Michael Watson starts a new series of columns for Dentistry magazine in which he answers a question on the lips of many dentists…

Dentists ask: ‘What are the government’s intentions for NHS dentistry? Surely in five years time it will all be private for the majority of people?’

The reply you will get from the chief dental officer (CDO) for England, Barry Cockcroft, to this question will be quite unequivocal. As he did at the BDA Conference in Manchester this year, he will point to the number of practices he has personally opened, all of which are state of the art, rather than ‘cheap and cheerful’.

He also said at that meeting that spending on NHS dentistry had gone up by £1 billion a year since 2003. That, he will tell you, is a measure of the government’s commitment to NHS dentistry. He was recently quoted in the House of Lords as saying that ‘all the basics are there now to deliver a really functioning fully comprehensive NHS dental service for anybody who needs it’.

It is easy to dismiss this as spin whether it comes from the CDO or a minister. But one does need to ask whether any government would have gone through all the flak that inevitably accompanies change if they were going to walk away from NHS dentistry. It is some 20 years since the then Conservative Government effectively pushed optical services into the private sector.
It is a mystery to many of us why governments of all persuasions, over 60 years, have insisted on keeping this rod for their own backs in the form of NHS dentistry.

The answer must be that they perceive the criticism they would come under for withdrawing dentistry from the NHS as politically unacceptable.
Brand-NHS is one of the strongest in the UK. It can survive dirty hospitals, GPs cutting their hours and lack of access to NHS dentistry. So strong is the NHS brand that it seems no politician can be seen to knock it. One of the first acts of David Cameron, after his election as Conservative leader, was to pledge his party to the NHS and they now put themselves forward as ‘the party of the NHS’, in contrast to the Labour Party, who are deemed to have now failed the service.
Whether we like it or not, it is premature to report the demise of NHS dentistry. There is no reason, however, why it should not co-exist with a thriving private sector.

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