I do wish I’d said that..#3 – How dare Premiership Rugby criticise London Welsh and deny them right to play in top flight?

How dare Premiership Rugby criticise London Welsh and deny them right to play in top flight? It is gross hypocrisy.

Brendan Gallagher, Daily Telegraph

Right, time for a few painful home truths about clubs I otherwise admire and love but who now stand accused of gross hypocrisy over the London Welsh promotion issue.

Make no mistake, it is Premiership Rugby, and the clubs therein, that are making life nigh on impossible for those clubs wishing to better themselves. The compliant RFU are in effect the policemen, but Premiership Rugby have laid down the ridiculous regulations.

How dare Premiership Rugby get all precious over London Welsh, and indeed Cornish Pirates. They have had 17 years to sort themselves out and are still, in many cases, a complete mess groundwise. Up to this point I have judged them purely on their rugby, but they started this nonsense so here goes.

For years now I have sat in what amounts to a bomb site in the “press area” in the condemned stand at Vicarage Road. You can see 50 per cent of the game at best because your sightlines are ruined by huge pillars – most of the time you have to train your binoculars on the TV screen over 100 yards away.

For the best part of a decade Sarries have been telling us they will be moving to another ground, but nothing happens. Match day at Saracens Road in the middle of winter is among the most depressing sporting experiences of all time, but we stick with it because they are a fine club and an excellent team, populated by individuals we admire and respect. The Kassam Stadium would be absolute Rugby heaven in comparison.

Sarries, remember, were born of the parkfield that was Bramley Road, where players and spectators alike had to pick their way through dog excretia or worse. They are a product of the system that they are now helping to destroy.

It goes on. Edgley Park was right up there with Vicarage Road in the horror of its facilities, while Bath have got away with murder ever since professionalism started because we love the Recreation Ground.

Ahh, the Recreation Ground. Yes I do have a soft spot for the place but our patience is running very thin, it doesn’t meet Premiership Rugby’s own ground criteria, there is no parking worth mentioning, the majority of spectators are housed on a curious ad hoc structure in the middle of the cricket pitch and, unless you can bag a seat in the front row of their suspended press box, you have no chance of viewing the game.

How dare they criticise London Welsh. Who do Premiership Rugby think they are? Have they completely forgotten recent history? At various times Harlequins and Northampton have rightly been relegated to Division One but prospered massively from the experience and bounced back as model teams.

How dare Premiership Rugby, via the RFU, attempt to deny that to other equally ambitious rugby clubs. How dare they be judge and jury when the only people benefitting is their self-appointed elite. It is so against everything Rugby Union stands for as to be laughable, which they will quickly discover if this London Welsh situation is allowed to go any further.

A natural process of promotion and relegation should always decide who the elite are. Two years ago, Exeter’s promotion was greeted with guffaws around the League, and predictions of their instant relegation and humiliation. Well how wrong were Premiership Rugby on that.

Exeter are a model club in all respects, full of Championship Rugby virtues, and have raised the standards in the Premiership. We need more like Exeter, not less. We need a more dynamic self-satisfied League structure and we need much less of this nonsense.

It’s the creeping duplicity I dislike. If Premiership Rugby want a self-enclosed, self-perpetuating elite like the Super 15, the NBA, the NFL then they should come clean, put their proposal on the table and the game will vote Yes or No. But this big, bullying approach is going to lose them a lot of friends – as they will discover in the weeks ahead if it continues.

The glory of English rugby, so we are always told, is the numbers game, the million-plus people who play. If that is ever going to be translated into a consistently successful national team the way forward has to be via two top professional leagues, with free passage between the two via promotion and relegation. Make the numbers work for you.

It’s quite evident, however, that such a scenario is the last thing Premiership Rugby want while the RFU’s mystifying failure to find a sponsor for the Championship sends out the same message.

The OFT has spoken…again

For the second time in less than a decade the Office of Fair Trading has investigated the Dental Market, their report was released today; the press release is below, I find it interesting that the press release is far more dramatic in it’s summary than the report itself, but that’s government spinners for you:

OFT calls for greater patient choice and competition in dentistry market.

The OFT today called for major changes to the £5.73bn UK dentistry market after a market study found that it is not always working in the best interests of patients.

The OFT study found that patients have insufficient information to make informed decisions about their choice of dentist and the dental treatments they receive. Alongside this, a new survey conducted as part of the study suggests that each year around 500,000 patients may be provided with inaccurate information by dentists regarding their entitlement to receive particular dental treatments on the NHS, and as a result they may pay more to receive private dental treatment.

The report also raises concerns about continued restrictions preventing patients from directly accessing dental care professionals, such as hygienists, without a referral from a dentist. The OFT considers these restrictions to be unjustified and likely to reduce patient choice and dampen competition.

The OFT also highlights concerns with the current NHS dental contracts in England. As the majority of these contracts are not time-limited, and only a small volume of new contracts are put out to tender each year, it is extremely difficult for new dental practices to be established, and successful dental practices which offer a higher quality of service to NHS patients are prevented from expanding.

Other issues of concern highlighted in the report include the complexity of the complaints process for patients and instances of potential pressure selling by dentists of dental payment plans.

The OFT has identified a wide-ranging package of recommendations to address these concerns, which includes:

  • Provision of clear, accurate and timely information for patients – the OFT is calling on NHS commissioning bodies, the General Dental Council and the Care Quality Commission to be proactive in enforcing existing rules which require dentists and dental practices to provide timely, clear and accurate information to patients about prices and available dental treatments.
  • Direct patient access to dental care professionals – the OFT urges the General Dental Council to remove restrictions preventing patients from making appointments to see dental hygienists, dental therapists and clinical dental technicians directly, as soon as possible.
  • Reform of the NHS dental contract in England – the OFT is urging the Department of Health to redesign the NHS dental contract to facilitate easier entry into the market by new dental practices and allow successful practices to expand. The OFT is not convinced that indefinite contracts to supply NHS dentistry are in the best interests of patients.
  • Simplification of the complaints process – the OFT considers that the current system should be reformed to make it simpler, easier and less time consuming for patients and dentists to resolve complaints.
  • Sale of dental plans – following discussion with the OFT, the British Dental Association has agreed to develop a robust and effective code of practice covering the sale of dental payment plans.

John Fingleton, OFT Chief Executive said:

‘Our study has raised significant concerns about the UK dentistry market which need to be tackled quickly in the interest of patients. All too often patients lack access to the information they need, for example when choosing a dentist or when getting dental treatment. We also unearthed evidence that some patients may be receiving deliberately inaccurate information about their entitlement to NHS dental treatment, and we expect to see robust action taken against such potential misconduct by dentists.

This study has also highlighted that the current NHS dental contract in England may well not be working in the best interests of patients, (my bold) and that regulations unjustifiably restrict patients from getting direct access to dental care professionals like hygienists. Reform in both these areas is needed without delay.’

NOTES

  1. Download the market study report.
  2. OFT market studies are carried out under section 5 of the Enterprise Act 2002 (EA02) which allows the OFT to obtain information and conduct research. Effectively, they allow a market-wide consideration of both competition and consumer issues. They take an overview of regulatory and other economic drivers in the market and consumer and business behaviour. Possible outcomes of market studies include: enforcement action by the OFT, a market investigation reference to the Competition Commission (CC), recommendations for changes in laws and regulations, recommendations to regulators, self-regulatory bodies and others to consider changes to their rules, campaigns to promote consumer education and awareness, or a clean bill of health.
  3. The OFT has provisionally concluded that it is not appropriate to make a market investigation reference on the UK dentistry market to the Competition Commission at this time, and invites views on the proposed decision. Interested parties are invited to submit responses to this consultation by 5pm on 10 July 2012 to dentistry@oft.gsi.gov.uk or in writing to the Dentistry Market Study Team, Services and Infrastructure Group, Office of Fair Trading, London, EC4Y 8JX.
  4. The OFT is unable to provide advice or resolve individual complaints for consumers. The Citizens Advice consumer service provides free, confidential and impartial advice on consumer issues. Visit http://www.adviceguide.org.uk or call the Citizens Advice helpline on 08454 04 05 06

Now compare with their conclusions in 2003.

Purpose of the study
To address competition concerns and concerns regarding levels of consumer protection in the market.
To investigate transparency of prices, the level of competition and the way complaints are handled and redress offered. To look at access to dental services and patient guidance before treatment.

Findings

The findings of the study showed:

  1. Consumers lack basic information on price, quality of service and treatments available on the NHS so unable to make informed choices.
  2. Standards promoted in professional guidance published by the General Dental Council (GDC) not routinely monitored/enforced, and compliance in some areas low.
  3. Unlike the NHS, there was no universal complaints system, and procedures for dealing with complaints and securing redress for consumers were inadequate.
  4. Regulatory restrictions on the supply of dentistry services limited consumer choice, competition, business freedom and the potential to develop and deliver better services.

Recommendations
The recommendations of the study were to:

  1. Improve consumer information through better self-regulation The regulatory framework should be strengthened and broadened to help ensure that consumers can make properly informed decisions about dental services. Compliance with the standards for patient information set out in the existing GDC guidance to dentists should be monitored and enforced
  2. Improve resolution of problems, complaints and redress Each practice should have a complaints procedure and patients should be made aware of this when they register with the practice. In line with NHS procedures, an independent complaints procedure should be established to examine complaints which could not be resolved at the practice level
  3. End restrictions on certain professionals complementary to dentistry (for example, hygienists), so that they were free to supply their services directly to consumers. Support for Department of Health (DH) proposals to remove the restriction on the number of corporate dental bodies under the Dentists Act. Urged DH to consider removing the remaining restrictions.

Action following market study
All the OFT recommendations were accepted.

  1. The Dental Complaints Service, an independent complaints service funded by the General Dental Council (GDC), was established in March 2004 to help resolve complaints for private dental patients, with sanctions against dentists who fail to reveal all the options and full costs.
  2. Changes to s60 Health Act 1999 removed restrictions on certain professionals and allowed the GDC to register additional care professionals.
  3. OFT also carried out an awareness campaign – with a consumer information leaflet published in 2006 so that consumers of private dental services knew what information they needed and had a right to expect.

My thoughts

  • The Independent Dental Complaints System has been a great success, it is efficient and works well for both parties in a dispute. The NHS systems, however, particularly if PCTs get involved has resulted in a massive escalation in complaints leading to a backlog of cases waiting to be heard by the GDC; this hasn’t been helped by the GDC changing their standards for what complaints have to be taken further.
  • The changes to the health act did little or nothing to remove restrictions on hygienists etc to work independently (whether that be right or wrong remains to be seen). Instead they have escalated the number of registrants with the GDC by including Dental Nurses, this has led to a fall in morale and the departure from the profession of many experienced Dental Nurses. So the DoH dropped the ball there.
  • The removal of restrictions on corporate dental bodies has led to the proliferation of dental “factories” which have been able to take advantage of the changes introduced in the 2006 contract which the OFT says “may well not be working in the best interests of patients” – with all due respect to the OFT, any and every dentist could have told them that the contract has been a disgrace and everybody involved in its conception and implementation, from CDO down, should be ashamed of themselves.
  • This report is just another stick to beat dentists and their teams – I am not trying brush over the fact that some dentists are less than true to themselves and their patients about where NHS coverage ends and what they are providing privately. Surely its time to say that you’re either NHS, with a limited budget where GDPs are salaried or you’re part of the free market where you provide what you wish at the price that is able to reflect the time spent, materials used and the investment made in updating your premises.
  • The Big Lie (thanks to Tony Kilcoyne) is that there is not enough money to provide a dental service on the terms set down by the Department of Health and no reports, commissions and investigations will change that, until everybody involved in UK dentistry admits this from the DoH including the BDA, dentists and patient groups then the system will remain unfit for purpose as government is so fond of saying.

 

The Monday Morning Quote #168

“When a man tells you that he got rich through hard work, ask him: ‘Whose?'”.

Don Marquis

The Monday Morning Quote #167

“The price of anything is the amount of life you exchange for it.”

Henry David Thoreau

What every Dental Practice needs in their Gents’ loo!

Just what you need to keep ahead of the opposition…

The Monday Morning Quote #166

“The trick is in what one emphasizes.

We either make ourselves miserable, or we make ourselves happy.

The amount of work is the same.”

Carlos Castaneda

Free Guidance on CQC Inspection from Practice Plan & Apolline

Sounds good to me…

Practice Plan News Flash!

You will be very interested to know that Practice Plan, in partnership with Apolline are offering free guidance on CQC inspection visits. The guidance is based on practice visits that have already taken place so really cannot be missed!

Practices can access this free information through BoD website, if they are a registered user, or, if a Practice Plan member through the PPHub. If not a Practice Plan Practice they can find out more at  www.bodhub.co.uk/cqcinspectionsguidance.

The guidance is being offered under the BoD brand and I have attached the Guidance document below for your info, but this is for your eyes only and not to give to any practices if that’s ok.

We really just want to spread the word, as its such a great opportunity, so if you wouldn’t mind whilst your out and about in yours or our practices letting them know about this great offer and if there are interested just tell them to contact Practice Plan direct or if not with Practice Plan they can just register with BoD, we would really really appreciate it !

Thanks again.

I do wish I had said that…#2 – Is the Boa of Bureaucracy killing Professionalism?

A recent posting on GDP-UK by Tony Kilcoyne

Dear All,

The essence of being a Professional is to put patients’ best interests first, before our own, before any systems we may work within and even before Government Policy and experimentation.

Yet it is clear such Professionalism is under constant attack and being compromised – a classic example in Dentistry is the débâcle of NICE guidelines on dental recalls being imposed upon NHS Dentists, where they have to send as many patients as they can away for two years to help bureaucrats hit centralised dental access targets before 1st April, even though this increases risks of disability, disfigurement and even death for those who can no longer have their Oral Cancer checks annually at their dental check-ups. (BMJ article link here)

Dentistry is a ‘fixed-budget’ service so after fixed-overheads are paid out only then is any funding left to treat the same number of people. Even in Private Practice in these recessionary times this is true, because one cannot simply just raise one’s prices in a free market without suffering less turnover, which has tended to happen with more Dental Practices struggling or even going bankrupt now than at any other time in our history.

So if the fixed costs (incl. bureaucratic) increase, patient funding decreases inevitably – yet what does this Coalition Government do having promised to reduce Bureaucracy for healthcare workers so they can spend more time and resources on frontline care for patients – yes it massively INCREASES the Bureaucratic burden on Dental Practices instead, by imposing the CQC upon an already GDC regulated Profession that was already held accountable for it’s premises and management systems ( GDC Publication here) with plenty of FtP disciplinary cases to show how registrants can be struck off for such breaches.

It was the English DH who made-up the case for the CQC to Ministers on a cost-saving basis, but it now is becoming apparent his was very poorly done and badly judged, if the latest comments by the cross-party Parliamentary Accounts Committee into the catalogue of CQC poor performances is anything to go by.  (Read report here)

The above report concludes the CQC cannot even adequately govern it’s own poor performances, let alone that of others, yet those who gave them Dentistry to govern have no responsibility or accountability for their poor judgement or the knock-on effects at all

There simply isn’t room here to list all the waste & additional meaningless paperwork policies we have been forced to waste limited time and resources with CQC, which ultimately one can only conclude MUST have harmed patient care overall in our fixed-budget systems.

Do I even mention HTM 01-05 and it’s experimental and costly imposition upon Dental Practices too, where hospital systems that kill 3000-5000 people a year are being imposed upon dental practices who kill zero people annually? This then compounds things even worse in other Countries like Northern Ireland who copy and go to further unnecessary extremes, forcing dental practices to lose a Surgery that COULD have been treating patients to create an LDU, or be closed down! Either way precious limited resources are diverted away from providing frontline care and this in a Country where their young child dental health is one of the worst in Europe and set to suffer more.

When I think of National statistics that show the third most common MEDICAL reason for ANY child to be occupying a hospital bed is rotten teeth, (Daily Telegraph article here) yet we are wasting Millions of Pounds and Millions of Professional hours on Bureaucratic experimental folly like above, it makes me want to cry as a caring Professional, yet we are all dis-empowered from stopping such policy-based misery continue year after year

The CQC, RQIA, HIW, HIS and other regulatory bodies are very keen on child protection policies and training within Practices, yet they totally ignore or may even be partly responsible for perpetuating the National-Scale of Child Suffering & Abuse caused by the widespread systematic SUPERVISED-NEGLECT of the dental health of younger children in Society who depend upon Central Policy Planners and Systems, that ultimately ignore and don’t protect them.

Will children born today be still occupying so many hospital beds because of rotten teeth in 5 years time
Almost inevitably, unless we start putting Patients before Paperwork, Scientific-evidence before politicised policy, returning more Professional Freedom instead of the continued tightening Boa of Bureaucratic rules and regulations that pretend to be patient centred ultimately.

What have we learnt from the Mid-Staffordshire Hospital disaster where some 400-1200 extra deaths were caused by unaccountable management systems imposing experimental Bureaucratic policies and centralised targets upon already stretched Professionals? (Daily Telegraph article here)
Nothing it seems and it’s possibly got a LOT worse since then too.

We can wait for a miracle or we can act – where many internal pathways to the DH and politicians are continually met by excuse-making responses to try and justify this continued restrictive trend upon our Professionalism, then we are only left with one option in the Public Interest as a Professional group – Whistleblowing

The Boa of Bureaucracy is ever-entwining and restricting our Professionalism and independence to act in patients’ best interests before those of experimental bureaucrats – whilst we have a little Professional breath left, we need to raise the Alarm so others who have the power to make change externally, can be publically informed and rescue the situation from it’s inevitable demise

The best protection the public have is our Professionalism and independence to raise the Alarm publically – what is bad for Dentists and their Teams is bad for Patients too – that includes the deadly Boa of Bureaucracy in Healthcare.

Yours genuinely concerned,

Tony.

I do wish I had said that…#1- My life in Bureaucracy

To start this occasional series here’s an excerpt from Beverley Martin’s Blog

My Life In Beaurocracy(sic)

From the age of 14, after reading an article in ‘Mizz’ magazine about career choices, all I knew was that I wanted to help people. I didn’t know how; I just wanted to make lives easier, the way mine sometimes could be made easier. I started studying psychology, from A level to degree level, and although I wasn’t able to use my BSc right away due to starting a family almost as soon as I graduated, knowledge of behavioural science has been immensely useful to me ever since. While my children were little, I worked for voluntary organisations such as the Samaritans and undertook courses in counselling skills, whilst working in retail for the flexible hours and useful extra money. Even my time in retail wasn’t wasted in conjunction with my ‘career plan’. After being taken on by the John Lewis Partnership at the age of 22, I was kept out of sight of the customers for an entire week whilst being rigorously trained in a training suite within the store, which equipped me with the skills to identify and find ways of meeting the needs of the customers I would encounter.

When I began working for the youth service, I loved the idea of identifying specific needs a child or young person may have, in order to be able to meet them  which in turn would help them and make their lives easier. Both my John Lewis and counselling training helped with this. I didn’t love the unfamiliar vocabulary, which sounded disconcertingly like ‘Newspeak’, the language from George Orwell’s novel 1984 to me. However, I acclimatised.  Needs not only had to be identified and met, but outcomes had to be identified, evidenced and documented. Although in fairness, I have no experience of or idea how to effectively manage a countywide youth service, in times of crisis, the youth service response would often paraphrase that of Reg, the leader of the People’s Front of Judea in Monty Python’s ‘The Life of Brian’:  “Right. This calls for an immediate………assessment form”.

Young people, many of whom were blessed with the sort of attention spans of which goldfish would be wildly jealous, found the endless form-filling as tedious as I did. Especially when it rarely led to the outcome they’d been hoping for. “What’s the point of all this” they would ask. If I told you how many times I resisted the urge to reply “I have no idea – but I suspect it’s so you can be fooled into thinking your individual needs count for anything to the government, whilst they can fool everyone into believing they’ve met them anyway.”, you probably wouldn’t believe me.

In around 2007, the local authority decided to roll out an entirely new system, which although was intended to provide a better service for children and young people, had failed spectacularly every time it had been rolled out in other areas – a fact that did not deter them in the least. The centralisation of services, and the centralised assessment form which many users found virtually impossible to fill out accurately, meant that many young people were slipping through the system or being offered services which were inappropriate for them.

At about the same time, the local authority spent many thousands of taxpayers’ pounds forcing youth workers through an NVQ level 3 course in youth work, which involved spending many extra hours of their own time identifying, evidencing and documenting the screaming obvious. Hilariously, just before youth workers realised this was actually mandatory, they had been forced to ‘apply’ to do the course, to justify why they should be allowed to do something they were contractually obliged to do (despite the fact that this was not specifically in any employees contract. Contracts at my local authority were spoken of in the reverent terms usually reserved for the Loch Ness Monster and Xanadu. One employee actually thought they saw one once, which caused great excitement. It turned out to have been a non-contact form).

Many youth workers who had no confidence in their academic skills left the service at this point which was desperately sad for them and the young people for whom they’d been providing invaluable support. However, the local authority were not the slightest bit perturbed, which made sense in 2012 when the entire youth service was deleted……imagine how much more money they would have wasted on those meaningless qualifications if those youth workers had stayed and completed the course! Therefore, despite my love for working with young people, I realised that I was not evidencing or meeting my own personal need; to help them and make their lives easier. I had identified an outcome which I was failing to achieve! The system in which I was working was procedure-based, policy-based, evidence-based and database-based, but not people-based. I was part of a problem, whereas I’d always wanted to be part of the solution.

So I decided to try and fulfil a little daydream I’d had for a while about becoming a dental nurse. It was something that appealed based entirely on the way it would enable me to help people and make their lives easier in certain specific ways, yet appeared to be free of the meaningless beaurocracy involved in youth work.  I was taken on as a trainee by a wonderful, family owned practice whose patient list includes grandchildren of patients who first attended as children themselves. From the moment I first walked through the door, I loved it – it felt warm and caring, and I felt I could do good there. I felt I could help people and make their lives easier, the way mine could sometimes be made easier.

However.

In the three short years since I became a dental nurse, dentistry has become the oral health equivalent of the youth service. An expensive leviathan of a quango, ostensibly a “regulator” (despite that fact that all dental professionals were already regulated by an existing regulator; the General Dental Council) known as the CQC, decided that care homes, hospitals and dental practices were hotbeds of hazard. In an attempt to justify its existence, it demands that dental practice staff have in-depth knowledge of legislation relating to vulnerable adults and children and implement policies relating to everything from infection control (which makes sense) to patient restraint (which does not).

The CQC demands that all staff should be CRB checked – a requirement I could understand as a youth worker, working often alone with young people, but less so as a dental nurse whose contact with children and vulnerable people is ephemeral, who is never alone with children or young people and in times past would have been considered the chaperone for the dentist, instead of an equally suspected paedophile who has to pay around £44 to prove that I’m not. In case anyone is in any doubt, CRB checks, pushed in the wake of the Soham murders, would not have saved Holly and Jessica because Ian Huntley did not work at their school. His contact with them was enabled by his relationship with Maxine Carr, their teaching assistant, who had a previously clean record and would, therefore, have sailed through a CRB check. I think we can all agree that is £44 well spent…….on top of the annual £80 I pay in personal indemnity in case I accidentally hurt a patient and the annual £120 I pay to the GDC to prove I’m not Harold Shipman MkII. That’s despite the ironic and appalling fact that under the watch of the present chief executive of the CQC, well over 1,000 people died as a result of inadequacies and disgusting conditions in hospital in Mid-Staffordshire. A death toll that Harold could only have dreamed about.

It isn’t enough for dental practice staff to regularly check the contents of their emergency drugs kit and keep a log of checks – a check log of the log of checks must also be kept. Just to make sure those divvy dental professionals know how to tick a box. I, as a dental nurse, have to tick a box to state that I have followed the correct procedures for cleaning my surgery at the end of a session. I’m no longer trusted to simply clean my surgery, you see. I have to EVIDENCE it. The evidence of my spotless work surfaces, dental chair, floors and sinks is not at all admissible. My little ticked box, however, is. I must stamp all sealed packets containing dental instruments with the date three weeks hence. After this period of time, the instruments will unaccountably (and I do literally mean unaccountably – despite all the evidence required from dental professionals, the evidence underpinning these requirements is suspiciously absent) become contaminated and need to be re-sterilised even if the packet was untouched and unopened……..unless I was to live in Wales rather than England, where micro-organisms take a whole seven days longer to contaminate sealed instruments. Moreover, if we had a vacuum autoclave, sealed instruments would become contaminated after 60 days in England, whereas Irish micro-organisms become highly dangerous within a sealed packet after only 30 days. How amazing that the government has discovered those pesky bacteria behave differently depending on their geographical location. Of course, aside from the sheer tiresomeness of these pointless rituals , they ensure I spend far less time than I used to in the dental surgery assisting my dentist, looking after and reassuring our patients and doing….well……my job.

As if that wasn’t enough to contend with, all dental professionals must be well versed in the law regarding child protection and have knowledge of the contents of the Mental Capacity Act (MCA) – a controversial piece of legislation which states that even the most obviously mentally incapable patient should always be treated as capable of making decisions relating to their dental treatment unless they, in the small time frame in which we get to see them, act in a specific way – or even dress in a specific way – which suggests otherwise.

Don’t make the mistake of thinking that dental professionals only need to look after their patients, monitor their physical safety, respect their dignity and go out of their way to ensure they leave the practice happy and pain-free – practices where staff cannot demonstrate knowledge of the MCA are judged by the CQC to be failing at “standards of caring for people safely and protecting them from harm” and even judge patients to be “at risk” from staff who have not undergone safeguarding training, or who have not undergone an enhanced CRB check. You’d think “standards of caring for people safely and protecting them from harm” would directly relate to making sure our standards of infection control are adequate, or that our equipment isn’t about to fall to pieces on them. If you did, you’d be wrong. You’d assume dental professionals are there to look after our patients’ teeth. You’d be wrong.

Dental practices have been dragged into the Brave New World. The world I thought I’d escaped when I left the youth service; the world which chased me into dentistry. There is no escape from the stranglehold of beaurocracy, which has led despairing dental professionals to leave the profession, frustrated that they can no longer focus on what they were trained to do. I constantly consider leaving myself, but the thought that it either already has or will shortly infiltrate all professions depresses me enough to conclude I’d be better off staying put. At least this way I still – sometimes – get to help people and make their lives easier. The way mine isn’t being made easier.

I could go on……but that’s about all I have to say – apart from the fact that every time a CQC apologist reminds dental professionals that they are risking patient’s lives by not attending the optional mandatory safeguarding training (yes, it is both optional and mandatory), somewhere in the world, a dental nurse is one step closer to a cardiac arrest. Now, if that’s not a good reason to check the check log of the check log of emergency equipment, I don’t know what is.

The Monday Morning Quote #165

“Per Aspera Ad Astra

“Through hardships to the stars” (thanks to Richard Feynman)

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