforce their quest for the 1st April deadline.
Such protests though have caused alarm. When bad publicity is to be avoided at all costs; one article in the Yorkshire Post about an impending Battle Bus at Leeds Post Office, and the BDA complaints suddenly leads to the number of post offices able to carry out verification of documents for CRB checks to be trebled. Never under estimate the power of GDPUK. At a recent presentation by the CQC, one mention of a supposed petition on the website got the CQC official into a cold sweat.
Since the Health and Social Care Bill was introduced in 2008 the powers of the CQC have been widened from those over only the large providers of healthcare, with additional regulations that came into force from April 2010 allowing inclusion of dental practices. It appeared to have some logic in regulating providers of service, with the GDC regulating individuals, but many of the outcomes listed as CQC requirements clearly overlap and duplicate those of the GDC.
The Consultation on CQC registration fees will no doubt be a whitewash exercise. The CQC must know by now what operating budget they will need for dentistry, and it’s only the number of registrants that fee is to be collected from, which will lead to the calculation of fees levied on each individual. The enhancing of the role of the CQC may allow this fee to grow exponentially, and who will challenge that?
Clearly when legislation occurs, it is imperative for the profession via the GDPC to challenge laws that run contrary to what we as professionals feel appropriate for dental practice and our patients. This is rarely easy when consultations by Government often run to telephone directory size of papers for scrutiny, and these follow in quick succession one upon another.
It is exactly this reason why everything currently out for consultation with the NHS White Paper on “Liberating the NHS” must be fine tooth-combed by the GDPC and BDA Secretariat to try to prevent such future legislation causing such angst as we currently have with the CQC.
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