‘Not just a rollercoaster year, this time it’s Blackpool’s The Big One!’ – Practice Plan’s Nigel Jones and BDA chair Eddie Crouch reflect on the events of 2023.
Highs and lows
Eddie Crouch (EC): There were some real highs this year followed very shortly afterwards by some significant lows. We fought long and hard to get a Health Select Committee inquiry into dentistry. And if the BDA themselves had written the report that came out of it, I don’t think there’d be very much difference in tone. It basically vindicated what we had been saying for a decade or more.
Nigel Jones (NJ): Agreed, Eddie. What I found so interesting about the select committee report was that when I was watching the hearings, I found myself feeling dismayed at their apparent acceptance of the answers they were getting from some of the people giving evidence. And then to read the report and realise that they hadn’t been taken in by that was very reassuring.
EC: Yes, there were some weasel words. For example, at 11 o’clock on the day that the minister was to give evidence in the afternoon, he announced to parliament that there was going to be an NHS dental recovery plan.
Now, you don’t have to be a cynic to be suspicious about someone announcing measures in parliament three hours before he’ll be giving evidence to a select committee. Especially when the civil servants standing outside the hearing seemed totally bemused by what had been announced. They didn’t seem to know anything about it at all. And here we are approaching the end of the year with no further information.
The health and select committee report I thought was a high, but the lack of ambition afterwards in response to the committee’s report, any movement on a recovery plan has seen the dip in the rollercoaster.
‘Treading water until the general election’
NJ: In trying to understand that dip, I imagine there are many factors, but it’s hard to see how they address all of the issues raised within the Health Select Committee report without additional funding.
EC: Well, the recovery plan was really about an urgent short-term, creeping to a medium-term plan to stabilise or begin to restore NHS dental provision. The recovery plan was never going to be a long-term piece of work.
NJ: I meant both. The fact that there hasn’t been a formal response to the select committee report and there hasn’t been a recovery plan. Or is it potentially as simple as them just treading water until the general election, when it’ll be somebody else’s problem?
‘Small tweaks while the rest of the system falls apart’
EC: It gives that impression. It probably matches our experience with NHS England in contract negotiation. If we go back to what they termed ‘quick wins’ last year, which turned out to be neither quick nor a win, we have the marginal effects of those small tweaks. I believe the mindset of NHS England is to continue making small tweaks while the rest of the system falls apart.
And they don’t seem to get it, despite the amount of parliamentary time dentistry has taken up, and MPs requesting meetings because they’re getting letters from the constituents. So, it implies they don’t really know what to do, and they don’t have the resources to put it right.
NJ: To me it feels like the current government is just trying to do what it can to manage the PR rather than solve the problem. They give out something that sounds plausible to the public and the media, like the marginal gains, which they can then reposition as a contract reform. ‘We’ve reformed the contract’ makes it sound like something’s happening when any of us that are close enough to it realise it’s negligible, if anything at all.
The image of change
EC: Even when you come down to access figures, they compare it to a time during the pandemic when access was at an all-time low. And so, it looks like there are improvements. It’s all about the image of looking like things are on the change, so you’ve just got to give it time. I think anyone working in the profession knows we don’t have that time.
NJ: Exactly. There’s a bit of me that wonders if the government does get it, but it suits them not to acknowledge that.
EC: I wouldn’t dispute that. I think that Neil O’Brien did get it. He was a bright, intelligent man who got it. And I think you can see by his resignation and subsequent tweets that he was frustrated by the fact that he wanted to do something but was held back by the dreadful position we find ourselves in as a country and across the whole of the health service.
‘Cause for optimism’
NJ: I suppose it’s too early to say how the reshuffle will affect things. Although the choice of the latest Health Secretary is an interesting one!
EC: You couldn’t make it up that you appoint a health minister whose husband is the CEO of British Sugar. I spoke to Phil Bamfield from the British Medical Association (BMA), who had been in a meeting with Victoria Atkins. And he thought that she was someone who would get up to speed quickly, as she’s a bright woman with a barrister’s background who takes in information quickly. He felt there might be cause for optimism.
The former Health Secretary, Steve Barclay, was the epitome of the man who says ‘no’. We have too many people in serious places in dentistry who, if you come up with a bright idea, say ‘no’. And that’s been the frustration of the whole year that we’ve had plenty of people who have come up with ideas, the Health Select Committee, and various others who’ve said, this is a way forward. And the people with the real power have said ‘no’.
NJ: Too true, Eddie.
Read part two here:
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