Tariq Drabu Expresses Reservations on GDC Direct Access Decision

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Tariq Drabu says “The removal of the dentist as a team leader will lead to a reduction in quality for patients.”

Tariq Drabu

Tariq Drabu

Up until a few years ago the practice of dentistry was restricted to a small group, namely those doctors and dentists that were registered with the relevant regulatory bodies

Tariq Drabu leading Manchester dentist and specialist oral surgery provider has today expressed his concern at the recent decision by the General Dental Council (GDC) to remove its barrier to Direct Access by the general public for some dental care professionals. Up until now every member of the dental team had to work on the prescription of a dentist which meant that patients had to be seen by a dentist before being treated by any other member of the dental team. The GDC press release is here.

Commenting on the changes Tariq Drabu said “up until a few years ago the practice of dentistry was restricted to a small group, namely those doctors and dentists that were registered with the relevant regulatory bodies. Therefore it was limited and restricted as to who could practice dentistry; this was backed up by legal sanction if a non-registrant was found to be practising. In 2006 registration became compulsory for a further group of practising colleagues namely dental nurses, dental technicians, orthodontic therapists and clinical dental technicians – known as dental care professionals (DCPs). Therefore since 2006 the practice of dentistry has been redefined as being performed by these particular groups. However up until now each group has had its own parameters as to what it can and cannot do in terms of the practice of dentistry and that is known as the ‘scope of practice.’ Up until now it was a requirement in almost every case for a patient to see a dentist in the first instance and for the dental care professional to be working under the prescription of a dentist. So for example a dental hygienist could administer gum treatment to a patient on the prescription of a dentist as part of an overall treatment plan. Pretty much the only exception to this protocol is for the construction of complete dentures by a clinical dental technician.”

Commenting further Tariq Drabu said “the introduction of Direct Access means that any member of the general public will have access to any member of the dental team without first referring to a dentist. This was one of the recommendations of a recent report to dentistry last year by the Office of Fair Trading. Many in the dental profession that the report was very one sided and made very far-reaching conclusions on the basis of some very flimsy statistical evidence particularly by extrapolating data. These far-reaching conclusions were then pounced upon by the media as the headlines and much of what is positive in the report about dentists and dentistry was overlooked. However whether we like it or not the OFT report was supported by the government and therefore it was inevitable that direct access would become the norm. Therefore I guess the question that we all have to ask ourselves will be ‘does seeing a dentist in the first instance increase the protection of the public or is it actually a restriction of practice?’ If you read the dental press you will see that the GDC is seen in a very poor light by the majority of dentists who are at best suspicious of its motives and actions. It has also been recently criticised by the healthcare watchdog the CHRE.”

Tariq Drabu highlighted his reservations about the decision of the GDC which many dentists have. He said “The purpose of the GDC is to be there to protect patients. I support the position of the British Dental Association that the removal of the dentist as a team leader will inevitably lead to a reduction in quality because only the dentist has the training to provide a comprehensive oral health assessment and then formulate a treatment plan to provide patients with an appropriate choice of the full range of treatment available to them. With this new decision dental hygienists and dental therapists can carry out their full scope of practice without a dentist’s prescription and without the patient having to see a dentist first and dental nurses can participate in preventative programmes without the patient having to see a dentist first. Cost is of course a factor but it should not be the overriding principle – however for some people it will be an opportunity to try and shop around for something cheaper than a visit to the dentist.”

Tariq Drabu pointed to his own team at Langley Dental Practice as an example of team development. He said “here at Langley Dental Practice we have dental nurses who are trained to apply fluoride to patients and also take x rays. However this is under the prescription of a dentist as part of an overall treatment plan. I believe in developing every member of the dental team to their full potential and for career development in dentistry to be seen in the context of a process of lifelong learning and improvement but I believe that direct access even with all its current caveats will in the long term undermine patient safety.”

http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/Patient-safety-at-the-heart-of-decision-over-Direct-Access.aspx

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