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Blueprint for regulation must ensure fairness, tackle illegal dentistry and give profession a seat at the table

 The British Dental Association has warned the voice of registrants and protections against illegal practice cannot be casualties in needed reforms to modernise the creaking legislation underpinning healthcare regulation.

Comments follow the closing of the Department of Health and Social Care’s wide-ranging consultation. The proposals offer more flexibility for regulators to adapt to change, ask for increased transparency and recognise that registrants should not be effectively cross-subsidising work beyond a regulator’s core remit.

Proposals could see the General Dental Council freed from the legislative limitations set in the Dentists Act 1984 that have hindered some necessary improvements over the last decade, enabling greater ability to evolve and respond to changes in practice over time. However, reforms could mean significant new powers for case examiners, the loss of ‘health’ as a separate fitness-to-practise ground, and potential changes to how the ‘practice’ and the ‘business of dentistry’ are recognised in law.

These and a number of other proposals have raised concerns about patient and registrant safety if the ideas are moved forward without modification. It is of course clear that modernisation needs to happen, and at speed. Another concern is that necessary and positive changes may be delayed for a considerable time while the government considers the number of regulators. In this context, the BDA has argued for the retention of an improved dental-specific regulator, safe from amalgamation with others.

In its full response the BDA has underlined its support for changes that help make dental regulation more flexible so that the regulatory framework is enshrined in legislation, with regulators able to develop the ways in which they work within that framework through their rules. But equally it highlights deep concerns about areas where there is a risk of reduction of fairness for registrants, a risk of destabilising current systems for example through delegating regulatory functions to others, and a risk to the GDC’s ability to retain the professional knowledge it has and to prosecute illegal practice of dentistry.

Shareena Ilyas Chair of BDA's Ethics, Education and Dental Team Working Group said:

“The Government has a chance here to deliver a more responsive dental regulator.

“Liberating the GDC from antique legislation could carry real benefits for patients and practitioners alike. However, Ministers must not throw the baby out with the bathwater.

“Professional input into the Council’s decision-making processes must be guaranteed, and these proposals jeopardise this.

“Fairness must remain one of the guiding principles – the proposals for case examiners are deeply concerning and including health cases under ‘lack of competence’ in the fitness-to-practise system is a truly regressive step.

“Dentists have felt semi-detached from their professional regulator. Reform that leaves it lacking professional perspective or any real teeth to tackle backstreet operators will put patients at risk and make rebuilding trust nigh on impossible.”