The General Dental Council (GDC) has been heavily criticised in recent years about the way in which it deals with fitness to practise cases. Details of its failings have been set out in the last three audits carried out by the Council for Healthcare Regulatory Excellence (CHRE), which has responsibility for overseeing the work of certain healthcare regulators, such as the GDC. In response to the well publicised concerns about the GDC, the CHRE is currently carrying out a further investigation in to whether the GDC is failing to satisfy its statutory functions; at the request of the Department of Health.
The Investigating Committee
One of the areas of concern, identified in the CHRE's most recent audit published in September 2011, is the consideration of complaints by the GDC's Investigating Committee (IC). The IC is a statutory committee. This means that its existence, role and powers are enshrined in legislation. Its purpose is to consider complaints made to the GDC, and which are considered by the GDC's registrar to constitute an allegation. The IC's role is to decide whether the allegation ought to be referred on to one of the GDC's three Practice Committees (the Health Committee; the Professional Conduct Committee and the Professional Performance Committee). The IC does not decide whether the allegations are true. Instead, it must consider whether there is a realistic prospect of a Practice Committee deciding that the allegations are true and that, as a result, the fitness to practise of the practitioner is impaired.
The IC meets in private to consider allegations; neither the complainant nor the practitioner, attends the meeting. The IC generally comprises five members, including dentists and lay members, and usually has access to representations from both the GDC and the person being investigated. The ICs powers include:
- taking no further action
- adjourning the meeting and ask the GDC to carry out further investigations
- closing the matter, but giving a letter of advice
- closing the matter, but giving the person complained of a warning
- referring the matter for consideration by one of the Practice Committees
If the IC decides that the allegations should be referred to one of the Practice Committees for a full hearing, it can also refer the case for consideration of whether an interim order (such as suspension) is necessary pending the final outcome of the case.
Criticisms of the Investigating Committee
In June 2011 the CHRE carried out an audit of 100 cases which the GDC had closed during the early stages of its fitness to practise process, since the beginning of 2011. These were cases which had been disposed of without being referred to one of the Practice Committees for further consideration.
The CHRE reported its findings in September 2011, and concluded that its audit had revealed several problems in the GDC's fitness to practise procedures. For example:
- weaknesses in failing to explain sufficiently the reasons for closure of cases after consideration by the IC, particularly in circumstances where the IC had found evidence to support the allegations.
- situations where the IC had decided to issue a letter of warning, but had failed to explain to the complainant whether that warning letter would be published on the GDC's website.
- occasions where there had been "extensive unexplained delay" in cases being referred to the IC. Examples given by the CHRE included:
- A case which took five months to be considered by the IC after it had been referred by the Registrar
- A case which took several months to be referred to the IC because the GDC's staff failed to chase the complainant for permission to access their medical records.
The GDC has also recently been criticised by a Scottish Court in the case of Stuart Lutton v The General Dental Council . Dr Lutton had received a warning from the IC following a complaint by a patient regarding the treatment he had provided. Dr Lutton successfully applied to the Court for a Judicial Review of the IC's decision, on the grounds that the reasons which had been given for the decision to issue a warning, together with the steps the dentist was expected to take as a result of the warning, were not sufficiently detailed.
Recent steps taken by the GDC to improve
The CHRE's 2011 report explains that In order to tackle the backlog of cases, the GDC has increased the number of IC meetings which are held. Other steps it has taken to improve its processes include increasing staff numbers and appointing legally qualified Committee Secretaries to assist the IC.
In November 2011 the GDC also introduced a new guidance manual for the IC. This sets out in detail the duties of the IC and includes specific guidance about providing reasons for decision (referring to the Lutton case, see above).
It remains to be seen whether the steps which the GDC has taken will resolve the problems with its fitness to practise procedures, particularly relating to the function of the IC. As a consequence of the CHRE report, the IC may refer a greater number of cases to a full fitness to practise hearing. The range of powers which the IC has to deal with fitness to practise allegations, and the ability of Practice Committees to terminate a dentist's registration highlight how important it is that if dentists are the subject of a complaint to the GDC, they obtain specialist legal advice at an early stage.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.