HAMMER--NUT GDC and the dental profession

Happy 2020 to Dr Moyes and colleagues.

I hesitated before putting finger to keyboard on this topic, it’s too easy, and a real barn door isn’t it? In fact I wrote, rewrote, and finally binned, one piece and started again.

Here are some New Year wishes for the General Dental Council. They make demands and enforce what they say are patients’ expectations of the Dental profession; surely this should not be a one-way street?

Empathy. If there is one quality that is essential in any successful relationship it is empathy or “The ability to understand and share the feelings of another”. I have looked back through the last decade of the GDC and seen little evidence that they have made any concerted effort to either understand or share the feelings of the tens of thousands of people on their register. Lip service from the occasional survey perhaps, worded in such a way to avoid exploring the real fears of day-to-day clinical practice.

Context. All practices are different, all patients are different. There cannot be one rule for all. Yet it seems we are reaching a point where any treatment that is less than “ideal” is unacceptable and therefore negligent. I was able to convert my practice away from a reliance on the NHS in the early 90s. When I reached my personal ceiling and sold it I then did locums in different sorts of places and had my eyes opened. In some places the practice of dentistry is like working in a war zone with a shifting population, all with different wants, needs, expectations and budgets.

In the same way with the massive shift towards corporate and chain practices there can be pressures on, but little support for, younger dentists. When shareholder value, rather than patient care, becomes part of a company’s ethos the clinician is often caught in the middle between bean counters and patient expectations. It can take years to build an appropriate trusting relationship with a patient yet pressure to “produce” can put unrealistic and unfair expectations on clinicians.

Engagement. When was the last time any of the staff actually listened and responded face to face with a group of dentists and their teams about what the future has planned for them? The current (Corporate) Strategy is so full of “corporate speak” that any message is hidden behind paragraphs like this one, “Key to fulfilling our statutory responsibilities is ensuring that our resources are allocated to reflect our priorities and that opportunities to improve the efficiency and effectiveness of our operations are taken promptly. Much has been achieved in this respect, but there is more to do and we are actively pursuing further opportunities.”

Humility. Dr Moyes could learn a lesson or two from the Chief Dental Officers who put themselves in the (metaphorical) firing line at conferences and speak… and appear to listen. They have learned from the mistakes of predecessors, the GDC shows no such humility. This aspect is damning.

Leadership. The morale of many dentists, especially young dentists, in the UK is at an all time low, there is clearly a disconnect between what their expectations are and what the reality is that they encounter. The only body that has control over both education and daily dentistry wherever it is practiced is the GDC.

Brexit and more. It is clear from the cases that come before the GDC that many overseas graduates are not prepared for practice in the UK. The responsibility for that falls on the shoulders of the GDC. Or are they under such pressure to keep the dental lights on and the dental queues at bay that things could are fudged?

Blame game. Reports of meetings from official and unofficial sources say that the usual excuse for any lack of action is “it would take government intervention” which translates into “we don’t have the will”.

It is clear that large, unrealistic contracts, [like the famous cross infection control case in Nottingham] have been awarded, the profession has known that, why hasn’t the GDC taken steps to ensure things are running well and the mistakes remedied? Or would that be the clip-boarding, tick-boxers of the CQC’s responsibility?

Finally. I challenge you to grasp one simple nettle, just the one, only one. Allow registrants to pay their registration fees monthly by direct debit. It is one element that typifies the lack of listening, the lack of will to take action and the inability to appear to be anything other than a Dickensian schoolmaster who knows only wrong in others.

Happy New Year to you and to all who pay the fees that you collect, spend and keep in reserve. I wish you all the very best for 2020.