Regulators and regulations: who will guard the guards? (or ‘quis custodiet ipsos custodes’ as old juvenal used to say)

In the UK, we have reached a seriously worrying point in healthcare generally, but in dentistry in particular. Amongst many other problems, various supposed ‘authorities’ have grabbed, or been given, so much power that they are now regarded with awe and fear by many dentists or members of their teams. A possibly unintended but understandable consequence of that perception is that many dental professionals now think that their first duty of care in dealing with difficult, sometimes urgent, clinical problems is to stay within these often mutually conflicting guidelines or ‘regulations’.

There is now a sort of tacitly accepted ‘ménage a trois’ going on in UK dentistry involving the patient, the dental team and one of the regulators, such as the GDC or the CQC.

The net effect of these quietly dubious arrangements is that many dentists are now trying to serve at least three ‘governors’. These are in the ‘patient's best interests’ while simultaneously trying to appease the often conflicting expressed, or implied, interests of different UK ‘regulators’. To this complex mix one ought to add various financial pressures, organizational and ownership changes, as well as complicating social shifts and different demand factors.