The DDU has some urgent items for the health secretary's in-tray, says John Makin.

In her own words, the priorities of the new health secretary for England are "ABCD - ambulances, backlogs, care, doctors and dentists". I'm pleased that dentistry was on that list and I sincerely hope that a change of leadership will provide the fresh impetus that the service urgently needs.

In the last issue, I expressed concern that dental practices were getting flak for a morale-sapping situation that is not of their making. The DDU continues to assist members with complaints about access and commissioning delays, and as I write there were yet more headlines about patients resorting to DIY dentistry because they were unable to access an appointment. Most NHS patients understand the constraints that dentists are working under, but there will always be those who let their frustration and anxiety spill over into aggression.

If highly-skilled and hardworking dental professionals feel they are not properly supported, there is a risk that many more will walk away from the NHS or leave practice altogether. Of course, members want to see urgent action on funding and a thorough overhaul of dental commissioning but I'd also highlight these areas where urgent progress is desirable and achievable.

Fitness to practise reform

The government has shelved plans to reform the GDC and other healthcare professional regulators until 2024/25, which means more dental professionals will be snarled up in protracted fitness to practise investigations.

According to the GDC's own 2021 annual report, the median time for initial FTP hearings to start was 337 days (11 months and two days) from referral by case examiners, compared with 296 days (nine months and 22 days) in 2020.

The DDU has an excellent track record in defending members at the GDC: of the in-house legal GDC cases that went to a practice committee in 2021, 50% were concluded with no finding of impairment. Unfortunately, we also have cases in which senior dentists have been interim suspended for over a year or had interim conditions imposed while little progress has been made in their case. It is likely that many more dental professionals are in a similar position.

This summer, the GDC has been carrying out a public consultation on its corporate strategy for 2023-25. This sets out its four strategic aims to protect the public, including that "concerns are addressed effectively and proportionately to protect the public" and "dental professional regulation is efficient and effective and adapts to the changing external environment." These are laudable aims but they cannot be achieved without government legislation.

Further delay has a human cost and doesn't make sense when we need to attract and retain as many dental professionals as possible.

Further delay has a human cost and doesn't make sense when we need to attract and retain as many dental professionals as possible.

A fair clinical negligence system

The government is already considering the introduction of fixed legal costs for lower value clinical negligence claims, following a consultation earlier this year. This cannot come too soon. In our experience, the legal costs in many dental negligence claims are excessive and disproportionate.

Although we closed more than 63% of dental claims in 2021 without paying damages, where claims do have to be settled, the legal costs frequently exceed the level of compensation. For lower value dental claims settled up to £10,000, the average legal costs were £13,000. For claims settled for between £10,000 and £25,000, the average was more than £22,500.

We're pleased that legal costs are on the government's agenda, although we believe that to make a real difference, fixed costs should apply to claims of up to £250,000 rather than £25,000.

But this is only one problem with an outdated clinical negligence system that is failing at huge cost to the public purse. According to NHS Resolution's Annual report for 2021/22, an eye-watering £128.6 billion has now been ringfenced to cover the total cost of clinical negligence claims against the NHS in England, compared with £17.5bn in 2011.

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Together with our parent organisation, the MDU, the DDU wants to see the government commit to more ambitious legal reform that would address rampant claims inflation. This should include changes to how compensation awards are calculated, caps on the level of damages awarded for future care, and more proportionate damages for loss of earnings.

The goal must be a clinical negligence system that ensures patients are properly compensated for negligent harm, but which is fair and affordable for the country.

Addressing these neglected areas would go a long way to addressing financial pressures on the health service, as well as showing support for dedicated dental professionals who have been largely left to pick up the pieces following the pandemic.

The DDU has a strong record of campaigning for dento-legal change and you can be sure that we will continue to speak out on your behalf, whoever is in charge.

This page was correct at publication on 28/09/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.