Dental Protection has in recent years assisted thousands of members who have made requests for assistance with General Dental Council (GDC) investigations. A small but significant subset of that group has sought assistance with applications for Voluntary Removal (VR). We are therefore very well placed to make constructive comments on this important policy.
Background and General Comments
Dental Protection welcomes the fact that this Consultation is taking place with a view to publishing a Guidance document on this important and sensitive subject. It is surprising and disappointing that such important guidance has not been published previously as its absence has left registrants and their advisers unclear about the process that the GDC has adopted up to this point regarding voluntary removal from the register. In the absence of such clarity, there has been a lack of transparency as to the decision making process and criteria adopted, and this in turn has fuelled a sense of there being a lack of fairness and consistency in earlier decisions concerning applications for Voluntary Removal (VR). There have also been concerns surrounding the GDC’s rationale for decisions to refuse VR given that there is often no public interest rationale when dentists are no longer practising anyway.
Fitness to Practise investigations are highly stressful for the registrant and their families regardless of whether or not the ultimate outcome results in a finding of impairment. In April 2015 Dental Protection published the findings of a survey of members (all dentists) who had been investigated by the GDC1. 78% of respondent dentists reported a detrimental effect upon their mental or physical health. 94% reported an impact upon their stress and anxiety. 76% said it had an impact on their personal life and 67% reported an adverse effect on their confidence. A staggering 34% of dentists considered leaving the profession after having been investigated by the GDC.
The above statistics may not all be surprising but they are revealing in terms of the impact that a GDC investigation can have on even the most robust of registrants. The GDC needs to be mindful of the fact that this stress arising from any serious investigation (for example GDC or NHS Fraud) can become unbearable for a small number of affected registrants. Unfortunately in these situations suicide is a very real risk.
Whilst we naturally welcome the recognition (in paragraph 25) that there will be “exceptional circumstances” when VR will be granted in situations where there is “evidence that the process carries a risk of suicide” we strongly urge the GDC to adopt a humane and proportionate view when considering applications for VR. The balance, in our experience, has swung too far towards justifying hearings on the supposed basis of “protecting the public interest” and “maintaining public confidence in the profession” at the expense of the health and wellbeing of registrants. In some instances, and especially where a retired and perhaps unwell former dentist chooses not to attend a hearing, we believe that insisting on a hearing in these circumstances can have quite the opposite effect. For example, in such circumstances the only possible public interest is to maintain public confidence in the profession and yet, in all bar the most serious cases, the absence of the dentist from the hearing hardly achieves this. It is also a significant waste of the Annual Retention Fee paid by registrants, at a time when this has become a highly sensitive issue.
This consultation represents a welcome opportunity for this imbalance to be addressed. The Council is well aware that the purpose of an FTP investigation is to determine whether or not a registrant’s fitness to practise is currently impaired. A hearing must not proceed on the basis that the registrant is to be punished for previous misconduct, and we submit that any consideration of an application for VR must be considered against this background.
When a registrant decides that he/she will never practise dentistry again and applies to the Registrar for VR, we believe that there would need to be “exceptional circumstances” to justify refusal of that request rather than the reverse as the GDC seems to propose.
Dental Protection recognises and understands that the GDC has a statutory duty to protect the public, including through the FTP process, however we question whether the costs to the other registrants and the stress to the registrant concerned can be justified when a registrant has retired and no longer practises.