Colonel Watson blog – 12 December

BDA politician John Milne spoke on 6 December at the local dental committees officials’ day. He revealed a tough side both to his character and his dealings with the government. I have, for many years, said we should not underestimate the determination of this Yorkshireman to get his own way.

‘Speak softly, but carry a big stick’ was the motto adopted 100 years ago by US president, Theodore Roosevelt. John speaks softly, but does he carry a big stick? In a BDA press release Dr Milne said: ‘We are nearing the time when we must focus on the detail of what new arrangements must deliver.’

According to him the reforms must ensure that practices are viable and stable, that patients can get the care they need and that we have a strong foundation for our mission to improve England’s oral health. He pledged that the BDA’s General Dental Practice Committee (GDPC), which he chairs, must continue to press hard for the reforms to meet these criteria.

‘Government must continue to engage constructively with the profession as the dialogue enters a more detailed and potentially more difficult phase,’ he added. As an aside, I do wish that the BDA would let its officers speak publically in the same clear English as they use in private. Nevertheless the message from John is clear. The GDPC has its ‘red lines’ that it will not let the Department of Health cross.

Big stick or compromise?

But does he have a big stick? The ‘new’ contract will be presented as a variation of the old. So contract holders will have the choice of carrying on with whatever is offered or hand their contracts over to the competition who will gratefully take them up. The 80% of dentists who are associates will have no choice but to live under the new arrangements if they want to keep a job.

Not much leverage for there for John. Although he may not have a big stick, he has some clout. The government is anxious that this reform is accepted by the profession, unlike the situation in 2006. The minister for dentistry says so every time he opens his mouth. NHS England will need the support of the GDPC is making the transition to the new arrangements.

My personal plea

But my personal plea to John is not to forget the four out of five dentists who will not be affected directly by the changes, as they do not hold an NHS contract, but could well be worse off both in terms of remuneration and conditions of service.

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