GDC Blog Comments on Suicides
- Details
- Published: Thursday, 04 April 2024 09:39
- Written by Peter Ingle
- Hits: 1695
It has been a turbulent few months at the GDC. Challenges have included: high level departures, continued pressure over its failed Fitness to Practice (FTP) process, including from its own regulator, and increased awareness of its reluctance to admit the numbers of registrants that have committed suicide during FTP. Despite this, things have recently got worse for the regulator.
A Coroner has taken the step of sending the GDC a Regulation 28 ‘Report to prevent future deaths.’.
The GDC were obliged to respond to this. The GDC letter, sent to the Coroner a day before the deadline, is now in the public domain and has come under some scrutiny, including on GDPUK. An employment lawyer familiar with the GDC offered their two sentence summary of the four page letter: “We didn’t do anything wrong and anything we did do wrong is the fault of the legislation. But we’ll do a review just to confirm we did nothing wrong.”
This may have contributed to the GDC breaking its prolonged silence on the issue.
The GDC website now has a blog published, by their Executive Director, Strategy, Stefan Czerniawski. As one of the remaining two established members of the Executive Team, he represents the very top of the organisation.
The title “Transparency, trust and improving the fitness to practise process” raises expectations of a serious piece. It begins with a brief, “We know that Fitness to Practise (FTP) is a stressful and difficult process.” This is followed by the assertion that the GDC seeks to minimise stress and anxiety for, “the small number of dental professionals who are involved in an investigation,” and that those registrants are, “supported by us and others and that their wellbeing and mental health is a priority.”
That Mr Czerniawski felt able to write this despite the fact that the Coroner’s report was centred on the GDC’s failures in this very area, is troubling. He continues: “There are two important issues that we’d like to explain at this point: the level of detail published from Interim Orders Committee (IOC) hearings, and how we plan to report deaths during an FTP investigation.”
In a moment of insight he then added: “Overriding both of these are issues of transparency and trust, which I’ll return to later in this update.”
The next section was about the level of detail published from IOC hearings, which was the key concern expressed by the Coroner. She had suggested that this was not necessary and that change was required, bluntly stating that, “In my opinion action should be taken to prevent future deaths and I believe you, the General Dental Council, have the power to take such action.”
For the first time since its arrival at the GDC, five months previously, the Coroner’s report was openly acknowledged by the regulator in this communication by Mr Czerniawski. He then repeated the points that the GDC had made to the coroner in its reply. These can be summarised as: a review was under way, protecting the public, engaging with chairs of FTP committees, engaging with other named healthcare regulators – although the GMC was not mentioned here. The review recommendations would be “reviewed by the Registrar in the coming months, before a decision is made on any changes.” The registrar is the other well established member of the Executive team.
The blog was an edited version of the letter sent to the coroner, although it did not include the familiar protestation that legislation limited the GDC in its actions, and would be required in the event that the review process concluded that changes should be made.
Mr Czerniawski then moved to a further stain on the GDC’s character, or as he described it, “Reporting causes of death during FTP investigations.” GDPUK readers unfamiliar with this miserable story may wish to read this from May 2023, but to summarise, after failing to reveal how many dentists have taken their lives while involved in FTP proceedings, then promising to publish the data within 6 months, and then saying that they could not meet their own deadline, the GDC have gone silent on the subject, batting away any enquiries.
Mr Czerniawski says that in future the GDC will publish data about deaths during FTP in line with the established GMC approach. In regard to the long overdue figures he writes: “We have further work to do to bring together a report that covers the period 2019 to 2022, which we will publish in 2024.” This will in all likelihood mean a two year delay after the GDC originally said it would produce the data. It is believed that there are a total of 16 relevant cases in this period for the GDC to analyse.
Future reports covering periods of three years, will be published “no sooner than two years” after the period ends. This is to: “allow time for the cause of death to be formally recorded and for the certificates and conclusions to be gathered and analysed.” It is no doubt an entirely unintended consequence of this timing, that some years after the events the information will be far less newsworthy, and less likely to tarnish the GDC’s reputation.
There is a paragraph headed “Reducing stress in the FTP process.” It contains little that is new or of substance.
Lastly, comes a section headed, “Transparency is important to building trust.” Mr Czerniawski begins: “We know that many dental professionals are not confident that that balance is set in a way which is fair to them.” His solution appears to be to educate the misinformed registrants, “so it’s important that we do what we can to explain why the system works as it does and to be clear about the steps we are taking to improve it.”
This is followed by another moment of insight: “If the process – and the regulator – are not trusted, that in itself can create a risk to patient care through defensive practice and as a result of adding to the stress of already stressful work.”
The final paragraph is somewhat puzzling: “The Samaritans give clear guidance that assumptions must not be drawn between circumstances and cause of death due to suicide and that reporting must be sensitive to the subject. We would ask all dental professionals and interested parties to act in accordance with this guidance.”
It is not clear if this is a rebuke to the Coroner, for having the temerity to suggest that the GDC’s behaviour might have contributed to a registrant’s death, or those who dare to question the Council’s performance?
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