The GDC and Legislation: Handcuffs Or Convenient Excuse?

The GDC and Legislation: Handcuffs Or Convenient Excuse?

The GDC has a favourite excuse. Whether it is a question of refusing to accept registration fees in instalments, or allowing international dentists that fail its own practical exams to register as therapists, the GDC blames the legislation.

That same legislation is according to the GDC, also responsible for many of its repeated failures to meet the Professional Standards Authorities standards in its Fitness to Practice (FTP) operation.

The Government had first consulted on reforms to healthcare professional regulation in 2017, and again in 2021, setting out proposals for a new consistent and modernised framework. Meanwhile more and more of the dental regulators apparent failings appeared to be due to out of date legislation rather than the fault of the GDC.

When pressed on many issues, the GDC response took the form of accepting that the situation was not ideal, saying they were eager to improve matters, but that their hands were tied by the existing regulations. The beauty of this formulation was that it absolved the GDC of responsibility. It was not always true. For many years the GDCs reason for not having an instalment plan to pay the Annual Retention Fee (ARF) was that the legislation prevented introducing such a plan. And then the GDC did introduce such a plan. There had been no legislative change, though there had been a change of GDC Chair, which may be the actual reason for the Councils unexplained about turn.

The Government has now set out its timetable for reforms to the legislation underpinning UK health regulation, but there is a catch. In a recent news item the GDC said that, “We welcome this important milestone but are extremely disappointed by the timetable.” It claimed that they will not see full reform of their legislation, “for years to come.” The GDC went on to say that, “In the absence of proposals for wider reforms, we will be focused on changes to the international registration process and making performance improvements in fitness to practise”

Repeating the GDCs familiar line, Stefan Czerniawski, GDC Executive Director, Strategy, said, “The current legislative framework is a real barrier to efficient, effective and proportionate regulation and the need for reform is urgent.”

This was initially echoed in a statement from Dental Protection (DPL). The defence organisations

Deputy Director, Yvonne Shaw, said: “Dental Protection has long argued for reform to the legislative framework that underpin the GDC. Vital changes to the 1984 Dentists Act, are seriously overdue. The Act remains outdated, requiring the regulator to conduct some of its operations in ways that are not always in the best interests of patients or professionals.”

The delays were “frustrating and disappointing” and DPL called on the Government to commit to a specific timetable for improving dental regulation. The government had prioritised Physician Associates and Anaesthesia Associates for reform along with the regulators for doctors and nurses and midwives, but did not specify a time for the GDC. As a result, reform was unlikely before the next general election.

However there is a good deal that the GDC could do while waiting. For example, Dental Protection maintains that the GDC does not need to wait for legislative reform to improve its tone of communications, IOC sanctions, decision making and decision timelines in Fitness to Practise processes.

Responding to GDPUK, Yvonne Shaw, said: “The structure and tone of communications, in particular formal letters, can have an impact on registrants’ mental wellbeing. We would suggest a review of the GDC’s current style, considering best practice across regulators. Across society, the direction is moving away from language that may be perceived as intimidating. Communications from a regulator about an investigation into fitness to practise are going to be one of the most stressful events in a professional career that will inevitably provoke overwhelming emotions but this can be greatly reduced by communications that use a more sympathetic tone and language.”

There was more the GDC could do, “The GDC should also continue efforts to ensure that cases that do not require a sanction can be closed down sooner, and that interim sanctions are only put in place when it is proportionate to do so. Delays in an investigation can impact a dental professional’s career in many different ways and the uncertainty also affects their wellbeing as they are under constant stress whilst waiting for an outcome or the date of a complaint being reviewed or hearing.”

“In our experience in dealing with the regulator, there are delays – of several months at the very least – in both the initial investigation stage and where the case examiners adjourn the case and direct the registrar to make further enquiries. Such adjournments are frequently being required due to insufficient investigations at the outset before referral to case examiners. Likewise, Rule 9 reviews where an assessment decision is reopened – often due to inadequate investigations at the early stage of a case – add further to the delays. In terms of cases referred to an initial interim order hearing, 39% of these in 2021 concluded with no interim sanction which suggests that many cases should not have been referred in the first place.”

Concerns about FTP are not new, and those about the GDCs lack of regard for how it affects registrant’s mental health are still brushed aside. For all its eagerness to see the Dentists Act updated, the GDC could improve matters now, within current legislation. It just needs the will.


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