02 September 2014
Members will be aware that in order to provide private treatment to patients, registration with the RQIA is essential.
Should the RQIA become aware that a dentist has appeared before the Professional Conduct Committee of the GDC and the outcome is the dentist’s suspension from the GDC Register, the RQIA will assess whether a dentist can continue to satisfy and adhere to the requirements of various pieces of legislation, which govern the provision of private treatment by dentists.
By way of explanation, under Article 15 (1) of The Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003 (‘the 2003 Order), the RQIA may at any time cancel the registration of a person in respect of an establishment or agency, 'on the ground that the establishment agency is being, or has at any time been, carried on otherwise than in accordance with the relevant requirements.'
The requirements, detailed in the Independent Health Care Regulations (Northern Ireland) 2005 (2005 Regulations), states that:
- Person is not fit to carry on an establishment or agency, otherwise than in partnership with others;
- He satisfies the requirement that he is of integrity and good character; and
- In accordance with Schedule 2, paragraph 7, of the 2005 Order, which requires that the details of the registration of a health care professional are available / provided to the RQIA for the regulation of the profession.
The RQIA may argue that the mere fact of suspension means that a dentist is unable to fulfil the above criteria. The RQIA would also consider whether the matter giving rise to suspension raises issues regarding a dentist’s 'integrity or good character'.
In addition to imposing a period of suspension at the conclusion of the case, the General Dental Council can, in certain circumstances, suspend a dentist on an interim basis during the course of an investigation. An Interim Order of Suspension would not, in itself, call into question a dentist’s integrity and good character as an Interim Order does not involve any findings of fact. The RQIA may, however, take the view that the mere fact of suspension (even on an interim basis) precludes a dentist from meeting the requirements of the 2005 Regulations. Should this scenario arise, advice would be required based on the individual circumstances of each case and we would recommend that you seek advice from one of our dento-legal advisers.
Should the RQIA consider the above criteria are no longer met, they may issue a Notice of Proposal to cancel the registration of the dentist as a registered person. They will notify the dentist by way of letter, which will advise that the RQIA intends to issue the Notice of Proposal to cancel the registration of the registered person. A meeting will be offered so that the dentist’s view/ position may be heard, usually scheduled promptly after this letter.
The RQIA are likely to have two members of the RQIA Board, the Chief Executive and the Director of Regulation present at the meeting. During the course of the meeting, both the RQIA and the dentist, who may be accompanied, will have the opportunity to advance their respective positions.
Following the meeting, a further letter will be sent with the outcome. If the intention remains to continue to cancel registration, the RQIA will give the dentist notice of that, under Article 18 of the Health and Personal Social Services (Quality Improvement and Regulation) (Northern Ireland) Order 2003, and a copy of the Notice of Proposal will be attached to the letter.
Under Article 19 of the 2003 Order, the dentist will have the right to make written representations to the Chief Executive within 28 days of service of the Notice. The RQIA will then consider any written representations / submissions before deciding whether, or not, to implement the proposal and the dentist will be informed of the formal decision. In line with the RQIA’s enforcement policy and procedures, a Notice of Decision, under the 2003 Order, would be issued simultaneously.
Whilst this is not an entirely black and white scenario, if the RQIA do not consider a dentist who is registered with them to be of 'integrity and good character' or that the dentist cannot provide details of their registration with the GDC, it is likely that the outcome will be that the dentist’s registration will be cancelled. Whilst the individual circumstances of each dentist should be considered, on a case to case basis, it is difficult to identify a scenario where the RQIA would perceive that a suspension by the GDC (meaning that no GDC registration details can be provided to the RQIA, irrespective of good character) would mean that their registration with the RQIA could continue.
Despite this seemingly bleak picture, however, it is still worth making both personal and legal arguments to try to manoeuvre around the complicated legislation, which was not designed for dental practices or dentists in the first place! In addition, given that suspension is a temporary sanction only, a dentist should still make representations/ submissions, as in order to become re-registered these may be taken into consideration. If the reason for the suspension could be said not to impact on a dentist’s integrity or good character, for example, potentially, a health issue, the RQIA may refer to these submissions when considering re-registration.
Dentists should contact us in order to establish whether their membership will cover assistance with regard to this process.