Goldilocks, the Three Bears, and Dental Regulation

Goldilocks, the Three Bears, and Dental Regulation

This is not a fairy tale. It is a story of two dentists, two similar charges, two dental regulators, and two very different outcomes. The regulators happen to be separated by the Irish Sea.

The first case involves the GDC and the review of a dentist already suspended for 18 months. Redactions on the GDC’s hearing page do not refer to the nature of the dentist’s failings. However at the most recent review of their suspension the hearing report quotes the GDC’s counsel: “Ms Higgs submitted that there remains an ongoing risk of harm to the public and the public interest, notwithstanding the developments referred to in private as summarised above.” Counsel for the dentist submitted that: “the passage of time since the concerns are said to have taken place, with the concerns having weakened since they were referred, should be seen to lower any perceived risks to the public.”

The committee was tasked with deciding whether the suspension should continue or that conditions, allowing the dentist to work under supervision, might be more appropriate. Whilst the determination states that: “The Committee is mindful of the developments in the case as referred to above,” the final outcome was that the suspension would continue for another 12 months.

A report in a local paper sheds some light on the issues that bought the dentist to the GDC’s attention, as well as the recent developments referred to. It transpires that the dentist had faced criminal prosecution over an alleged sexual assault.

At first sight, exactly the kind of case where all would agree that the GDC’s protection of the public must take precedence. Except the case had been dropped when a Crown Court Judge had ordered a not guilty verdict.

This verdict had been given some four months before the hearing at which the dentist’s suspension was confirmed for another 12 months.

Meanwhile in Ireland, the Irish Independent reported that a dentist convicted of sexual assault would be allowed to treat patients. 

David O’Flynn, registrar of the Irish Dental Council, which is responsible for regulating dentists in the Republic, said outdated legislation overseeing dentists, introduced in the 1980s, left patients at risk. He described a series of cases where they were unable to act due to a lack of updated legal powers. The council had received notifications from other international regulators concerning around 40 registered dentists who have had sanctions applied in other countries. “The Dental Council was unable to act as these dentists were already on the Irish register when sanctioned,” he said.

According to Mr O’Flynn, “Dentistry is an outlier in this regard, both in terms of the regulated healthcare professions in Ireland and in dentistry internationally.”

The registrar’s main point was that the Council needed new powers­ since the Dentists Act, 1985 generally only allows the Dental Council to act in retrospect. While a new act will take time, the Council has proposed a series of amendments to the current legislation around inspection and a competence scheme which could be introduced on an interim basis.

The Irish and UK councils have something in common, in that they say that they are hamstrung by outdated legislation. However their approaches to regulation and the balance between public protection and the fair treatment of registrants could not be more different.

Returning to the three bears, the late Christopher Booker described the concept of a three way choice, where "the first is wrong in one way, the second in another or opposite way, and only the third, in the middle, is just right. This idea that the way forward lies in finding an exact middle path between opposites is of extraordinary importance in storytelling.” While so often sadly lacking, it is also important in professional regulation.

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