The Central Services Agency (CSA) undertook part of the investigation into the performance of George Bruce Kelso on behalf of the Eastern Health and Social Services Board (EHSSB). Initially this involved analysis of Mr. Kelso’s pattern of dental treatment and calling in patient record cards and radiographs. Following the decision of the police in 2002 to discontinue their investigation into Mr. Kelso, the CSA assisted the EHSSB by compiling all the available records, reports, correspondence, claims and radiographs into a single master file in electronic format. This was a substantial task which was performed to a high standard. This master file was submitted to the General Dental Council (GDC) in June 2004 by the EHSSB. The Chairman of the Professional Conduct Committee of the GDC, while passing judgment on Mr. Kelso, stated ‘the standard of evidence from the CSA was clear and detailed’.
Following the erasure of dentist George Bruce Kelso from the dental register for serious professional misconduct, the Department has reviewed the management of the investigatory process into Mr. Kelso’s conduct. The Department will shortly be issuing guidance to Health and Social Services Boards which will apply the lessons learnt from this case. The Department is also developing guidance for dealing with underperforming doctors and dentists and this should be available in the new year. In addition, legislative changes in 2007 will provide Health and Social Services Boards with increased powers of suspension for independent practitioners. Given the measures outlined above, I do not feel it is appropriate to conduct an independent review into this case.
There is a robust framework of checks in place for all health service dental practices. The Referral Dental Service based in the DHSSPS undertakes post treatment dental examinations on a random sample of health service claims. Health Boards undertake inspections of health service dental practices in their area to ensure compliance with health and safety and other regulatory requirements. The Central Services Agency (CSA) undertakes pre-treatment checks on proposed courses of treatment which are in excess of the prior approval limit (currently £384). The CSA also generate practice profiles of all health service practices on a quarterly basis which outline individual practitioner’s treatment prescribing patterns and bench mark these against local and regional averages. Since 2005, Health Boards have undertaken probity checks of a random sample of claims from all health service dentists. The practice at 14 The Square, Portaferry would have been included in those checks which were available during the years in which it operated health service dentistry (June 1995 to January 2001).
Central Services Agency records indicate that Mr. Kelso had the following numbers of patients registered across three practice addresses:
Number of patients 2001 2,869 patients registered (Portaferry1 24 patients; Greyabbey 1,063 patients; Newtownards 1,782) 2002 2,729 patients registered (Greyabbey 997; Newtownards 1,732) 2003 3,718 patients registered (Greyabbey 882; Newtownards 2,836) 2004 2,576 patients registered (Greyabbey 763; Newtownards 1,813) 2005 2,308 patients registered (Greyabbey 688; Newtownards 1,620) 1 Portaferry practice closed in January 2001
Number of patients
2,869 patients registered (Portaferry1 24 patients; Greyabbey 1,063 patients; Newtownards 1,782)
2,729 patients registered (Greyabbey 997; Newtownards 1,732)
3,718 patients registered (Greyabbey 882; Newtownards 2,836)
2,576 patients registered (Greyabbey 763; Newtownards 1,813)
2,308 patients registered (Greyabbey 688; Newtownards 1,620)
1 Portaferry practice closed in January 2001
Records of complaints against general dental practitioners are held by the relevant health and social services board, in Mr. Kelso's case this is the Eastern Health and Social Services Board (EHSSB). The EHSSB does not hold records of complaints about general dental practitioners prior to 1991. The records show that there was a total of six complaints received by the EHSSB about Mr. Kelso:
two complaints in 2000
two complaints in 2001
one complaint in 2003
one complaint in 2004.
Departmental records indicate that the then Chief Dental Officer would have been aware of the concerns about Mr. Kelso in early 1999 following the findings from a series of post treatment examinations undertaken by the Referral Dental Service. Following this, in accordance with procedure, the case was referred to the Eastern Health and Social Services Board (EHSSB), in its role as commissioner of this practitioner, to further manage. The EHSSB then utilised the Referral Dental Service based at the Department to undertake targeted examinations of Mr Kelso’s dental treatment.