ARF increase
regulation The changing face of
GDC lay council member Alan MacDonald explains the reasons behind the proposed increase to the ARF
A
s I’m sure you’re aware, the GDC is currently consulting on a 64 per cent increase (£945) of its Annual Reten- tion Fee (ARF) for dentists
and a 6.7 per cent increase for dental care professionals (£128). As a lay Council Member – I am a quali-
fied solicitor living in Lanarkshire – I want to take this opportunity to put some of the issues being faced by the GDC into context, and perhaps dispel some myths at the same time. When I was re–appointed to Council
last year – joining the first lay Chair William Moyes – I was already aware that regulation is changing. We are not here to ‘represent the profession’; we are here to protect patients and the balance of regulating the profession and protecting patients has considerable challenges. On the whole, patients say they’re
satisfied with their dental treatment. But complaints are going up. Not just for the GDC, but for all healthcare regulators and we must better understand why this is. We need to hear from patients and the profes- sion. Finding out about complaints is part of our work programme going forward. The ARF was last increased in 2010.
Since then, Fitness to Practise complaints (FtP) to the GDC have increased by 110 per cent. Without further significant invest- ment in our FtP processes we’ll be unable to deal effectively with the very large and continuing increase in our caseload. This is the most expensive part of our work. If a case reaches a hearing, the cost is about £19,500 per day and the length of a hearing ranges from a third of a day to 35 days. We are investing substantial sums
to tackle these problems in FtP, many of which were highlighted in
24 Scottish Dental magazine
the recent Professional Standards Authority report. There is no doubt that the report was critical of the GDC. Failure to meet the PSA’s standards is entirely unacceptable and all our efforts are focused on tackling the problems. This has already
involved recruiting more staff and more FtP panellists to clear a backlog of cases and to process new cases faster; more robust management of staff performance; and improvements to our IT and related systems. But there is also an urgent need for
legislative change. All of us were disap- pointed at the lack of a Bill in the Queen’s Speech. But we are now working with the Department of Health on a S60 Order to introduce a very significant change to our FtP processes. This change – the introduc- tion of case examiners – will not only allow us to improve the way we handle cases but will also save us up to £2m a year. Without a S60 order we are unable to make changes to the legislation that sets out what we can and cannot do. Our decision to propose the ARF
increase stems, virtually entirely, from the huge increase in complaints now being brought to the GDC and the subsequent cost to FtP. Patients have a right to complain, and the
GDC has an obligation – where appropriate – to investigate. I know many of you have been surprised
to learn of the costs involved in FtP. Going forward we will continue to be as trans-
parent as possible about these. We know there is a need for efficiency savings and we are keeping all our costs under review and will make savings wherever we can. We are already making
considerable savings in legal costs by building up an expert in–house legal team. We plan to bring more legal work in–house to reduce
our costs further.
The patient’s voice It is a key role of all healthcare regula- tors to ensure the patient’s voice is heard. Indeed, it is at the heart of the recom- mendations by Robert Francis QC, in his report published in 2013 in the wake of the Mid–Staffordshire scandal. It’s of great importance that bodies like the Dental Complaints Service (DCS) are known to patients. The types of complaints about private
dental care being dealt with by the DCS are not dealt with by any other organisa- tion – other than bringing issues to the GDC – it is the ONLY body in existence to deal with private dental complaints in this way. Rather than increasing the GDC’s workload, it is dealing – very effectively – with complaints that might otherwise end up at the door of the GDC’s much more costly FTP department.
The prevention agenda We’ve heard just how good local resolution can be from both dental professionals and patients and we actively encourage it. We are working with stakeholders in Scotland and across the rest of the UK with a view
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