Sir, a recent article1 in the BDJ reported on proposed research into the meaning of 'seriousness' in the assessment of fitness to practise (FtP) cases at the General Dental Council (GDC). The subject arose from the GDC's Moving upstream document2 in which the GDC acknowledged a need to learn how to improve their ability to assess whether a case is serious enough to warrant a full fitness to practise investigation. The article included quotations from the GDC's head of policy and research programme. Apparently, the research will not define seriousness and will not make a list of serious issues in possible FtP cases. Yet it is stated that a 'framework' for guidance and clearer policy for fitness to practise panels will be devised. It said further that this will provide more information that goes beyond the current provision to decision makers in FtP cases.

However, with the refusal to define seriousness and to list possible issues, how will the GDC and the rest of us know what we are talking about? We will not know and I think it follows that the proposed framework will be empty. If, as reported, this really is the basis of the research the 'results' will be meaningless, like trying to tie a knot using water.1

If the people at the GDC who make judgements about seriousness lack knowledge of dentistry, the present poor situation is not surprising. As human beings we make judgements on the basis of analogues or comparisons with that which we have seen or experienced before. If you ask an untrained person to make judgements about things that happen between a patient and a dentist, that person will struggle because they have few comparisons to make. Conversely, a dentist will have had training in dentistry and years of clinical experience to provide a host of relevant situations and comparisons. Judgements made by a dentist would thus be informed and probably more useful and just than those made by an untrained person. Is it not time to employ the obvious resource, ie dentists, to make these judgements?

In a recent unpublished review of the document Moving upstream2 (now submitted to the members of the council of the GDC), I have noted in addition to the above that the problems of the unworkable NHS and the atmosphere of fear dentists endure have been ignored. The GDC offers a continuing state of uncertainty, disquiet and uneasiness for both patients and the dental profession. This prolonged experiment with governance by the unqualified must be terminated soon. Surely it is time to end the torture and install a new governing body?