Hospital orthodontist warned over “misconduct”

Tuesday 25 February 2020

Jersey hospital’s senior orthodontist has been handed a ‘warning’ by his professional body after a patient accused him of “misconduct”, it has emerged.

Bruce Skinner was handed the reprimand by the General Dental Council (GDC) after one of his patients accused him of “not providing an adequate standard of care and failing to obtain informed consent for orthodontic treatment” between 2014 and 2019.

Mr Skinner - who, the Government have confirmed, has retained his post in the Health department - will still be able to practice following the reprimand, but the warning constitutes a 'black mark' against him on the professional register.

The GDC did not consider the complaint serious enough to warrant a public hearing, but it felt it needed to issue Mr Skinner with a warning to ensure “that a message is sent to [him] and to the wider profession regarding the importance of maintaining appropriate standards".

Pictured: The GDC have issued Mr Skinner a formal 'warning' over the allegations of "misconduct".

In their public judgment, the GDC case examiners found “there was evidence to suggest that [Mr Skinner’s] overall conduct had fallen below the standards expected to a degree, warranting a formal response from the General Dental Council (GDC)".

They then issued the formal warning to the dentist, who has been registered to practice since 1979, on the following grounds: 

• that failing to “undertake and document a full assessment of a patient’s dental condition” can affect a clinician’s ability ”to identify and appropriately treat all presenting conditions of the patient”;
• that failing to “ensure that sufficient treatment planning is carried out, particularly when embarking on complex orthodontic treatment, can have adverse effects and may result in inadequate care as well as significant impact upon patients”;
• that the same is true for a “failure to justify, grade and report on radiographs” and this “departs from accepted standards”;
• that a “failure to fully discuss treatment options, risks and benefits undermines patient choice”;
• and a “failure to obtain and record valid informed consent can have serious effects on the individual patient, and on the wider trust and public confidence in the profession. [Mr Skinner] must ensure that he obtains fully informed consent prior to carrying out any procedures, and this should be documented. He must ensure that he adequately communicates treatment plans to patients and confirms they fully understand them before embarking on treatment.”

The warning will remain published from 7 January until 6 October this year, but Mr Skinner may have to disclose it beyond these dates as part of his “fitness to practice” record.

A HCS spokesperson said: “Health and Community Services will not comment in detail about an individual staff member, as we have duty of care to that person, but the department can confirm that Mr Skinner was not suspended as a result of the reprimand and continues to be employed by Health and Community Services.

“As with all health care professionals employed by Health and Community Services, when there are potential issues identified and that matter is referred to their professional body, HCS will work with the individual and the professional body to ensure that the matter is dealt with appropriately."

The news comes as Jersey's free orthodontic service at the hospital continues to suffer challenges with its waiting lists.

Pictured: Jersey's free orthodontic service continues to suffer challenges with its waiting lists.

Express revealed nearly three years ago in 2017 how parents were spending thousands on private dental care for their children as some faced waits of up to five years for treatment.

Later in the year, the government blamed recruitment struggles when a Freedom of Information (FOI) request uncovered that waiting times had hit their highest level in half a decade.

At the time, Health officials said they were looking at a number of initiatives to alleviate the situation, including an investment proposal to recruit more staff in 2018 or contracting the work to private dentists to meet demand.

However, waiting times for treatment remained high last year amid continuing difficulties in attracting another full-time orthodontist to the island.

Advertisements for a Consultant Orthodontist in Jersey, carrying a salary of £88,000 to £159,000, were posted at the tail-end of last year just prior to Mr Skinner’s formal ‘warning’ taking effect at the beginning of January.

More recently, parents have reported that their children’s long-awaited orthodontic appointments have been cancelled with no indication of when they will be rescheduled.

Pictured: Parents have reported that their children's long-awaited orthodontic appointments have been cancelled with no reschedule date.

One father, Paul Bisson, told Express that his eight-year-old son had been waiting “several months” to have his brace fitted – only to be told yesterday (Monday 24 February) that the March appointment was cancelled. 

Mr Bisson said that the hospital even advised him to go private instead of waiting for another appointment. 

“His March appointment was cancelled this morning by phone, with no rebooking offered and the suggestion made that we seek private treatment instead.

"This is surely terrible news for Jersey schoolchildren, the majority of whom have relied on free orthodontic services in the past.”

Of this, the spokesperson for Health confirmed plans to recruit: "Due to the ongoing demand for dental appointments two part-time Locum Consultant Orthodontists have recently been engaged to help run Jersey General Hospital’s orthodontist service. Unfortunately, this has led to some appointments having to be rescheduled to the weekends. From April 2020 we will be increasing our Orthodontist establishment to provide increased continuity, with the aim to reduce current waiting list times.”