Neel Kothari explains why NHS dentistry needs more than just money if it is to work.
Whilst there is no doubt that years of below inflation pay rises has left NHS dentistry in a precarious position, in my opinion the issues extend far beyond funding and cannot be fixed with money alone.
Whilst we can analyse the system from many different angles, there is one perspective that I would like to explore in this article, which is whether NHS dentistry is still fun.
This may seem like a rather puerile angle, but when I speak to NHS dentists, nurses, receptionists, etc, a central theme begins to emerge which is that for many – they simply don’t enjoy working in the NHS or feel that it offers them a chance at doing meaningful work.
Why is this important? Well, recent research published by Marcus Buckingford in the Harvard Business Review informs us that pay is a factor in retaining staff, but not quite as significant as other factors.
Impede chances
For example, whether they were excited to come to work, can use their strengths whilst at work and having a chance to do something that they are good at and something that they love doing.
Perhaps many wouldn’t say that they ‘love’ what they do, but without doubt the never-ending rules, regulations, policies, fear of complaints, etc, do nothing more than suck the fun out of our daily lives and impede our chances of finding meaning in our work, as it lowers our enjoyment of what we do.
By extension, this applies to private dentistry too. But NHS dentistry is uniquely afflicted, in part due to the complexities of the NHS dental contract and equally in its addiction to endless data gathering and box ticking under the questionable guise of improvements – or whatever their reasons may be.
Let’s take for example a referral to secondary care.
There was a time we could simply write a letter to the hospital (often a named consultant) and that was it. Now, we are faced with a multiple page document requiring us to set aside at least a 15 minute slot.
In the grand scheme of things, I appreciate that this may seem as trivial as Prince Harry complaining about having to have the smaller half of a room whilst staying in a castle.
But we as individuals differ temperamentally and healthcare overwhelmingly attracts people who are empathetic and have chosen careers that involve working with other people.
Rules and regulations
Whilst we are subject to administration, we are not administrators and for people like us, having to waste 15 minutes of our day on bureaucracy in order to bow down to organisations addicted to data gathering is quite simply not fun.
I wholeheartedly reject the idea that boxes should be ticked because it ‘only takes a minute’. This is both true and soul crushing to those temperamentally unsuited to accountancy (I think I’m allowed to say this as my father is one).
It isn’t that I’m against rules, but rather untested rules and regulation based on the subjective whims of individual bureaucrats with an undeniable bias towards complexity.
This strips us of our most valuable resource, which is time, and increasingly separates us from direct patient care – the very thing that gives our careers meaning.
We need rules and regulations. But we need them to be tested to an objective standard. Where they fail to do so, it is imperative that our regulators recognise the harm that they are doing to the morale of our staff, who are motivated by a multitude of factors and not just pay alone.
In my opinion, it is unrealistic to expect the government to drastically increase spending on NHS dentistry in the current climate. But even if it could, it wouldn’t be enough.
Healthcare workers are leaving the NHS in droves and it is my contention that this cannot be addressed with money alone.
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