CONTENTS


IN THIS ISSUE A FEW years ago some dental nurses set up a Facebook group called ‘I’m a dental nurse and I hate patients because…’ It was described as a forum for members “who are sick of patients and their bad attitudes, their stupid comments, their bad personal hygiene and the way they assume it’s OK to burp in your face.” Some 497 people joined. Not surprisingly the GDC didn’t find it quite so funny and


threatened disciplinary action against any UK-registered dental nurse in the group for failing to ‘treat patients with respect and dignity’ and ‘maintain patient confidentiality’. The informality of social networking sites like Facebook and Twitter can easily tempt healthcare professionals to dash off comments more appropriate to a chat over drinks. But beware – the internet has a tenacious memory and reach as we discover on page 14.


In this issue of Summonswe also continue to offer a range 12 16


of voices and opinions in the ongoing debate over the Health and Social Care bill. Dr James Kingsland has long been a champion of GP commissioning and on page 10 he discusses his role as National Clinical Commissioning Network Lead and the need for renewed momentum in NHS reform. On page 18, associate editor Joanne Curran looks at the


ongoing challenge of improving dental health among children and especially those in low income families. In an interview for the article Professor Jimmy Steele says: “Dentists can only do so much; parents and schools both have a role, as does wider society.” And on page 18 Professor Alistair Burns highlights the


shameful fact that antipsychotic drugs are still routinely used to manage symptoms in people with dementia despite being inappropriate and potentially dangerous in the majority. Jim Killgore, editor


CARE NOT CONTROL Antipsychotic drugs are still


routinely used to manage dementia patients but Professor Alistair Burns hopes to help change this


Urquhart look at the pitfalls of doctors and dentists using social media


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Cover image: Permanent Bloom by Stuart Cargill. 1993. Medium: oil on canvas. Born in Scotland, 1972, Cargill graduated form Duncan of Jordanstone College of Art, Dundee in 1993. Cargill was commissioned by


the French Institute (Georges Perec Season) in 1992. Cargill won the John Milne Purvis Prize in 1993 and has exhibited throughout Scotland. ‘Permanent Bloom’ is one of a series of paintings inspired by literature ranging from Chekhov to Perec and aspiring towards a Matisse like quality. Art in Healthcare (formerly Paintings in Hospitals


Scotland)works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit www.artinhealthcare.org.uk, Scottish Charity No: SC 036222.


SUMMER 2011


Tackling the problem of poor dental health in children


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Editor:


Jim Killgore Associate editor: Joanne Curran


Editorial departments: MEDICAL Dr Gail Gilmartin DENTAL Mr Aubrey Craig LEGAL Simon Dinnick RISK Peter Johnson


CLINICAL RISK REDUCTION Informed consent – the


difficulties of communicating risk to patients


AT THE ROOT OF THE PROBLEM


TWEET AND BE DAMNED Paul Motion and Lindsay


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REGULARS 4 Notice Board 6 News Digest 8 Employment law: Switching roles? 9 Ethics: Does familiarity breed consent? 10 Q&A: Dr James Kingsland 20 Case studies: Right to decide, Private or NHS care, Folic acid only 22 Addenda: A tragic waste, dental instrument case, Crossword and Vignette: Sir Thomas Lewis


Please address correspondence to:


SummonsEditor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


jkillgore@mddus.com


Design and production: CMYK Design 0131 556 2220 www.cmyk-design.co.uk


Printing and distribution: L&S Litho


Summonsis published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208


Email: General: info@mddus.com • Membership services: membership@mddus.com • Marketing: marketing@mddus.com • Website: www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Memorandum and Articles of Association. The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily reflect the opinions or policies of The Medical and Dental Defence Union of Scotland.


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