The BDA has, for some time, had a challenging relationship with our regulator. As the voice of dentistry, we know there are few issues that command as much attention from the profession as the GDC. So, we have always invested considerable time and energy in holding the regulator to account. It is fundamental to what we are as a professional association.
Reflecting on the challenges in dental regulation
It might be euphemistic to describe that relationship as having been on something of a ‘journey’ over the last dozen years.
2014 was a particular low point, and for good reason, with a high-profile disagreement over the Council’s decision to implement a 55% increase in the Annual Retention Fee for dentists, which ended up in the High Court. We won the argument that the GDC had acted unlawfully, but the Council was allowed to implement the increase anyway because frustratingly, the judge accepted the argument that reversing the uplift would destabilise the regulator.
That court case was probably symptomatic of the relationship between profession and regulator. Put simply, the GDC did not retain the trust of the profession it was regulating. There is an argument that over the past decade, the GDC has begun to recognise and try to address that problem.
Recognising signs of progress
At a headline performance level, the Council is assessed regularly by the Professional Standards Authority (PSA), which is essentially the regulators’ regulator. In 2015 the PSA report said that the GDC did not meet seven of its 24 standards of good regulation. Its core failings then were focused in the key area of Fitness to Practise (FtP). Currently, the Council is achieving 16 of the now 18 PSA standards. This certainly represents an improvement, but the standards not met still include the significant area for the profession of timeliness in FtP cases.
Across that period and certainly more recently, there have been clear efforts by the GDC to connect across the sector, and to engage in dialogue, if not necessarily always to win hearts and minds. There has been more outreach from the executive team, and both immediate past chair Toby Harris, and new chair, Helen Phillips, have shown a desire to engage with registrants and their representatives. That is something to be welcomed.
The regulator’s new and ambitious strategy (2026-2028) has, as a central focus, the realisation that fear of the regulator is something that needs to be addressed. The document states that the priority is to reduce the negative impacts of regulation, which can lead to fear and stress for professionals, and to adopt a more empathetic approach. While this is no doubt a challenging task for the GDC, it does demonstrate a change in tone and approach.
An opportunity to engage directly with the GDC
Last week, the GDC Chair took the unprecedented step of inviting us to share our perspective directly with the Council. As far as we are aware, never before has the GDC welcomed such input from a representative organisation. We routinely meet with the GDC leadership team and respond to countless regulator consultations, but this was something new, something different.
Firstly, informally in conversation, and then formally at the Council meeting, we were able to spell out the facts on the key issues currently impacting on dentistry. BDA Chair Eddie Crouch, Chief Executive Martin Woodrow, and Head of Indemnity, Len D’Cruz joined me in discussion with GDC Council members. It was helpful to learn more about Council members individually, and to hear how they are motivated to improve the regulatory environment.
The fact that we were the first organisation to be afforded this opportunity speaks volumes for the importance attached to our voice. And I can reassure you that we did not waste the opportunity to raise the issues bothering the profession.
Presenting the profession’s concerns
In our conversations, we majored on the worrying ongoing issues around FtP and the damage that ineffective processes and long delays have on registrants. Within that, we covered the thorny matter of ‘blue-on-blue’ referrals by one registrant in relation to another. We talked about trust in the regulator, and the GDC’s role in speaking out on the situational factors that impact performance, not least the constraining impact of NHS contractual frameworks. We covered dental tourism and illegal practice, the GDC’s role in overseas registration including the overseas exam waiting list and place allocation, the important issue of educational standards, and new challenges around the use of artificial intelligence in handling complaints and in professional reflection.
I’m not naïve enough to expect that engagements like these will solve the problems faced by the dentistry sector. But it can only be helpful for GDC Council members to hear directly from us on these important issues, on your behalf. And I have to say it felt as if the Council was interested, and listening.
Dialogue as a route to improvement
I know that colleagues want us to continue to hold the GDC to task on the things that matter regarding dental regulation. We reiterated last week that we will never shirk from calling the GDC out on any ineffective or disproportionate approaches or processes. But there is certainly also a place for dialogue as a positive means of bringing about change.
Ultimately, any value in such interactions will be demonstrated by whether we are collectively able to ensure improvements in regulation for the benefit of registrants and patients. But for now, this is a welcome sign of a regulator that is ready to engage and listen.
