GDC chiefs grilled by health committee
The chairman and chief executive of the General Dental Council (GDC) were forced to defend their positions at the helm of the troubled regulator during last week’s Accountability Hearing in front of the Health Select Committee.
Dr William Moyes and Evlynne Gilvarry were put through their paces by the group of MPs in the first hearing of its kind with the GDC.
After the opening exchanges, Andrew George, Lib Dem MP for St Ives, pulled no punches when he said: “It seems, from the evidence we have been given that the BDA’s General Dental Practice Committee, the BDA’s UK Council, the BDA’s English Council, the Conference of Local Dental Committees, the Scottish Dental Practice Committee and a whole host of others, including regional committees, have expressed no confidence in the GDC. Has anyone any confidence in you?”
Dr Moyes responded by saying that patients have confidence in the GDC along with DCPs and the dental schools, which the regulator inspects. He continued: “It is not true to say that the loss of confidence is absolutely universal. As Evlynne said, last year was an odd year. It is not often that a body like ours asks for such a big increase in fees, but after four years of zero increase and the reserves being eaten up it is not surprising that we needed it. But I would not take 2014 as a typical year at all.”
Mr George then asked whether the “current state of affairs is unsustainable” and that “the degree of lack of confidence must be something you cannot dismiss lightly. It does not happen in many other professions.”
Dr Moyes responded by saying: “I am not dismissing it lightly; it is something that the council and I discuss regularly. We are aware that in the past we have communicated very badly. That is one of the reasons why we are reviewing completely the way we communicate, what we communicate and how transparent we are.”
The committee chairman, Dr Sarah Wollaston (Conservative MP for Totnes), brought up the tone of the GDC’s press release following the outcome of the BDA’s Judicial Review in December. She asked: “Do you regret the tone of the press release you put out after the court judgment, which was very defensive and dismissive and described it as a procedural error, and then just reminded people that they had a few weeks to pay? Do you think, on balance, that that was a good way of rebuilding the confidence of the profession? Do you think it was unfortunately worded?”
To which, Ms Gilvarry said: “The tone and nature of our communications have not been perfect and, yes, there have been lessons to be learned from our communications generally. We have a plan to be better on that. There was no arrogance intended. The whole JR experience was not easy for the organisation. There was certainly no high-handedness or arrogance intended in that press release. We were simply putting information out there from our side, from our point of view.”
Conservative MP for Newark, Robert Jenrick, then asked both Dr Moyes and Ms Gilvarry if, given the lack of support from dentists and the ARF debacle, they were the right people to lead the GDC and if they should continue.
Dr Moyes responded by saying: “The BDA represents less than half of dentists. We may not have the vocal support of the BDA, but I am not prepared to accept the proposition that all dentists uniformly are antagonistic towards the GDC. I do not believe that to be true.”
And Ms Gilvarry said: “We are getting on with it. We have had to work hard in an organisation that necessarily had to expand very rapidly. We did not get everything right, but we are absolutely determined to put the organisation on a steady stream from here on in.”
When asked about the Telegraph advert, Ms Gilvarry apologised to the profession and denied that it had led to an increase in complaints. She said: “What it did was to serve as a lightning rod for the anger of the profession. It looked provocative, and I am sorry; it was not meant to be that way. The ad was booked many months in advance. For us, it did not seem in any way unusual; it was just part of a series. It came out on that Sunday. The timing was viewed by others as being quite wrong, and I accept that that is how it came across. I am really sorry that it came across that way.”
However, she did say that it highlighted the misunderstanding within the profession about the differences between the GDC’s statutory FtP processes and the non-statutory Dental Complaints Service, which deals with complaints from private practices only.
Charlotte Leslie, Conservative MP for Bristol North West, also weighed in with some hard-hitting questions. Most notably, she pointed out that neither Dr Moyes nor Ms Gilvarry had a background or qualifications in dentistry and asked: “Do you think perhaps you should, if the profession is to have trust that you understand what it is like to be a dentist and the issues that dentists face?”
Ms Gilvarry answered: “I do not think the fact that I am not a dentist or that the chairman is not a dentist is the issue. The most important thing is that we have access to the opinion of the
profession – up to date and continuously – and we have that access in a number of ways.
“We need to understand continuously the changes in dental practice – changes that really meet the challenges that dental practitioners are facing. The best way we can do that is notby being dentists ourselves, but through recognition – I do recognise that – and continuous dialogue with dentists and the dental care professionals.”
Ms Leslie countered by saying: “Many might argue that the only way you can have real empathy with a profession and understand the actual daily workings of things is by doing – understanding by doing. There would be an argument that there is a unique brand of understanding that is needed for absolute empathy, and therefore understanding how the profession works.”
She asked Ms Gilvarry how many of the GDC’s senior leadership team had a background in dentistry, to which the answer was none. Before asking: “How would you know what you did not know? You do not know what you do not know because you are not a dentist. It may be that dentists look at what you think is understanding, and I have no doubt at all that you do a very diligent job at your consultation, but epistemologically you would not know if you did not understand dentists; that is the very definition of not understanding. How certain can you be, and how satisfied do you think the dental profession is, that you understand the dental profession and empathise with them in that very grassroots way?”
And Ms Gilvarry said: “That is a very fair question, but our understanding of the dental profession has to be driven by our statutory duties, and we are here for patients. Our core responsibility to protect patients drives us to develop that understanding of the dental profession in various ways. It may not be the most forensic, complete understanding of every feature of dental practice – of course not – but we take our steer from what patients tell us they want and what we perceive patients need, and we develop our understanding with the profession accordingly.
“We are a regulator, after all, so every piece of regulation we formulate has to reflect an understanding of current dental practice; of course it does. That is what drives our dialogue with the profession. I really do not think it is necessary to be a dentist, but it would be a problem if we did not have that level of awareness of the need to get the information to make good dental regulation.”
To download the full transcript of the Accountability Hearing, click here.