Today’s Ezine.
BDA slams GDC proposal to raise the annual retention fee by 64 per cent
The chair of the British Dental Association’s Principal Executive Committee, Mick Armstrong, met with GDC leaders this morning and expressed his alarm at the dental regulator’s plans for a 64 per cent rise in the annual retention fee.
The proposal for the fee rise which was announced yesterday would see dentists fees rise from £576 to £945. Dentists have no choice but to pay, in order for them to practise lawfully.
Dr Armstrong told GDC leaders that that such a rise is wholly unacceptable. The scale of the rise is unprecedented and is at odds with the actions of all other regulators. It also comes on the back of a highly critical Professional Standards Authority (PSA) report on the GDC.
Sir Humphrey was briefing the minister (episode 3). (with apologies to Antony Jay, Jonathan Lynn, Paul Eddington & Nigel Hawthorne)
Minister, “Now what on earth is going on with these dentists this time Humphrey? I have had that guttersnipe from South Yorkshire on the phone again.”
Sir Humphrey, “Who exactly, Minister”
Minister, “You know him, Big Mick, the ferret fancier from Castleford. Armstrong. I thought Maggie had got rid of that lot when she shut the mines in ’84. He’s on at me about somebody called Arf, nothing to do with Scargill is it?”
Sir Humphrey, “No minister, it stands for Annual Retention Fee, it’s for the GDC.”
Minister, “Not another bloody acronym Humphrey what’s that?”
Sir Humphrey, “The General Dental Council, minister.”
Minister, “Oh yes, I thought we had privatised them. Gave the job to Bill Moyes on the promise of a knighthood if he kept them quiet.”
Sir Humphrey, “Indeed minister”
Minister, “Well what’s going on?”
Sir Humphrey, “The GDC are increasing the ARF minister.”
Minister, “That’s fine, another few quid, those bloody dentists are rolling in it. Have you ever met a poor one, eh?”
Sir Humphrey, “It’s going up by 64% minister.”
Minister, “What!? How the hell do they justify that?”
Sir Humphrey, “There have been a lot of extra expenses minister.”
Minister, “What sort of expenses, Humphrey and who the hell is running the show?”
Sir Humphrey, “Well apparently there has been an increase of 110% in, ahem, what they call ‘Fitness to practice’ cases.”
Minister, “What the hell have they been doing Humphrey? Slaughtering their patients in droves with their drills and pliers?”
Sir Humphrey, “Not exactly minister. You see a lot of the cases are brought against the dentists by the National Health Service. Every case has to be investigated thoroughly and then they insist on checking as many more patients who haven’t complained as they can so they can make sure they’re guilty of something.”
Minister, “So what about the private dentists, they must be guilty of something – even if it’s only charging too much.”
Sir Humphrey, “Actually minister there is a different system for private complaints.”
Minister, “I bet it costs loads more though.”
Sir Humphrey, “Actually no, it’s far quicker, easier, less costly and usually leads to a successful outcome with much less fuss.”
Minister, “So why don’t they use that for all the cases then, Humphrey?”
Sir Humphrey, “I really don’t know minister.”
Minister, “Well, this is a complete mess Humphrey, but presumably once they have dealt with the backlog of cases they will be on top of things and then reduce the fees?”
Sir Humphrey, “Not exactly minister. You see the system is set up already and actively encourages people to complain. Then with the NHS commissioning bodies really strapped for cash they are trying to reclaim every penny that they can from the NHS dentists. It’s certain to carry on spiralling upwards unless we do something drastic.”
Minister, “What did you have in mind, Humphrey and please spare me anything that Cockcroft had a finger in.”
Sir Humphrey, “What an elegant phrase, minister”
Minister, “Just get on with it Humphrey.”
Sir Humphrey, “Well minister, do you remember we had that meeting with IDH, ADP and so on?”
Minister, “Spare me the bloody acronyms please Humphrey.”
Sir Humphrey, “Sorry minister. The heads of the corporate dental companies.”
Minister, “Vaguely. Yes. Why?”
Sir Humphrey, “Well remember that the plan post-2015 is to, err, encourage the large corporates to take on as much of the NHS provision as possible?”
Minister, “Too right, Humphrey. Big business, that’s what the NHS needs. We’ll get all the ‘stick in the mud’ GPs retired as soon as we can and then get everything run in a business like manner. Cousin Virginia told me how to do it and her company is set to help us.”
Sir Humphrey, “If we can just keep our eyes on the dentists, minister?”
Minister, “Okey Dokey, Humphrey but let’s not get down in the mouth eh? Geddit?”
Sir Humphrey, “Very droll, minister.” Well do you remember we talked about Crown Indemnity” at the meeting?”
Minister, “Remind me please Humphrey.”
Sir Humphrey, “Well minister if someone is employed by the crown, for instance if they work in a hospital they don’t need to take out indemnity insurance against any negligence.”
Minister, “Really? Who picks up the tab then?”
Sir Humphrey, “The state does minister.”
Minister, “That’s a good idea is it?”
Sir Humphrey, “In principle, yes minister, the complaints take years, sometimes many years to be processed and usually the people who are making the complaint die, run out of energy, money or both so by the time the person responsible is brought to book they have taken early retirement.”
Minister, “A bit like complaints against the police then?”
Sir Humphrey, “Quite, minister.”
Minister, “Where are you going with this Humphrey?”
Sir Humphrey, “Well minister, the dental corporates wanted to, ahem ‘cut a deal’ as they so eloquently put it, so they would take care of all their complaints “in house” as the GDC is so inefficient and expensive to run.”
Minister, “So what’s in it for them?”
Sir Humphrey, “Well, with George Osborne’s plans to make all dental associates employees to increase the tax we can raise from them, we thought about reducing the burden on the dental people by offering a reduced rate of GDC membership.”
Minister, “Go on, Humphrey.”
Sir Humphrey, “Thank you minister. With the corporates taking all their risk, so to speak, there will be little for the GDC to do with them apart from keeping the names on a database. The companies will ensure that their compliance procedures are kept up to date, we have their word on that, and of course the CQC will still do their diligent inspections as they do at present.”
Minister, “Where’s this going Humphrey?”
Sir Humphrey, “Well that takes care of 50% of the NHS dentists, they are all now within their companies “self-regulating” which is what those irritants at the BDA keep banging on about.”
Minister, “And the other 50%, Humphrey?”
Sir Humphrey, “Now this is where we stick to Plan A, minister.”
Minister, “Remind me Humphrey.”
Sir Humphrey, “Distract them with rumours of new contracts. Regulate them with CQC, GDC, cross-infection rules, pensions for their staff, health and safety, make ‘em have nightmares about red tape. Squeeze them with the need for more cleaning rooms, more compliance people, don’t listen to their review body. Patronise them, send Earl Howe to the conference to do his ‘you’re all doing awfully well act’.”
Minister, “Oh yes old Freddie Curzon is very good at that, he learned it at Barclays Bank I think.”
Sir Humphrey, “Indeed minister.”
Minister, “Humphrey these are intelligent people, surely their leaders will say “enough is enough” and they will turn their back on the NHS? What happens then?”
Sir Humphrey, “Look at the portrait of the Iron Lady on the wall minister. What would she have said? I’ll tell you – the market will decide.”
Minister, “Excellent, I can’t wait to tell Cousin Virginia.”
Sir Humphrey, “Ah the fragrant Mrs Bottomley, such a shame she didn’t stick to her guns.”
Minister, “She’s done alright for herself since Humphrey, don’t worry about her. Now what about the NHS provision, if they are all squeezed out, I can’t have queues on my watch. They’ll end up calling me that Naughtie word.”
Sir Humphrey, “Tesco, Lidl & Morrisons are always looking for new, ahem, income streams. Beardy Branson wants to get into healthcare in a big way and the current corporates are still very keen with their big is beautiful philosophy.”
Minister, “What about the small practices who have remained loyal to the NHS? Humphrey.”
Sir Humphrey, “Do you remember Darwin, minister?”
Minister, “In Northern Australia, Humphrey?”
Sir Humphrey, “No minister, Charles Darwin, the Descent of Man, man.”
Minister, “I did PPE at Magdalen, not bloody zoology or whatever science that is.”
Sir Humphrey, “Well minister you must have heard the phrase ‘survival of the fittest.’?”
Minister, “Of course Humphrey.”
Sir Humphrey, “Well in this case the fittest will survive because we will ensure that they train properly.”
Minister, “So let’s get this clear. The GDC is stuffed and broke because they can’t run a tight ship. The BDA is stuffed because all they are able to is moan. The thing is Humphrey they are making a lot of noise about this ARF thing.”
Sir Humphrey, “Big chance for you then minister.”
Minister, “How so.”
Sir Humphrey, “Step in. Intervene. Show leadership.”
Minister, “Steady on Humphrey we don’t do that in this government.”
Sir Humphrey, “Tell the GDC they’ll have to make savings, and that this fee increase is too much for a profession that is already hard pressed. Then tell them they can only put it up by 10%.”
Minister, “What then Humphrey.”
Sir Humphrey, “Well minister, the 64% was a ruse anyway to throw a spanner into the works just before the summer holidays to ruin it for them.”
Minister, “That’s not very nice Humphrey,”
Sir Humphrey, “They’re only bloody dentists minister. Do I need remind you what happens next May?”
Minister, “Of course not Humphrey, election time.”
Sir Humphrey, “Quite so, no votes in teeth minister, in spite of the dentists thinking themselves so important.”
Minister, “Then?”
Sir Humphrey, “Afterwards we unleash the dogs of war on the NHS, in come the insurance schemes and the corporates big time. Nye Bevan’s dream becomes a distant memory. You are hailed as the man who sorted out the biggest political problem since World War 2. On a tide of popularity you depose David Cameron and become PM”
Minister, “Gosh”
Sir Humphrey, “Indeed, minister.”
Minister, “All that by standing up to the dentists?”
Sir Humphrey, “Yes minister.”
The Incisal Edge 