Michael Watson’s dentistry blog

Anthony Kilcoyne's appearance on ITV's Daybreak programme last week reinforced my view that this campaign is a hideous mistake. Not because it is critical of the Government and NHS England; they can look after themselves, but because it could well rebound adversely on the profession.

The programme highlighted a survey of 340 dentists, organised by GDPUK, who were self-selecting and who were overwhelmingly dissatisfied with the effect of the NHS contract on the professional practice. The programme extrapolated this to say that 92% of all NHS dentists said the NHS system led to patients having teeth removed rather than saved. And 95% said that they could give their patients the best quality of care for fear of losing funding.

The truth is that there is no NHS system; NHS England does not run NHS dentistry. It contracts the job of running the show to those practices and corporates who have contracts. These get the blame if they fail to deliver a good service for patients.

Such 'outsourcing' is increasingly common in public services, with big companies like Serco, G4S and Capita leading the way. When it goes wrong, as it did with security at the London Olympic Games, it is the contractor, in that case G4S, that is blamed, not the commissioner, in that case London Organising Commitee of the Olympic and Paralympic Games (LOCOG).

In addition it is patently untrue to imply that if a contractor dentist loses funding, they won’t deliver the best quality of care. They receive an annual sum and have to divide it up between patients according to their needs. For them there is no ‘Units of Dental Activity (UDA) value’ which restricts the care they can offer.

For the 80% of dentists who are associates, however, there is a UDA value set and enforced by their practice owners. No doubt some of them have problems treating patients with high needs. But responsibility for this lies with the contractor, not NHS England.

Anthony Kilcoyne may now be receiving the plaudits of his peers for his performance on Daybreak. Will this still be true when the whole campaign unravels, as may well happen. Will he be thanked when the public blame their dentist, not the NHS.

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