Roy Lilley speaks…sense.

I often disagree with Roy Lilley (especially when he discusses dentistry) but his newsletter today makes a few points well, particularly these.

…the only way to achieve that is to de-pompous the GMC and NMC, strip them back to maintaining a register and stop hounding clinicians with all the masonic, legal palaver of hearings…

Clinicians are rarely criminals but they are always human beings and we make mistakes, get confused, get tired, get screwed up by poor systems, bad designs and pressure.

If people think owning up to a mistake could end their career, they’ll hide it and hope.  That is hopeless and serves no purpose.  We have to put a purpose into honesty.  The purpose is to keep us safe and that is all that matters…

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…same sh*t, different profession…

I write mostly about what happens to dentists and the business of dentistry…but let’s not forget that the UK is a pretty lousy place for a lot of professions at the moment, especially the ones that put patient care at their core.

This from the BMJ via reestheskin

“Why do doctors feel the need to do this? A study in The BMJ in 2015 suggested that there is an association between increased defensive practice and a reduced likelihood of being involved in litigation.2 One might conclude that defensive practice is a logical behaviour in the face of a culture that leads to doctors being fearful of the consequences of making an error or even of a known adverse outcome.”

“No doctor sets out to practise defensively, but a system has been created where this is inevitable. The GMC acknowledges that medicine has become more defensive.3 Doctors often lack confidence in the fairness and competence of investigations and continue to see the GMC as threatening.”

One rule for you, one rule for the rest…

Inspired by John Naughton.

Picture this – one dentist manages to lose one set of notes of one patient, who was one month old, who had made one visit to the practice as an emergency and treatment consisted of examination and parental reassurance. The notes are passed to a recognised third party for disposal but turn up on a patch of waste ground. The CQC and the GDC would be involved and that dentist would probably go through months of anxiety whilst it was decided how big the case was for them to answer.

Meanwhile…. “sometime between mid-May and July, Equifax was hacked via a security flaw in the Apache Struts software that it used to build its web applications. The flaw, which gave hackers an easy way to take control of sensitive sites, had been fixed on 6 March and patches were made available to every organisation that used Struts. That meant, as various commentators pointed out, that Equifax’s IT department had the tools to plug the security holeand two months in which to do it. For some reason, they didn’t.

As a result, the hackers were able to steal the personal information of 143 million Americans. It is the most important financial data available on any citizen – names, dates of birth, social security numbers, home addresses and in some instances a lot more, including credit card details of more than 200,000 US consumers (and some UK consumers). It’s everything you need to engage in identity theft on an epic scale. “On a scale of 1 to 10 in terms of risk to consumers,” said a fraud analyst at consultancy firm Gartner, “this is a 10.””….

…Equifax discovered the breach on 29 July, but didn’t reveal it publicly until 7 September, no doubt because the internal investigation was long and complex. During that period, however, three of its senior executives unloaded shares in the company valued at $1.8m. But this, apparently, was completely coincidental: the poor dears (who included the chief financial officer) were not aware that an intrusion had occurred when they sold their shares. 

…..if some poor unfortunate forgets to pay a library fine and then discovers that they can’t get a loan because a check on Equifax’s database reveals the payment lapse, well… that’s just tough. If you want to understand the populist revolt, then this is a good place to start.

The Monday Morning Quote #369

“And I won’t sit down
And I won’t shut up
And most of all I will not grow up”

Frank Turner excerpt from Photosynthesis

– thanks to Colin Campbell whose superb presentation “My Fitness to Practice (FtP) case and other more important matters” was one of the highlights of the BDA Conference in Manchester this weekend. Colin quoted Frank Turner’s lyrics during the conclusion of his presentation.

To read more about Colin’s case and presentation take a look here, here and here and subscribe to his blog.

Whilst you’re reading enjoy Frank’s song.

GDC v BDA – contd (for UK readers only)

Press release

5 April 2016

BDA: ‘new era’ at GDC comes with £½ million cleaning bill

The British Dental Association (BDA) has issued an open letter to General Dental Council chair Bill Moyes, in response to his recent comment piece: A new era of dental regulation.

The article, published in The Probe in March, contained numerous misrepresentations on the PSA’s whistleblowing inquiry and un-evidenced assertions about the rise of patient complaints.

The BDA has now published figures from a recent Freedom of Information request to the GDC indicating it spent over £¼ million on legal costs during the whistleblowing enquiry. Factoring in the added costs of staffing changes this amounted to a total outlay of over £½ million.
The FOI has also identified £250,000 bill to leading international PR firms, for a wide range of services beyond, including prepping the chair and former Chief Executive for their appearance in front of the Health Select Committee in March 2015.

Mick Armstrong, Chair of the BDA said:

“This profession wants nothing more than an effective and efficient regulator, but that journey will only begin when the GDC can show it is capable of confronting some hard truths. Sadly this recent article revealed its leadership is unwilling to even start down that road.

“The Chair has gone to great lengths to absolve the current Council from the sins of the past. A glance at any calendar shows that the bid is futile, as the PSA inquiry into the handling of the whistleblowing issue fell into the time of the current Council. To suggest that the current Council had nothing to do with this inquiry but simply oversaw the rectification of the problem is a stunning misrepresentation. Given the Council’s own deliberations in public, these feelings may also not be shared by the other Council members.

“Bill Moyes has again demonstrated he would rather spend registrants’ fees on firefighting than acknowledge any error on his part. This half million pound price tag for avoidable legal costs and tokenistic staffing changes is particularly galling, and flies in the face of stated commitments to openness and transparency with the PSA on whistleblowing. The GDC chair clearly wants this profession to believe he has clean hands – and this it seems is the cleaning bill.

“The GDC Chair’s conduct seems less like a new era for regulation, and more business as usual.”

What would John Ruskin have said about Groupon in Dentistry?

sad_grouponThe news that a practice in Manchester has gone bust is sad for the patients, the associates and the staff. The fact that this practice had apparently been selling orthodontics via Groupon limits the sympathy that I feel for the owner(s). If anyone has heard me speak in recent months then they will have had no doubt about my feelings regarding the race to the bottom tactics adopted by many “business people” running practices who seem to think that a weekend course or two and a slick marketing allied to a named treatment system is the key to riches.

Here’s a link to the MEN: Angry dental customers left out of pocket after cosmetic firm’s collapse

Of course it’s cases like this that the GDC should be policing and preventing but no amount of CQCs will address it. With Chairman Moyes’ ideas about Dental Care being just a variation on grocery shopping surely the consumers should be protected before the event rather than more ethical colleagues being left to pick up the pieces and restore dentistry’s reputation. No doubt the GDC will chase the associates and the nurses because they are easy meat but the really guilty people will get away with it muttering “Caveat Emptor, don’t you think Dr Bill?”.

What odds on the next good idea to emerge from 37 Wimpole Street being that all dentists who do any private dentistry (and are thus unfaithful to THE brand – NHS) should be forced into an ATOL type of cover so that claims against one dentist can be shared by all. The administration will no doubt come through an arm of the GDC, will be paid for by all registrants who have the temerity to do any private work and will be hailed as a victory for the consumer.

Before this develops into another rant, I’ll share with you the words of John Ruskin which I had typed, framed and hung in my reception area when I turned my back on the NHS in 1992.

  • “It’s unwise to pay too much, but it’s worse to pay too little.
  • When you pay too much, you lose a little money – that’s all.
  • When you pay too little, you sometimes lose everything, because the thing you bought was incapable of doing the thing it was bought to do.
  • The common law of business balance prohibits paying a little and getting a lot – it can’t be done.
  • If you deal with the lowest bidder, it is well to add something for the risk you run, and if you do that you will have enough to pay for something better.”

 and as footnote:

  • There is hardly anything in the world that some man cannot make a little worse and sell a little cheaper, and the people who consider price only are this man’s lawful prey.

It’s all rather sad but predictable.

2016 #24

All UK Dentists should watch this.

logo-mainIf you’re a dentist and not UK based, or not a dentist at all then look at the way that UK government works.

This is a clip from Parliament TV featuring the House of Lords Grand Committee, discussing “Orders and regulations: General Dental Council (Fitness to Practise etc.) Order 2015”. Meeting held on January 18th 2016 starting at 3.30pm.

Lord Hunt speaks from 15.43pm and gives the GDC quite a kicking. Will they listen? More to the point will the people who appointed the current Chief Executive and Chairman listen?

http://www.parliamentlive.tv/Event/Index/39e6196a-ab86-4997-967a-1835f5cb0b24

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