You thought 2020 was bad? Well, 2021 wasn’t THAT far behind.
January set the tone for the year with the Minister for Health Jo Churchill failing to reassure the profession that the (at that time, it MIGHT have been revised since) controversial 45% contract target on NHS dental practices would be overturned, regardless of overwhelming support from MPs.
Despite Putney Labour MP Fleur Anderson warning the Government that they it was “Sleepwalking into the biggest oral health crisis since the creation of the NHS,” the Government walked, snoring obnoxiously loudly, into the biggest oral health crisis since the creation of the NHS.
January also saw the beginning of the search for a suitable candidate to replace the General Dental Council’s controversial Chair, Dr William Moyes, who had resisted calls for his resignation since 2016. We were all on tenterhooks - would the GDC choose a registrant this time round, or not?
In February, hopes were raised when GDPUK reported that the draft White Paper outlining Health and Social Care reforms would make the abolition of the General Dental Council much easier to carry out.
Dental Protection bolstered the notion of the GDC going the way of the Dodo when a spokesperson said “In recent years the Government has consulted on reducing the nine health professional regulators down to three or four, a move which many expected would lead to the abolition of the GDC in its current form and dental professionals being regulated alongside many other health professions by the same body.”
The GDC was still in existence at the time of going to print.
BUT, invaluable research published by the General Dental Council in February suggested that the NHS dental service could suffer ‘system-wide overstretching’ as NHS dentists switch to providing private services.
In a post analysing the key findings of the GDC’s research into the effects of COVID-19 on dental care, the regulator said its findings indicate “A possible shift by NHS providers to private provision, driven by the need to meet growing costs and to better mitigate the impacts of fallow time in relation to incomes and business costs.”
How right they were. Great insight - though a quick look on Twitter every morning would have been a lot cheaper and a lesser drain on the GDC’s plentiful stash of ARF money.
In March, it was reported that NHS England was telling NHS trusts to have ‘one-to-one’ conversations with all health service staff refusing to have the COVID-19 vaccine. At the time it had been uncovered there was some resistance to the vaccine amongst dental professionals. Earlier in the year, England Chief Dental Officer Dr Sara Hurley said “As frontline health professionals, it is important that when you are called to be vaccinated, you attend.”
We all know now that the advice was heeded by everyone and that UK dentistry is at one with COVID safety.
Also in early March, NHS dental associates who hadn’t been paid fully during the pandemic were being encouraged to give voice to their pay concerns.
NHS Business Services Authority (BSA) had launched a new pay concerns year-end form on behalf of NHS England and NHS Improvement. Apparently, some scallywags hadn’t been passing on due pay to their associates. And we wonder why there’s an associate shortage?
Meanwhile, it was better late than never, when he General Dental Council finally announced a quarterly Direct Debit scheme for payment of the Annual Retention Fee.
The GDC completely ignored desperate calls for such a scheme in 2020, when dental professionals were in dire need. Announcing the payment by instalment scheme, the GDC said it was “Designed to support dental professionals who pay their own fee by enabling them to spread the cost over the year with quarterly Direct Debits.” The GDC is all heart. It must have realised then, that it hadn’t got any unnecessary High Court costs to pay out this year.
We spoke too soon. Early April saw the GDC admitting to Dental Protection that it acted ‘unlawfully in undertaking an under-guise operation without reasonable justification.’ As a result of Dental Protection’s successful defence of their member, the GDC had to pay an undisclosed sum of damages to a clinical dental technician. GDPUK reported that between 2017 and 2019, the GDC spent £17,208 on investigators, totalling £59,258.85 between 2013 and 2019.
Still, at least we were reassured that the GDC would see the error of its ways and wouldn’t be seen up before the beak again for a very long time, if ever.
April saw the appointment of former Chief Dental Officer for England Dr Barry Cockroft appointed as the interim Chair of the British Fluoridation Society (BFS). It’s sort of taken as read that Dr Cockroft recommends fluoride with the same relish he enthused about the new GDS contract when it was introduced.
In 2008, the British Dental Journal quoted Dr Cockroft as saying “There’s no shortage of dentists wanting NHS contracts and new services are opening all the time.” The BDJ reported “He believed access in 2008 was ’relatively stable.’” Currently, it’s believed that dentists are wanting NHS contracts with the same alacrity as an anti-fluoridationist asking Santa for a bumper box of Duraphat Varnish for Christmas.
Oooh Oooh Oooh, we forget, also in April, the GDC later confessed to GDPUK that the cost to the regulator of doing the illegals with private investigators, was about £38,000 - of YOUR ARF money, UNLESS they keep a slush fund for the dodgy ‘black-ops’ stuff.
May began with unnerving news when it was revealed that dental practice principals could in future be considered to be liable for the dental negligence of their associates, after the BDA News website revealed that in “A shocking court case,” a former practice owner in Wales was found to be liable for damages and costs - more than two decades after his retirement.
The BDA News website said that Dr John Croad “Had to defend this case out his own pocket and faces further potential costs estimated in the region of £100k to compensate the patient.” The court case sent shivers down the spines of many practice owners, and the implications of the judgement are still to be unravelled.
Later in May, the Dental Defence Union brought a smile to the faces of GDP’s when a case brought by a claimant who was represented by the lovely Dental Law Partnership, was successfully defended by the dental indemnity organisation.
An allegation that the defendant, an experience dentist, didn’t perform an adequate root canal treatment and provided an ill-fitting crown, was thrown out by a judge at the County Court, Manchester.
The Dental Law Partnership’s client was seeking £18,000 in compensation and legal costs. The Dental Defence Union said it defended its member because “With the dentist’s reputation on the line, the case was about much more than financial consequences.” Hopefully, the DLP will have learned their lesson well and they will maybe diversify in the future into, I dunno…how about whiplash?
Ooopsy! We spoke too soon about the GDC not getting into trouble with legal stuff. The end of May saw the regulator instructed by the Information Commissioner to disclose a copy of an email sent by GDC Chair, Dr William Moyes (for it is he) to colleagues on 27th April 2020.
Failure to comply with the instruction would have meant the possibility of facing contempt of court charges in the High Court. The email concerned the decision by the GDC to top-up furlough payments to its staff, when it had both denied registrants the option of paying their ARF by instalments AND ruled out a reduction in the ARF during the first year of the pandemic. We’re absolutely convinced that the GDC will do the right thing and reveal the contents of the email in the interests of ‘transparency’ (one of the GDC’s very favourite words). Anyway, the GDC has plumped for an appeal against the decision - more ARF money up-against-the-wall?
In June, Health Minister Jo Churchill drew wide criticism from dental professionals after making an ill-informed statement on the role of dentists in detecting oral cancer.
The Minister said “Whist dentists can play an ad hoc role in detecting oral cancers as a by-product of dental check-ups, oral cancer is primarily detected through the medical system.” That’s all you need to know about health ministers and their thorough understanding of referral letters and the way diagnoses are made.
June also saw the elimination of UDAs forever, in Wales. You could hear the TMJ crepitus of envious English dentist jaw-dropping, drifting over Offa’s Dyke.
The first month of summer also saw the Care Quality Commission taking the bull by the horns and act on the controversial direct-to-consumer orthodontic business. Presumably after being frustrated by the GDC sitting on the fence (presumably a gold-plated one paid through the ARF) the CQC said “We consider orthodontic treatments provided to patients following an intra oral scan or when a patient has taken impressions themselves to be regulated activity. This is in the same way that treatment planning and diagnosis associated with aligners is also regulated activity.” We suspect the GDC was reluctant to take any meaningful action, mainly because it had run out of suitably grubby private detectives to use.
More importantly in June, Ronaldo moved a bottle of Coke and did more for caries prevention than a century’s worth of professional dental dietary advice.
July saw the announcement of a 3% increase in pay to NHS dentistry…er…whoopy do?
More ‘good’ news in July was that the General Dental Council announced the appointment of its new Chair of Council - a Baron, no less. Lord Toby Harris isn’t a registrant, but he does have an impressive career-long involvement in health issues, though Lord Harris’s most admirable characteristic is that he’s not Dr William Moyes.
July also saw the sad passing of Dame Margaret Seward. Dame Margaret was the first female England Chief Dental Officer, editor of the British Dental Journal and the first female president of the General Dental Council. BDA Chair Dr Eddie Crouch said “Words cannot express the depth and breadth of Margaret Seward’s contribution to this profession.” He said she was “A dentist who inspired every colleague she met.”
The issue of vicarious liability reared its ugly head again when it was revealed that Dental Protection’s Dental Director Dr Raj Rattan was to fight a case in the High Court “As a matter of principle given the potential repercussions for the dental profession,” after the Court decided that as a practice owner, he was liable for treatment carried out by associate dentists at his former practice. As you would naturally suspect, the claimant, against Dr Rattan was represented by the Dental Law Partnership. Dental Protection said the claim was pursued against Dr Rattan under vicarious liability and non-delegable duty of care, despite the fact that the treating dentists have been identified and are willing to respond to the claim. DLP and their client refused to engage with them and instead pursued Dr Rattan as practice owner.” We can only wish Dr Rattan and Dental Protection well.
August saw Chair of the BDA’s General Dental Practice Committee, Dr Shawn Charlwood warn that unless real change was seen in the NHS Dental Service, “NHS dentistry will exist in name only.” Dr Charlwood was speaking after Yorkshire Live reported that thirteen of the Healthwatch organisations reported that they knew of no dentists taking on NHS patients and were experiencing “Similar problems to York.” If we didn’t know better, it’s almost like the Government sleepwalked into an NHS dental crisis. Who’d have thought it.
August also saw the NHS dental access crisis hit Manchester. That’s it, really. The crisis was everywhere. If only the Government could come up with a plan to increase NHS dental access…
In the unlikely event you hadn’t noticed it yourself, the BDA revealed in August that England dentists working in the General Dental Service had “Seen taxable income fall by nearly 40% in real terms over the last decade.” If only the Government could come up with a plan to improve the working and pay conditions of NHS dentists, at the same time removing the spectre of clawback. Perhaps by December, they’ll have a strategy…
The late summer also saw mounting evidence of a growing dental workforce crisis when the GDC’s registration report show a significant drop in dental nurse numbers and the decimation in the numbers of dental technicians. The registration report showed that over 6% of dental nurses (3826) dropped off the dental register between July and August, reinforcing the feelings of many, that dental nurses were becoming difficult to recruit as a result of difficulties faced by the profession as result of the difficulties caused by the pandemic.
September saw the introduction of a fiendish new way of confusing and demoralising NHS dental professionals - SMOMED CT. Nobody knew what it did, (or even if it would work by all accounts). Paranormal investigators continue to investigate the SNOMED phenomenon.
The first autumn month saw the release of results from a study that found male dental students overestimate their performance more significantly than females. Er yeah? Every dental nurse since the dawn of time has had that flagged up on their internal radar.
September also saw the…well…BOMBSHELL news that the GDC had deleted documents related to its private investigator tendering process after an internal review into its response to a Freedom of Information request. GDP Dr Dominic O’Hooley had been exploring the GDC’s approach to securing the services of private investigators used in ‘under-guise’ operations. Just imagine if YOU had deleted patient records after two years. Face-palm and shock emoji’s galore.
The month also saw Manchester GDP and lecturer Dr Wendy Thompson hit the world headlines when she formally launched the FDI World Dental Federation’s pledge on tackling Antibiotic Resistance in dentistry at the first day of the World Dental Congress.
September also revealed a new report which showed more dental professionals blew the whistle on their dental colleagues than medical registrants did on their colleagues The ‘Whistleblowing Disclosures Report 2021 showed that in twelve months the GDC received twice as many whistleblowing disclosures than the General Medical Council. Proud of yourself, snitch?
October saw the GDC saying it couldn’t review cases heard by a former Chair of its Professional Conduct Committee who was suspended after making offensive and racially motivated comments. The GDC said it couldn’t respond to calls for the regulator to review cases that the former PCC chair Mr Rashpal Mondair had been involved in.
The NHS dental access crisis seemed to accelerate massively during October, resulting in British Dental Association Chair Dr Eddie Crouch address a rally held by dental pressure group Toothless In Suffolk. Dr Crouch told the crowd “I want to stand with you in this common cause, because we really shouldn’t have to be here.” He said “This is a wealthy 21st century country. Yet we’ve seen DIY dentistry that belongs in the Victorian era, with people waiting years for treatments, patients travelling hundreds of miles for care.”
Later in the month, dental contract reform hit a massive roadblock when the British Dental Association confirmed that a letter had been sent to prototype NHS practices to say that prototype regulations would not be extended beyond April 2022 “And that all practices will return to underlying GDS or PDS contractual arrangements from that date.” The return to ‘normality’ for the prototypes saw the end to any possibility of a new NHS GDS contract by April 2022. Still, Boris will come up with something. P’raps that’s what they were discussing at his Downing Street alfresco garden work session plastered over the papers a few weeks ago.
The new College of Dentistry officially launched in October. CGDent President Dr Abhi Pal said “Our college reflects and recognises the importance of this full workforce by welcoming as members and fellows, all dental professionals, dentists, nurses, hygienists therapists and technicians, so that together we can work to fulfil the mission of the college.”
Also in October, GDPUK headlined “New Dentistry Minister: ‘Committed To Driving Forward Long-Term Improvements’ – But No Money To Fund Ventilation In England.” See? We told you that the Cabinet reshuffle would make no difference.
In November, the GDC the reversed its previous “Never mind the quality, feel the width” attitude to Continuing Professional Development, by saying its new proposals for changes in CPD requirement would have a focus on ‘quality.’ The GDC said it would differ from “The current system which is focused primarily on quantity.”
The month also saw BDA Chair Dr Eddie Crouch take to the red sofa on BBC’s Breakfast programme to outline the problems facing the dental service. Appearing with Dan Walker and Sally Nugent. Dr Crouch said “The funding for NHS dentistry is one area of the NHS where it’s actually lower than it was a decade ago.” He added “Not a single penny from the Spending Review is coming to dentistry.” Dr Crouch emphasised the state of NHS dentistry when he said “I’ve worked in dentistry for 37 years. I’ve never seen my colleagues so demoralised .”
The biggest news of November came when Health Secretary Sajid Javid announced frontline NHS staff would be expected to be vaccinated against COVID-19 by April 2022. At least the announcement was uncontroversial and universally accepted.
Not so much ‘news,’ but more a ‘truth, universally acknowledged,’ a survey commissioned by the GDC found the words most associated with the regulator by registrants, were ‘unrepresentative’ and ‘aggressive.’ It seemed to be a heartfelt blow to the GDC, which said on its website that the results didn’t make ‘comfortable reading.’ Stakeholder and registrant perceptions were also more negative than positive. Who would have thought it?
Just for your historical interest, a new variant of the SARS-Cov-2 virus, Omicron, was identified in December. At the time daresay the Government with won’t consider it would make much difference to dentistry.
Early in December the GDC declared that its Fitness to Practise team was
“Too lean and lacked the necessary experience to maintain performance” towards the end of 2020. Still, I suppose true to form, the regulator will muddle through.
But what’s this? After everything we said about learning their lesson and not going back to see the wigged ones, the GDC was back in the High Court as joint respondents after the Professional Standards Authority appealed a decision made by the GDC’s Professional Conduct Committee. Judge Justice Lane imposed erasure on dentist Dr Mohammed Amir, after the PCC imposed suspension after he prescribed dental treatment for an incurable hereditary degenerative condition. Dr Jonathan Rohrer said that there was no known association between the patient’s condition and dysfunction of the temporomandibular joint.
After battling for years on the behalf of dentists, particularly through the pandemic, the BDA found itself at the end of vituperative criticism in mid-December after…basically stating fact. The had warned that fast-tracked parliamentary approval of mandatory vaccination of healthcare workers was set to have a calamitous impact on dental services already stretched to breaking point, with new evidence suggesting levels of hesitancy could push thousands out of the workforce - and so it could. BDA chair Dr Eddie Crouch emphasised the BDA’s position. He said on Twitter that the “BDA position is to encourage all of the dental team to get vaccinated.” He said the BDA was “Highlighting the potential effect” of mandating vaccines.
And late news just in…NHS England has introduced insane targets in the midst of the Omicron surge. The idea was apparently to increase access. See! We knew they would come up with a plan AND ignore the effects of Omicron.