Nigel Jones explains why there is still a long way to go before NHS dentistry improves.
In the recent House of Lords NHS dental contract debate, Baron Markham, Under Secretary of State for the Department of Health and Social Security, declared himself ‘under no illusions as to what needs to be done, and we are working on it’.
I sincerely hope that’s the case although the repeated references to fully utilising the existing budget were not an overly encouraging sign, unless the government thinks what needs to be done is to refocus the existing dental budget on those most in need, and the most vulnerable.
It’s more than a year since the last Prime Minster-but-one-but-one said that the government wanted to make the NHS a better place for the dental profession which, at the time, left me wondering, ‘better than what?’
Perhaps the thinking is that with the recent tweaks to band two UDAs and raising of minimum UDA values, the NHS dental contract in England has become ‘better’, so it’s mission accomplished.
However, surely what the NHS needs to be is better than early retirement or a change of career or, of course, private dentistry.
An area that many have considered a remarkably resilient example of the NHS being ‘better’ than private dentistry has been that of goodwill valuations when it comes to selling your practice.
Indeed, this was cited to me last year as being a reason for remaining in the NHS, despite the tremendous pressure felt by the practice owners with whom I was speaking.
However, during a recent webinar discussion with Alan Suggett and Mike Blenkharn, the subject of valuing practices on the basis of multiples of EBITDA came up, and with it the negative impact on practice values of rising costs that cannot be passed on to patients.
It seems reasons to remain in the NHS are getting even fewer.
There is a growing proportion of dentists and practice owners who feel remaining reliant on NHS dentistry could carry greater risk to health and wealth than transitioning to private care.
Addressing that is ‘what needs to be done’, and it is hard to see how that can be achieved without more money.