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Dentists Act 1984 (Amendment) Order 2005

My Lords, this order is welcome and I am grateful to the Minister for setting out its meaning and effect so clearly. The General Dental Council exists to promote high standards of professional practice and to protect the public. The changes that the order makes to the structures and procedures of the council will, I am sure, be conducive to those ends. Especially welcome are the provisions relating to the new patients’ complaints scheme and those that establish for the first time mandatory insurance or indemnity cover for dentists and dental care professionals. On that issue, I am aware that there are differing views about whether a contract of insurance from a commercial provider is preferable to an indemnity from a mutual, not-for-profit organisation. I have discussed the issues extensively with representatives from both camps. My conclusion, with which I hope that the Minister will agree, is that there are advantages to both approaches but that, provided the mutual has prudent levels of reserves, the suggestion that a discretionary indemnity arrangement is inappropriate or unsafe for dentists and patients is misplaced. Indeed, there are respects in which a discretionary indemnity can be more responsive and flexible than a contract of insurance. The Minister will know that dentists have voiced concern about three main issues. The first relates to erasure from the dentists’ register. Article 17 states that when erasure takes place, it must be for a minimum term of five years. The immediate question that arises from that is why the Government feel it necessary to be so prescriptive. If we believe in the principle of self-regulation for the dental profession, why should not the council have discretion to apply whatever term of erasure it deems appropriate to a particular case? The Government’s answer appears to be that there must be consistency across all the medical professions. Doctors and nurses, for example, are subject to an identical minimum term of erasure. The difficulty with that argument of symmetry is that, at least in one respect, dentists are not like the other self-regulated professionals. To be a proficient dentist, you absolutely have to keep your hand in. That means more than just maintaining your level of theoretical knowledge; it means crucially maintaining manual dexterity and practising the techniques of dentistry. If dentists do not use their skills, they lose them pretty rapidly. To erase a dentist from the register for five years would be equivalent to erasing him for the rest of his life, in practical terms. It would be virtually impossible for him to reskill. We need to ask whether that is fair or right. The order cannot be amended today, of course, but I hope that the Minister will agree to sit down with the representatives of the profession and talk the issue through further. To be saying, in effect, that a rule is a rule is to avoid the real argument. Article 25 has given rise to another worry. When an allegation against a dentist is received and referred to the investigating committee, certain people have to be informed straight away. If a health body is informed, an alert letter may have to be issued. One can see why that requirement should have been thought necessary. After all, we are dealing with the protection of the public—no one questions that. But what if the allegation were malicious or otherwise poorly founded? What if the committee looked at the allegation and quickly decided that there was no case to answer? If employers and others have already been notified that there is a question mark hanging over the dentist’s good name, the damage will in part have been done. I therefore think that we need to know that the GDC will refer to the investigating committee only those cases that it believes have potentially serious implications for the dentist’s fitness to practise. In other words, the GDC should make sure that some preliminary sifting takes place to separate the more serious allegations from the less serious ones. The third main area of concern relates to Article 39 and the provisions surrounding dental bodies corporate. The worry there is that, as drafted, the measures do not represent adequate protection for the public, because they do not include a robust regulatory mechanism. There is a power to investigate and fine a body corporate or director for various misdemeanours, but where a body corporate has acted wrongly but not in a manner serious enough to require erasure, there ought to be a power open to the GDC to take action in cases that might lead to suspension or the imposition of conditions. Equally, there is no power for the GDC to issue guidance to dental bodies corporate. Nor is it clear what information the GDC can require a body corporate to supply to it whereby it can be effectively regulated. Will the Minister reconsider those issues?