Kevin Lewis – a smiley white Christmas

veneersAs 2021 draws to a close, Kevin Lewis considers the state of the profession and an end to TV’s most luminous white smile.

You can safely put away your dark glasses. Let us all give thanks for the recently announced decision of Rylan Clark-Neal to cast aside his luminescent white veneers. They have graced (or arguably, disgraced) TV screens for far too long. It is actually only eight years, but it seems so much longer than that – as do the veneers, unfortunately.

I am accepting at face value the reports that they were indeed all veneers – but who knows? Three years after having them fitted Rylan had gone public in saying they were the biggest mistake of his life. One was left to guess whether he was referring to having had so many of his natural teeth irreversibly interfered with at the age of just 25, or to straying off-piste with the choice of shade. The Dulux colour palette would call it something like ‘Ultra Brilliant Dazzling Day-Glo’ white. Martin Kelleher once coined the immortal term ‘Lavatorial White’. This somehow captures the overall visual and artistic experience so much better I think.

From a technical/clinical perspective the veneers were a veritable car crash in almost every respect. While members of the public can laugh (or snigger), members of the dental profession and technicians can only weep with embarrassment. Hardly an advertisement for the best that UK dentistry and technology has to offer, nor for the lifespan of veneers even when one has (allegedly) invested more than £25k to acquire them. Even if Rylan is still looking forward to a white Christmas, it seems destined to be a lot less white than last year.

His original teeth, as far as we can judge from historic photographs taken in his ‘X-factor’ days, were a bit short of space. In fairness his problematic UR2 was pointing vaguely in the direction of a Russian satellite.  few teeth in Rylan’s oral galaxy, it seems, were spared from the spinning air turbine and ensuing whitewash; I hope he enjoys visiting dentists because I foresee a lot of that in his horoscope.

Glitter

The run-up to Christmas would not be complete without a touch of sparkle, glitter and decorations. If you can provide a drumroll or two I can reveal that the votes are in. The Bovine Excrement Award for November was hotly contested and is still steaming and warm to the touch even now.  

In the end the judges were unable to separate Jacob Rees-Mogg from an unnamed spokesperson for the Department of Health and Social Care. I don’t mean ‘separated’ in a literal, physical sense, you understand. The offending DHSC spokesman said: ‘Dental practices have been able to deliver their full range of face-to-face care since June 2020 and thanks to their hard work, urgent care is back to pre-pandemic levels’. 

Note the careful choice of words here, such as ‘urgent’ care rather than all care. Also, ‘the full range’, with no reference to the SOPs since June 2020 nor the ensuing quantity of that face-to-face care which could be delivered – which is what the statement was supposedly about.

Fancy footwork, then, but arguably equalled by the Leader of the House (of Commons), Jacob Rees-Mogg, who having acknowledged that dental care provision was severely impacted by the pandemic and also that this had created a sizeable backlog, went on to claim in Parliament – without any foundation – that ‘the resources are being provided to help with this’. He was referring obliquely, one would be led to assume, to the £6billion autumn budget pledge to help the NHS to reduce waiting lists and catch up generally.  

Eddie Crouch woke up the nation with a polished appearance on breakfast television and in the wider media. He pointed out that not a single penny of this multi-billion pound NHS catch up programme announced by Rishi Sunak has been allocated to primary care dental services in England, let alone to dealing with the backlog. Indeed he suggested that Jacob Rees-Mogg had knowingly misled the House. 

The year started with lockdown and closes with a national crisis regarding access to NHS dentistry. A local protest group launched in East Anglia, Toothless in Suffolk, touched a resonant chord and has sparked a series of bush fires that have coalesced into a national campaign group, Toothless in England. 

The six demands are – in equal measure – admirable, understandable and in cloud-cuckoo-land. For example, the call is for state funding of NHS dentistry to be doubled or possibly trebled (the combined effect of commissioning twice the number of UDAs, removing all dental patients charges forthwith and making UDA values and the contractual terms sufficiently attractive to lure back a lot more dentists who had ceased or reduced NHS provision). Good luck with that – in Suffolk or any other parallel universe.

All wrapped up

The 2021 Kleenex Award for the year’s least lamented adios from UK dentistry was very nearly not awarded this year. It was such a shoo-in that many felt that it wasn’t really a contest at all. But congratulations to Bill Moyes anyway for completing two full terms as GDC Chair – an achievement which had seemed highly improbable at the end of his inglorious first two years in office and the ritual kicking that he (and the GDC generally) had received from its own regulator the PSA, from the High Court (at the hands of the BDA on two separate occasions), and even from the House of Commons and the House of Lords in early 2015. It gave a whole new meaning to the concept of bringing the profession into disrepute.

But it also brought the credibility of the GDC’s research into disrepute at the time. Just seven months after taking office, he expressed the view that patients were misguided. He had no justification for having the high levels of confidence and trust in dentists which had been confirmed by the GDC’s own research. 

He questioned the basis on which they held those views and famously predicted that ‘the exposure of failure will grow’. In that respect he was proved half right. He intended this to refer to the failures of dental professionals, of course. Also, perhaps this meant failures that patients couldn’t see and recognise but he could? 

As things turned out, that clumsy choice of words unwittingly foretold the spectacular denouement of the GDC itself in the months that followed. And all of this on his own watch too.  His rare claim to fame is having united the profession against its own regulator. It continues to be a long, hard road back from that low point.

Lord Toby Harris has recently taken over as GDC chair and we wish him well. It’s not quite a poisoned chalice that he has been handed. However, a vigorous rub-down with a disinfectant wipe or two would not go amiss. A Labour peer from the time of Tony Blair, Lord Harris brings a varied range of background experience. This includes quite a bit of directly relevant experience in and around healthcare and public-facing organisations.  

No doubt he will be mindful of what went so badly wrong in the previous tenure of the position he now occupies. His predecessor had arrived in the wake of the Francis Report on mid-staffs. He believed that his brief was to deliver ‘tougher’, more muscular and more aggressive regulation. What he overlooked in his zeal to that end was the footnote ‘when necessary and appropriate’.

Lord Harris arrives against a very different background. Most notably, an acute undersupply of willing and available healthcare professionals, rock bottom morale amongst NHS dentists and the very real danger of an exodus of highly trained registrants in a post-brexit world where they are no longer in inexhaustible supply.

He has an essential job to do but a proportional, sensitive approach would serve him well at this delicately-poised moment. But as if that were not enough, he has further challenges ahead. We seem destined to enter an era of significant regulatory reforms in healthcare. Also, in healthcare more generally, in the aftermath of the COVID-19 pandemic and all the lessons to be learned from it.

It’s a wrap

So another eventful year draws to its close. I send you my very best wishes for the Christmas period, for the time you spend with family and friends, and for health, success and happiness in the year ahead.


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