Part 3 – All smoke and no fire
If you haven't read the previous blogs in the series it may be helpful to do so to help set the scene. They are here, here, here and here. Read the case here
Following my receipt of the letter from the General Dental Council in October 2013, the full impact of the process began to hit. I of course had to contact my defence union The Medical and Dental Defence Union of Scotland who were excellent. I spoke to my Dental Advisor and the suggestion at that stage was to ‘keep your powder dry’ as the case will go to Investigation Committee Hearing.
With hindsight and perhaps from discussion with others, it may be wise to go in hard at that stage in an attempt to rebut any claims but in truth, the case is not assessed by anyone clinical at that stage, only by the Civil Servants and the staff of the Registrar.
The information is collated, the patient’s complaint is documented, the case notes are collected, other case notes are collected and any other relevant material. You can submit comments at that stage if you like but it is unlikely to stop the process in its tracks because no one clinical is looking at it.
An expert report was then commissioned in my case, which was carried out by someone who is not on the Specialist Register in relation to detailed Oral Surgery procedures (I was a little surprised at that). Some correspondence is passed back and forwards in relation to the expert’s report and in request of radiographs, which the GDC already had - which I was able to point out. Huge periods of silence ensue and you hate the arrival of the Postman everyday.
After initial discussions with my union and the submission of my case notes, which happened towards the end of October 2013, I received no other formal communication from the General Dental Council (apart from requesting notes) until October 2014. A few days short of one year later, I received a letter informing me that my case had been passed to the Investigation Committee for a hearing in late 2014 and a list of charges related to the case. This bundle also contained a copy of the experts report for comment.
The only other actions to be undertaken in that year were to inform my Local Commissioners that I was under investigation and I was to be red flagged for further tendering processes and generally black balled as a result of the process. I will discuss this a little bit later on in the blogs – guilty until proven innocent - but there is a definite weighting against people who are under investigation despite the fact that the General Dental Council has a statutory obligation to investigate every single claim regardless of whether that claim will be proven or not.
The difficulty at this stage for a Practitioner is to decide whether or not to discuss the fact that they are under investigation by the General Dental Council. I felt this particularly sharply as my referral practice is based on reputation and I was concerned that people would judge me based on the investigation. There is no question that that is true in some quarters, there tends to be two sorts of response when you do (as I did) come clean on the fact that this is going on. To do this is very difficult because you realise that some people will judge you but in the main people were extremely supportive and hugely helpful through the whole process. I will not name the people throughout this blog but I have thanked them all personally for their involvement.
The difficulty is when you decide to tell a person and they go quiet and you realise that they’re casting judgment. You realise that their view is that there is ‘no smoke without fire’ when in fact; in these cases the opposite is often the case, there is no fire but lots of smoke.
The weight of the process and everything that happens makes some people believe that the General Dental Council would not go to the trouble of investigating something unless there was a serious concern. In fact the General Dental Council has a legal obligation to investigate each case and due to the fact at the present time that no clinical assessment is carried out at the early stages, it is almost inevitable that anything other than the most banal of cases are accelerated to an Investigation Committee Hearing. The difficulty from the practitioner’s perspective is that the outcome of the Investigation Committee Hearing is as follows:
1. Case dismissed
2. Case dismissed with advice
3. Private written warning regarding Registrant’s conduct
4. Public written warning regarding Registrant’s conduct published on the General Dental Council’s website
5. Fitness to Practice Hearing (approximately ten days, based in London – the full monty)
This causes huge anxiety for clinicians because it seems that you are one step away from a Fitness to Practice Hearing. It is also a concern that it feels as though a judgement can be made and a punishment handed out in your absence as you will have no presence at the Investigation Committee Hearing, which is carried out in private. It is also not clear whether any appeal regarding the outcome of the Investigation Committee Hearing exists and in fact, there is nothing in the GDC’s correspondence that suggests that appeal to the findings of the Investigation Committee Hearing are possible. I could be mistaken on this but throughout my process, I have never seen that there is any sort of appeal to stop the process at that stage.
It seems to me to be quite draconian that I myself could have received a full public warning published on the GDC website following the judgement of an Investigation Committee Hearing at which I was not allowed to be present. I sincerely hope that this system can be revisited and looked at to be made a fairer process. I am led to believe that the General Medical Council’s process involves two separate Investigation Committee Hearings before Fitness to Practice Hearings are invoked. It seems very important that everybody in the profession understands how the process works and if they have any concerns related to this that we get together as a profession as a whole to express our concerns appropriately.
I reached a point where I was happy to discuss the case (anonymously of course) when I lectured and spoke to different groups of dentists. This was very cathartic for me, but also I think for many of the dentists I spoke to, many of whom came up to me afterwards to discuss their own experiences with the General Dental Council or emailed me afterwards.
There were one or two occasions where people suggested there was a lot of fuss about the General Dental Council for nothing until I actually explained the process I was going through and that seemed to bring some clarity to people who were otherwise in doubt.
This process is horrible and devastating for clinicians who care about their work and their patients and it is devastating to read the comments that patients will write throughout the process.
It is essential that we all use the opportunity to get our views across to Government. Please submit your responses to the Health Select Committee Accountability Hearing by 19th February here.
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