Two years ago, a bit like anything the General Dental Council does lately, our oil-fuelled central heating boiler was condemned.

It was old and tired, was wasting money and was basically unsafe – yes, am still talking about the boiler, but, you know, there are parallels there.

Anyway, we had no choice but to renew the boiler and since gas has relatively recently come to our neck of the woods, we decided to take the opportunity to  forsake oil and get rid of the eyesore of a tank in the back garden. I always thought that other than the Great Wall of China, our oil tank was the only other structure you could see from space.

On my wife’s recommendation, we got Dan (‘twas not his name) the gas engineer who usually serviced our boiler, to do the installation and source the combination boiler. Dan had previously been reliable with his servicing, although he had never performed any major work in our bungalow.

Over four days he carried out the installation and it appeared to be functioning normally on completion. The only slightly worrying thing he said was that if the boiler started to lose pressure, it meant our pipework was leaking.

He then started work on removing the oil tank, but in doing so, spilled a LOT of oil on our drive and lawn, which over a couple of days caused the recently tarmacked drive to bubble up so it was unusable. Over ten days, much of our lawn died as the oil spread under the soil.

He immediately offered to fix the drive and lawn and we had the drive paved and new turf put down within a few weeks, courtesy of his insurers.

Within a few days of him signing off the installation, we had a call from the Gas Safe Register people, asking us if we wanted a free gas safety check, to ensure everything was ok with the installation. The representative on the phone said not everyone was offered a check, but we were chosen ‘randomly.’

We decided to go with the check after the problem with the drive, and sure enough, the two inspectors who came to the house found a ‘few’ problems that would have to be addressed.  They advised that Dan would have to be approached and told us the work would have to be done free.

When Dan came to the house, he wasn’t best pleased.  He had the pent-up rage of a criminal who had just come face-to-face with the nark who had grassed on him.

As I usually did, I backed my car off the drive so he could get his van on, when I scraped his front bumper with my car – basically because I wasn’t looking.  Also, the radio was blasting out loudly and I hadn’t even noticed I’d done it, till he pointed it out in rage after I got out the car.

While I was finding out my car insurance information, he ‘fixed’ the problems and went away.

The following morning, the water pressure had dropped, and we found he hadn’t connected the bendy pipe up after he finished the work, so we couldn’t top the water pressure up. A DIY job sorted it.

A few weeks ago, we had water from the loft leaking down and ruining the living-room ceiling and part of a wall.  A new (highly-recommended) gas engineer came to fix the leak from the boiler and found that Dan hadn’t connected the overflow pipe up properly as he should have done. He’d merely put sealer in to make up the deficiency when two ill-matched pipes didn’t fit anywhere near adequately enough.

We have just put our living room back together again after having to get professional decorators in to fix the plasterwork and paint it.

Now, Dan did a lot of damage with that one installation and the decorating and  repairs cost us a not insignificant amount of money.

But did I go to a solicitor to get compensation, or the Gas Safe people, to threaten his livelihood?

No.

Despair

Having been a member of a dental profession that I have, with despair, watched losing its confidence over the past few years as a result of increasing litigation from avaricious lawyers and a seemingly out-of-control GDC, I wasn’t going to inflict retribution on a previously reliable gas boiler specialist who happened to have an off day (or several days).

I hear from young dentists all the time that they are scared to carry out certain procedures because of the fear of something going wrong and end up being sued or reported to the GDC.  I even heard of one very experienced GDP recently who had decided to give up carrying out any RCT, for the same reason.

Unnerving Development

So I was chilled to the bone when I read this week about the dentist in Wales who is being held vicariously responsible for work carried out by associates, two decades after he retired from the profession.

The dentist hung on to his practice for a few years after his retirement and held an NHS contract, which his associates provided the work for. He eventually sold the practice.

A patient has brought an action against him, with her lawyers asserting the former owner was vicariously responsible for the work of his associates.  It’s not clear why action was taken against the boss and not the associates, bearing in mind they have their own performer numbers and (presumably) individual indemnity cover.

Anyway, the case has struck a chord with practice owners everywhere – that chord being ‘fear.’ 

It opens up the question as to whether patients and their voracious dental litigation lawyers can have a crack at doubling their money in compensation claims for dental mishaps.  And yes, I AM calling them mishaps.  All people have off days, just like Dan.

There was a fair amount of chatter on social media about this case after it was highlighted on the BDA News website and GDPUK.  The full horror that you could actually face litigation twenty years after retiring, for work you hadn’t actually carried out yourself, appeared to hit people very hard.

What really made me shiver, and frankly horrified and disappointed me in equal measure, was this statement I read in the court documents, written by (presumably) a dentist. This is verbatim.

“I will write an x ray report and send to you over the weekend…the bridge is crap and has been since it was placed if I was her and wanted implants, she should sue the dentist who did the bridge…give her number for Dental Law Partnership when you see her…but you can’t have the work done until the case is settled.”

 Sends a shudder down your spine, doesn’t it? I mean - APART from the appallingly bad grammar and colourful language.

Did those words in that email have any bearing on the Claimant’s decision to go to law? Well, yes. Those words, according to the court document “explains how the Claimant first came to instruct solicitors and thereafter commence proceedings.”

The Good Old Days

When I was in training, were told a number of times that it was actually unprofessional to disparage another dental professional’s work.  I took that on board wholeheartedly, and other than giving my opinion privately to other colleagues when they had a clinical problem with a new patient with existing problems, my views were never aired publicly or to the authorities.

Now that may be wrong in the eyes of some, but I am old school.

I’m not talking ‘covering up’ when someone is frankly dangerous or grossly and wilfully negligent.

But I do think it’s beyond the pale when dentists instil in patients the idea that they should either sue or report a dental professional to the authorities when that person has made a mistake.

Some years ago, I took on a new associate in my practice.  He was someone I knew in my early years after qualification.  Although we were roughly the same age, he had ten years more experience than me (since I started in dentistry very late).

John (‘twas not his name) was very kind to me and helpful when I was starting out, and jumped in to help without hesitation, whenever I got into difficulties.

So when I heard John had lost his associateship in unfortunate circumstances, I approached him to fill a vacancy that had just come up.

It was nice having him around, but then I began to become a little uncomfortable with some of the work he was producing and verbal complaints from patients.  There was nothing serious, but there was a pattern developing.

I wasn’t at all easy with the idea of addressing the problems that had come to my attention, but eventually, I had to go and speak to him privately, outside the practice.

The time had come to have a ‘quiet word’ with John.

I remember going to his house at his invitation, one Bank Holiday weekend.  I found it incredibly stressful, but I gently outlined my concerns.  His wife was there to comfort him.

My friend found it incredibly hard to take, but he appeared to take my words on board.  I told him that since more and more litigation was being launched  against practitioners, he needed to make his practice ‘water-tight.’ 

Like me, he had been of the ‘Exam. NTR’ generation and he was leaving himself open to an indefensible way of practising if any of the solicitor-vultures got hold of him.

As it happened, external forces intervened, and he retired early rather than cooperate with enforced retraining. But as I saw it, he had taken control of his own destiny and I escaped the potential lifelong guilt of having  thrown him to the wolves. He was a good and caring bloke, and didn’t deserve litigation or GDC hearings.

But when did dental professionals join in with the urge to lynch fellow members of the profession?

I know full well that the recent Welsh case isn’t an isolated incident.  I understand that many cases the GDC hears have their roots in matters brought to their attention by fellow dental professionals.  I know from bitter personal experience that in some cases, the motive is pure spite.

When I was at the corporate after I sold my own practice, I freely admit that I was knocked into shape notes-wise by an incredible head nurse who showed me where I was lacking and where I too could become ‘water-tight.’

And that’s where, it appears to me, everyone needs to be scrupulous in their own practise.  After the Welsh case this week, practice owners will also have to keep a closer watch on their associate and assistant colleagues to ensure they don’t get unnecessarily dragged into a court case or hearing.

A couple of years before I finally retired, I was confronted by a patient demanding a second opinion on work carried out by a dentist from a neighbouring town.  The patient made it clear that her intention was to ‘report’ her dentist to the GDC.  She also told me she was going to confront her dentist before doing so.

I didn’t know the dentist, but I rang him and told him of the consultation. In other words, I had a ‘quiet word’ with him.  Forearmed, he had a plan of action before she saw him and resolved the problems before it got out of hand he had to endure an  unpleasant  experience.

He later rang and thanked me – he admitted he’d had a narrow escape and said “I need to pull my socks up.”

Yes, I am a Line of Duty obsessive, but to use the programme’s terminology, there’s absolutely no need to be a rat or a CHIS.

Just have a quiet word. 

That way, your conscience will be water-tight.