Dentistry comment: Talking fireworks

I am of a generation that still associates the first week of November with the celebration of the exploits of Guido (Guy) Fawkes and his fellow conspirators, who on 5 November, 1605 were foiled in their attempts to blow up the Houses of Parliament. The so-called Gunpowder Plot failed because of an anonymous tip-off, we are told, so it would seem that whistle-blowing is not a new phenomenon.

The children of today probably think that Guy Fawkes was some kind of early 17th-century health and safety officer, such is the emphasis on this subject whenever Bonfire Night is mentioned these days. The statutory requirement for the wearing of flame-retardant underwear and safety goggles and the inclusion of a fire blanket in every pupil’s lunchbox must surely be something of a clue?

Sitting on wooden or moulded plastic chairs inside the local village hall watching a video of a bonfire (or even of fireworks disappearing in all directions off the London Eye on some previous celebratory occasion) doesn’t generate quite the same sense of adventure as clutching that sparkler, while soaking up he rosy glow of reflected heat from a huge bonfire and the smell of wet leaves on a foggy evening.

It is widely suspected, of course, that the Gunpowder Plot was not all it appeared to be on the face of things, and infact there may well have been a sub plot that was a great deal bigger than the one we all choose to honour every November. One theory is that it was the equivalent of a ‘sting’ operation, to assist the government in adding weight to the theory that there were dangerous (Catholic) anarchists at large in society. This version has a familiar ‘weapons of mass destruction capable to being deployed within 40 minutes’ ring about it, don’t you think? I have never been quite sure whether we are meant to be celebrating the capture and subsequent execution of the 1605 conspirators, or the fact that a bunch of people decided that they had had enough of the politicians of the day and decided to do something about it.

CHRE, the healthcare regulator with an over-arching function of overseeing the work of all the other frontline regulators such as GMC, GDC etc, has recently commenced its formal investigation of the concerns raised by Alison Lockyer as she resigned from the GDC.

It seems unlikely, so long after the event, that CHRE will discover anything resembling a ‘smoking gun’ – the GDC has known this investigation was coming for some time and if a smoking gun still remains on the premises, somebody needs shooting with it. But it is certainly not beyond the realms of possibility that CHRE will stumble upon a barrel or two of gunpowder in the cellars under 37 Wimpole Street, or detect some traces of explosive material under the fingernails of some of the surviving parties. We shall see in due course.

I have been very encouraged in recent months by the efforts being made by the director of regulation and his team to address the well-recognised and well-documented problems with the GDC’s Fitness to Practise (FtP) procedures. We are by no means out of the woods yet, but there are grounds for optimism that the worst of the worst may soon be over.

The GDC has been very roundly criticised and publicly humiliated over the lamentable deficiencies in FtP, and given the consequences for the dentists and other registrants who have suffered at the hands of these procedures, this is entirely as it should be.

But it is also appropriate that we should recognise any improvements in the direction of travel, and those who are working hard behind the scenes to make sure it happens. It is also true that plenty within FtP was working pretty well anyway – most of the problems were nearer the front end of the process, at the initial assessment and Investigating Committee stages. The GDC issued a press release on 17 October, setting out the steps it is taking to address some of the acknowledged weaknesses in FtP. On hearing that there will be well in excess of 1,000 days of FtP hearing days in 2012, most registrants would be incredulous.

But part of the reason for this extraordinary statistic is that huge efforts are being made to reduce the backlog of cases, and that (at least) should be seen as good news.

Having the Sword of Damocles poised over your head for many months, and sometimes years, is no fun for the registrant nor does it make members of the public any more confident in the system and its responsiveness and efficiency.

Unfortunately, some of the equally important changes will need changes to the Dentists Act itself before they can be implemented, and that won’t happen any time soon.
But which guy? I haven’t yet had the opportunity to comment upon the election of another dentist (Kevin O’Brien) as the chair of the GDC. It came down to a head-to-head between him, after serving less than two years as an appointed GDC member, and the alternative candidate (Derek Prentice), one of the most experienced lay members of Council.

As it happens, Derek had also been in the final dance-off against Alison Lockyer almost two years ago and had served as the acting chair for the five months or so since her resignation. No doubt he will feel doubly (or perhaps triply) disappointed not to have been endorsed by his Council colleagues for the definitive role. There is actually much that he could have brought to the position.

Having said that, my personal view is still that if ever there was a time when the profession needs to have a dentist in the chair of its regulatory body, this is it. One day the profession might be ready to accept a lay person in the role as chair of its regulatory body, but that moment had not yet arrived, no matter what the credentials of any lay candidate might be. The GDC will have quite enough on its hands while trying to carry the profession along in some of the policy direction that is simmering on the stove. Having a dentist in the chair may just make the difference between persuasion and imposition.

Alison Lockyer was – just like all the other members in the new-style Council – an appointed (albeit professional) member for her final, and ultimately, foreshortened term on the GDC. But significantly, I think, she had also been an elected GDC member for 10 years prior to that, so she was the last in the long line of GDC presidents and (latterly) chairs who the profession itself had put on the Council while the last dying embers of self-regulation were still glowing.

Kevin O’Brien doesn’t share that advantage, but at least his orthodontic background will have served him well if he is able to move the GDC in the right direction without collateral damage to or by adjacent structures.

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