Regulation, regulation, regulation. What a pickle.

It seems as if the growing Triffid of red tape is slowly strangling us and preventing us from delivering what we are best at and what our patients want and need: our ability to look after their oral care. The cumbersome bureaucracy over the registration for the Care Quality Commission (CQC) now appears to many to be the last straw.

So, what is the BDA doing about it? A question I have been asked frequently in recent weeks. In so far as each of us who is a BDA member is technically 'the BDA' then we all need to do something about it as well as our elected representatives and the staff at the London and Regional offices. Regrettable as we may see it, the CQC was established through legislation that was passed under the previous government and has jurisdiction over all healthcare, not only dentistry. If we consider ourselves part of healthcare then we have to also accept that there are rules which go with that role. However, this should not prevent us from engaging in protection of what we consider to be our own particular role in patient care and in attempting to persuade those in power that perhaps their view of what is best may not, in reality, be the best.

Postcard campaign to MPs

To this end, the BDA is engaged in a vigorous lobby of parliament to get three changes: to simplify the arrangements for the CQC to register dental practices, ensuring that the functions it performs do not duplicate those carried out elsewhere; to ensure that the fee for dental practices' registration with CQC is set at a reasonable level so it does not compromise the ability to invest in practices; and to delay the deadline for registration to allow time for these issues to be properly addressed. Sir Paul Beresford, a general dental practitioner and Conservative MP for Mole Valley took up the campaign in a House of Commons debate on 29 November 2010. In this, Health Minister Simon Burns urged dentists to lobby the CQC to make their concerns known and stated that the Commission's final fees scheme is subject to the consent of the Secretary of State for Health.

Additionally, every BDA member in England will have received details in the December issue of bdanews of the postcard to MPs campaign. If we are to make any progress on this collectively then we have to act individually as well. Complete and mail the postcard to your MP; thousands of postcards arriving in Westminster will, genuinely, have a huge effect. Plus, as stated here previously on other topics, every MP (well, probably most!) will visit a dentist. Is it you? If it is, then tell them directly what you think and about the difficulties the practice is facing.

Other actions have been suggested. A march of a thousand dentists on Parliament was one of the more fanciful suggestions. How would the press report such an event? Recent stories have continued to spread the perception, however much they have lacked accuracy, that we are well paid enough as it is and a column of dentists with placards complaining about some further bureaucracy that was intended to protect patient safety would not, I think, be an effective message.

On a more practical note, and to help raise patient awareness a line item on the professional fee note, for those of us who have the option, may be worth a punt, keeping in mind that under the NHS costs will have to be borne within practice expenses. Something like, 'mandatory government administration fee' might fit the bill and in answer to the patient's query comes the full explanation of why the Commission is intervening in the relationship between patient and dentist. Is there a precedent for such charges? Check your next airline ticket, it will almost certainly have costs additional to the actual flight such as tax, fuel surcharges, an extra security element but as travellers we sigh and accept it as just part of life. I think it might be worth a try.

These are all transitory measures but what we clearly need is a much more joined up approach to standards across all areas of dental practise and a thorough review of exactly where a profession sits in the UK society of the twenty-first century, perhaps a GDCQC. The Opinion piece in this issue by the Chair of the General Dental Council (GDC), Alison Lockyer, whilst explaining the modus operandi of the Council, serves only to make the organisation look increasingly remote. It emphasises once more the abrupt divergence away from any form of co-operative engagement with the profession in support of protecting patients and in doing so, creates alienation which will inevitably undermine the GDC's own lofty pretentions.

There comes a point at which this laudable, as it might seem to an outsider, and logical, as it might seem to a legislator, but endless regulation becomes burdensome and stultifying to those who have to operate within the system. It is also irksome to constantly have our trustworthiness questioned when our patients' trust in us is so continuously, robustly and demonstrably high.