The term 'mission creep' is well understood in military parlance; a gradual expansion beyond the set objectives that results in a different mission than was originally planned, and one for which the operatives are not fully prepared. While its overall objective of improving regulation is laudable, I fear that the GDC's recent discussion document 'Shifting the Balance' suggests that in some areas it may be in danger of losing sight of its role, succumbing to what one might describe as 'remit creep'.
I would suggest that evidence of this lies within the Chair's foreword, where there is a reference to the GDC's system that 'often fails to deliver the outcomes that patients want or expect,' and within the introduction, that it 'does not deliver clear enough benefits for patients…'
In my view such statements exemplify and contribute to the difficulty the GDC evidently has in managing the expectations of patients as to its role and what it can deliver. Nowhere in the Dentists Act 1984 is there any suggestion that the GDC's remit includes the delivery of outcomes or benefits. This duty falls to its registrants, with the GDC's role in this context being to ensure that they are 'fit' - that is, competent and capable - to do so. The role of the GDC is to set standards to protect the whole of the public. It does not exist to provide a remedy for individuals.
Elsewhere in the document, it is acknowledged that the GDC receives many complaints that raise issues that cannot and should not be addressed through a fitness to practise (FTP) investigation. Few of us would disagree with this, or with the suggestion throughout 'Shifting the Balance' that all stakeholders have their part to play in reducing the number of complaints finding their way into the GDC FTP process, with all its attendant costs, both human and financial, for individuals and the profession as a whole.
There are a number of immediate practical steps that could be taken to better signpost patients to where best to raise their complaint, which is more likely to be with a dental practice in the first instance, than with the GDC. For example, why does the Dental Complaints Service need a gdc.org web address, a link to the GDC website or its web landing page and email footer to refer to being GDC funded? It is actually funded by the dental profession through registrants' annual GDC retention fees, so why not say so?
The role of the GDC is to set standards to protect the whole of the public. It does not exist to provide a remedy for individuals.
I fully agree with the statement in the Chair's foreword that legislative change is not required for action to improve regulation, and note that the assertion that the GDC is 'getting on with as much as we can already'.
In my view there is no doubt that there is a genuine appetite for reform at the GDC and I have seen first-hand its willingness to consult, listen and make changes. This is particularly so in the Fitness to Practise Directorate, where there are early encouraging signs that improved triage of cases, and the introduction of the case examiner system may herald an outbreak of common sense. Regaining the trust and respect of the profession in this regard must surely remain the GDC's top priority and in my view it would do well to avoid 'off piste' distractions.
Notwithstanding these green shoots of reform, there remains much to improve. You may be assured that, on your behalf, the DDU will continue to be at the forefront of the campaign to force the GDC to put its house in order.
Head of the DDU
John Makin BDS PgDL PgCDE FHEA is head of the DDU. He qualified in Manchester in 1983 and has worked as a general dental practitioner in Lancashire and Devon before joining the DDU as a dento-legal adviser. He was involved with foundation training for many years as both a trainer and VT adviser/training programme director with the Manchester and Exeter DFT schemes.
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