The GDC - Clarity of purpose?
A "Daily Clarion" call for Clarity
What ever happened to January being a dead month when we hunker down to pay all our Christmas credit card bills? The CQC close a Salisbury practice facility [albeit for a month only]. [1] The GDC’s CEO has written a feisty fob off letter to the BDA [2], revelling in the end of year report she produced .[3]
But the real January action comes from two directions.
What? Which? Again?
The Consumer organisation, Which? Have published a report on the lack of clarity of dental fees. The link [4] below will allow you to read this. Indeed follow the page and you will find many leading colleagues at Oasis and BUPA all shouting loudly in favour of clarity of fees [5]. Indeed across the profession, and for sure on GDPUK, there is agreement that charging a fair fee is not the problem, it’s about letting the patient know in advance and giving the patient a proper chance to consider the fee and their decision.
“Clean Up Dental Costs” is the clarion cry from Which?. They already have quite active assistance with understanding dental costs at [6] and [7].
A Mixed Game
Of course the problem seems in part to lie in that murky area of practice, where some treatment is NHS funded and some is not. Mixed practice, in which the sliding scale of gaming can be applied.
“If the patient pushes, I can do it under the Nash, but if they don’t object I will whack in a proper fee because they don’t REALLY need it …”
Which? state in their campaign “Mission Statement that
We're calling on NHS England and regulators to make sure all dentists comply with existing rules and make information on prices clearly available. Dentists need to explain the treatment options properly and make sure patients know whether or not their treatment is available on the NHS.
Here is my challenge:
How can dentists be expected to explain how much or what treatment is available under the NHS consistently across the country when NHS Choices states that “all treatment that is deemed necessary“ is wholly available and yet it is the soon to be ex-Chief Dental Officer himself who has repeated that this decision of need is down to the individual dentist, in front of his or her patient.
Which? demand consistency, while the CDO [He of NHS England] espouses inconsistency.
Patently this cannot go on. Perversely, the Chairman of the GDC, being an OFT man ‘n’all that might be just the ally the profession needs.
As if by magic, albeit with ironic timing, the Department of Health’s long awaited Prototype Contract Document has emerged [8]
Nothing changes – the dentist decides “need”
Crucially, the suggestion is that nothing changes so far as the clarity that Which? and many others want.
The DH State
26. It is particularly important to be clear that nothing in the changes planned is intended to reduce or change the scope of NHS care available to patients. The changes are intended to ensure clinicians are supported to deliver the full range of care appropriate to a patient’s need. As with medical care, the NHS role is to meet clinical needs.
27. There is also no intention to end a patient’s ability to choose, if they wish, to have private treatment alongside their NHS care. As now patients will continue to be able to choose to have NHS care, private care or a mix of the two.
So contrary to what the Which? want, the DH propose to roll out yet another way of delivering dental care in which the opportunity for mixed practice will remain, but the rules are decided by the treating dentist with his individual patient.
So, not one consistent rule for all to work to but 22,000 odd individual rules and utter confusion for the patient. And more fodder for angry consumer organisations and patients “who know their rights”,
Is this really the best the DH can come up with?
The GDC are clear in their expectation – and this is COMPULSORY FOR ALL through their Standards for the Dental Team, [9],
PLEASE LOOK AT THAT WORD “PREFER”
1.7.4 If you work in a mixed practice, you must not pressurise patients into having private treatment if it is available to them under the NHS (or equivalent health service) and they would prefer to have it under the NHS (or equivalent health service).
2.3.7 Whenever you provide a treatment plan you must include: • the proposed treatment; • a realistic indication of the cost; • whether the treatment is being provided under the NHS (or equivalent health service) or privately (if mixed, the treatment plan should clearly indicate which elements are being provided under which arrangement).
Clear as Mud?
So the leading UK Consumer organisation are calling for the boundaries and costs of NHS and private dental care to be clear. Dentists and their LDC representatives are calling for the same thing. The GDC has made it compulsory for there to be clarity, and breach of this clarity demand will result in you visiting London for an FtP day out.
But the DH produce a Prototype Contract that suggest maintaining the present confusion.
Aside from it all beggaring belief, it is also now time for our Regulator to earn their spurs and take on the DH.
Calling Mr Moyes, calling Mr Moyes
It is time for the GDC to lay down to the DH in one hopes clear terms that lack of clarity for dentists and patients as to what is on offer under the NHS simply is not acceptable. It is no use asking the GDPC to achieve this for the DH simply bounce them.
This needs a man of words, in a position of influence, perhaps ideally with Consumer based experience, to deliver a Clarion Call for Clarity on what the NHS expect dentists to do, not for the dentists, but for the patients, whose very protection the GDC under your Chairmanship is charged with.
Come on down, Mr Moyes – time to play Dental Regulation for real.
Your time has come.
LINKS – THE NEWS
1 http://www.salisburyjournal.co.uk/news/11739251.NHS_suspends_dental_practice_following_inspection/
2 https://www.gdpuk.com/news/latest-news/1812-gdc-remains-defiant-over-jr
3 http://www.gdc-uk.org/Aboutus/Documents/FTP%20Improvements-Dec2014-MA-FINAL.pdf
LINKS – WHICH? CAMPAIGN
4 http://www.which.co.uk/campaigns/dental-treatment-costs/
LINKS – DH DOCUMENTS RE PROTOTYPES
8 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/395384/Reform_Document.pdf
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