Dentists lead call for action on regulatory fiefdoms

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The British Dental Association (BDA) has called on government to act on new calls from the Professional Standards Authority (PSA) for radical action on out-of-date, over-complicated and expensive healthcare regulation. The PSA’s report, Rethinking Regulation, is published today.

The troubled regulator, the General Dental Council, recently came bottom of the league in an assessment of the performance of nine healthcare regulators, published in June by the PSA. It has faced defeat in High Court judicial review proceedings and a recent House of Commons Health Committee hearing into its conduct.

The BDA has strongly supported the PSA’s calls for regulators to focus on fundamentals, and to rebuild trust with healthcare professionals.

Mick Armstrong, Chair of the British Dental Association, said:

“There are over a million regulated healthcare practitioners in Britain, serving tens of millions of patients. Political intransigence is letting antiquated laws remain standard practice. And it’s come at a cost, in time and money, and patients and practitioners deserve better.

“Bosses at the major healthcare regulators are in receipt of a salaries larger than the Prime Minister’s. The people running these fiefdoms are enjoying power without responsibility, and it’s about time they put patients first.

“We need to see a clear focus on the fundamentals. That means protecting patients, building firm foundations, not succumbing to inexorable mission creep.

“Too many regulators have lost the confidence of their professions. Effective independent regulation requires trust, and rebuilding that will mean genuine engagement, not just lip service.”

The General Dental Council: Failure in the spotlight

  • The General Dental Council (GDC) is the statutory body responsible for regulating dental professionals in the UK. A June report by the PSA highlighted that the GDC failed to meet a total of seven of its standards of good regulation. On fitness to practise, the GDC fully met only one of the 10 standards, and failed to meet six others, representing what the PSA describes as a significant decline in its performance compared to an assessment it carried out in 2013/14.
  • The GDC has been criticised, by the PSA and by the profession, for not progressing FTP cases more swiftly, resulting in a large backlog and some cases taking in excess of 18 months to go to a hearing.
  • The GDC have suggested the cost of an average FTP case reaching hearings in 2013 was £78,000. FOI requests have shown this is based on the 160 cases that reached its Practise committee, at a total cost of £12.4 million.
  • GDC Chair Bill Moyes took up office two years ago and has repeatedly stated his intention to substantially broaden the remit of the regulator well beyond the statutorily defined boundaries.
  • The GDC has lost the trust and confidence of the profession. A survey of 6,000 BDA members took place in July 2014. It indicated that 79 per cent of members are not confident that the GDC is regulating dentists effectively, and that 66 per cent of those who had experience of the GDC’s Fitness to Practise function rated the function fairly poor or very poor.
  • The GDC was defeated in a Judicial Review hearing at the High Court in December 2015, over a deeply flawed consultation to increase the fees in levies on the dental profession.

Political inertia

  • The Prime Minister, in his response to the Francis inquiry report into Mid Staffordshire Foundation Trust, promised action to "sweep away our outdated and inflexible framework" facing healthcare regulators.
  • In the command paper Enabling Excellence, published in 2011, the government acknowledged that the current legislative frameworks for all of the health and social care regulators are "expensive, complex and require continuous government intervention to keep them up to date”.
  • The Law Commissions of the four UK nations were tasked with compiling a Draft Bill on Health and Social Care Regulation, with the expectation of sweeping reform across all healthcare regulators. Published in May 2014, it has not yet featured in a Queen’s Speech.