NHS lawyers say dentists treating private patients for non-urgent care could be reported to the police
Lawyers advising NHS Scotland have said that health boards can report dentists to the police if they are found to be providing non-urgent dental care privately during the lockdown.
The advice from the NHS’s Central Legal Office (CLO) came in a letter sent yesterday to NHS registered dentists in the Glasgow and Greater Clyde from Lee Savarrio, the area’s Chief of Dentistry.
Its legal opinion on treating private patients during Covid-19 said that NHS boards do not have jurisdiction over the opening of wholly private practices. Mixed practices can see wholly private patients for urgent dental care only if they notify the board.
In Phase 2a of the planned ‘remobilisation’ of dentistry in Scotland, this can include aerosol generating procedures (AGPs) if they follow accepted protocols and patients are given the clear choice to attend an NHS Urgent Dental Care Centre instead.
The advice added: “The NHS Board has the power to carry out unannounced inspections in practices providing NHS general dental services in accordance with the PCA(D)2016(6). Grounds for unannounced inspections include concerns about patient safety or if information comes to light that necessitates investigation by the NHS Board.
The NHS Board could consider referral to the police or to the General Dental Council if there is evidence to suggest there is a breach of lockdown measures in relation to non-urgent dental care being undertaken during phase 2a.”
Questions from Scottish Dental to NHS Scotland, including whether an ‘unannounced’ inspection could comply with existing social distancing measures, were referred to the Scottish Government.
A spokesperson for the Government said: “NHS Boards have powers to visit a practice unannounced and it would be for them to determine how to do this safely.”
The reference to potential police action has angered dentists and follows confusion over over how private dental care is regulated in Scotland.
“Can we do private treatment on NHS patients or not,” asked one. “The wording of the CLO opinion is contradictory. There needs to be a clear distinction between ‘private patients’ and private treatments’”.
The Scottish Government spokesperson said: “NHS Boards sought the view of [the] Central Legal Office regarding their position should practices open to private patients in advance of Scottish Government guidance to the NHS. The Scottish Government cannot comment on advice issued from the Central Legal Office.”
In an update sent to dentists in Glasgow and Greater Clyde today, the Chief of Dentistry responded: “The CLO guidance quoted in yesterday’s update makes it clear that private treatment can be undertaken for NHS patients as would always be the case.
“The CLO guidance does note though that the patient should be offered the option of NHS treatment even where this can only be provided in the NHS UDCC’s and the patient should feel fully involved in the decision making and not feel coerced into accepting private treatments. This would be especially important in patients where for example there has never been provision of private care in the past.”
On the issue of potential referral to the police, he added: “The section in my update where this is referred to is advice directly from Central Legal Office to the Board and is merely advising options which could be open to the NHS Board.
“This is obviously only an option the Board would resort to in extreme circumstances where it was felt that there was a danger to patient safety. I would hope that you would recognise that NHSGGC as a Board always pursues local negotiation where possible and would think on police involvement or GDC referral as a last stage in our internal governance procedures.
“This section from the CLO merely suggests that anyone undertaking more than urgent dental care would be in breach of lockdown legislation and, similar to any other person or establishment that breaches this, would be subject to this approach. Just to reiterate, this would only be in cases where local negotiation and warnings have not been heeded.”