GDC Wriggle Over Registrant Mental Health And FtP
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- Published: Wednesday, 07 December 2022 07:51
- Written by Peter Ingle
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The GDC is eager to present itself as a modern and responsive regulator. Lately the council has become a regular commissioner of research. Some, such as its pair of studies into the impact of Covid-19 on the dental profession, might be considered somewhat removed to its core duty of maintaining the registers, and in so doing, protecting the public.
One of the GDC’s most important core activities is the Fitness to Practice (FtP) process. It has drawn a good deal of criticism for its stewardship of FtP for many years, with repeated failures reported by the Professional Standards Authority (PSA), and its predecessors. Recently the GDC has come under sustained pressure from both indemnifiers and registrants over its apparent indifference to the avoidable damage that FtP is causing. This includes adverse effects on mental health, and suicides, of those caught up in it.
Faced with criticism, the GDC has responded by avoiding answering a number of FOIs asking about registrant suicides. It has even gone as far as instructing its own communications and engagement department to refuse to talk to sections of the dental press.
In another ‘soft launch’ it has now sought to bury research that it has commissioned, in a blog post quietly slipped onto its website. Determined readers will need to follow a couple of links to get past the GDC’s Head of FtP, John Cullinane’s upbeat piece headed, “Improving fitness to practise processes in the absence of regulatory reform,” to the actual paper, which runs to over 130 pages. Experiences of GDC fitness to practise participants 2015 – 2021: A realist study November 2022 (gdc-uk.org)
The paper begins with a section “our findings in brief.” Some are reproduced below:
- Overall, we found that the experience had a negative impact on the dental professional’s state of mind.
- Indeed, certain parts of the FtP process may be making things worse: for example, when cases take a long time to resolve and also, when participants were unclear about the progress of their case.
- Members of the dental professions undergoing FtP procedures report needing more support. To enhance the experience, there is a need for better organisation of the process and a more empathic, formative approach.
- Quicker resolutions to less serious complaints will also help.
- To build on our research, the GDC needs to look at how they support particular individuals who may be at greatest risk of mental health problems caused by the FtP process.
- There is also a need to explore how other aspects of the GDC’s work influences the experience.
And at a time when there are serious workforce shortages:
- A non-supportive FtP approach might make things worse not only affecting the confidence of the individual dental professionals (DPs) involved so reducing the dental procedures (i.e. defensive dentistry) they will undertake but also resulting in them leaving the profession.
Findings in the body of the report include:
“Concerningly, in the latter group, in some cases there was a perception of guilty until proven innocent which ran throughout investigations and had subsequent impact on returning to the workforce.”
Particularly damming for an organisation that has been desperately trying to avoid revealing how many registrants have taken their life during or after FtP, is this finding: “A lack of support was identified for dealing with individual cases (for instance not having a consistent case handler) and also a lack of support for the wellbeing of all individuals throughout the processes.”
The ways that FtP damages registrants are illustrated in this section, “registrants feel compromised and develop a sense of otherness - they become part of an out-group. Professional attributes that many once have prided themselves on, such as conscientiousness, patient-centredness, and perhaps even altruism, are called into question. The case presented against them was deemed to impugn their character.”
John Cullinane’s post which will be all that many registrants see of the paper, paints a positive picture with the GDC’s familiar excuse that the shortcomings in its operations are due to outdated legislation, and celebrates the modest changes that the GDC are only now reluctantly making
Commenting on the paper, Stephen Henderson, Head of Dental at indemnifier MDDUS said:
"MDDUS is keenly aware from our own advice and support services how overwhelming fitness to practise investigations can be for dentists and dental care professionals. They often take far too long to resolve and can lead to individuals feeling distressed, disengaged or leaving the profession altogether.”
He added, "This “lived experience” research describes many of the concerns reported to us by our members going through fitness to practise investigations and demonstrates how the need for reform could not be more pressing. We call on the UK Government to act swiftly to ensure the regulatory framework is fit for purpose and fairer for clinicians and patients alike."
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