The profession reacts to the NHS dental recovery plan

Last week, the government announced the details of its NHS dental recovery plan. But what does the profession think of it?

Ken Dalley

My concern is that, while the Tories are still in power, the NHS will continue to decline. Dentistry is the thin end of the wedge to wholesale privatisation of health care in the UK. At the same time, the private companies at home and abroad are frothing at the mouth as NHS assets are virtually given away to them.

Unfortunately, many people in the UK are giving the hard times suffered by its citizens the stiff upper lip, or they don’t care or think that they have nothing to fear about future privatisation of health care because they can just about afford dental insurance.

I consider it outrageous that a mere £600 million is apparently being given towards oral healthcare considering the billions of our public money that appears to have gone astray under Tory government.

Sharif Islam, dentist

Essentially a pre-election gimmick akin to dabbing a little extra powder on the cheek to keep it rosy, the government’s NHS Dental Recovery plan falls into that vacuous and clichéd political totem of ‘a comprehensive raft of measures.’ Sharing less than a single vocational trainee’s salary amongst 240 dentists to encourage them to perform more NHS work is exactly as ridiculous as it sounds.

I tried to lather a single drop of shower gel over my entire body this morning and had basically a similar result.

Calling it a recovery plan implies an admission by the state that dentistry was suffering the pathology of chronic underfunding in the first place, and for some time. But rather than solving the problem in order to retain more dentists, the state wants to affix a sticking plaster to stem the bleeding until the election, while blaming those heartless, avaricious dentists for their exodus. Alas, no dentist can afford to pay their patient to sit in their chair and that paltry cash boost will not change anything.

Unrealistic expectations

Relative to other healthcare modalities, and due to the plethora of materials, equipment and technical skill involved, dentistry is an expensive service to provide. And yet for decades the state has been trying to offer it on the cheap. Of a nearly £200 billion healthcare budget a mere £3 billion is set aside to treat and manage arguably the most important orifice known to humankind (no, not that one). And that amount undoubtedly indicates the value that Whitehall assigns to dental health.

Expectations of the dental profession, the government itself and, subsequently, the general public are thus wholly unrealistic. And unless priorities are changed the provision of dental care by the state can only remain commensurately anaemic and members of the public will still be buying their own pliers…

Aidan McNally, dentist

Retired dentist here! I spent my entire career working in the NHS. The fact that dental care has become something that many can ill afford saddens me and some people having no access to dental care due to financial constraints appalls me.

I would consider returning to the profession to help meet what is clearly a desperate need. But for that to happen some things would have to change. The whole system of overseeing dentists was increasingly based on the premise that dentists were guilty of something unless they could prove their innocence. I once went to a meeting with the head of a primary care trust who told his audience that he would ‘never believe a dentist’s word over that of a patient’. (I promise that I’m telling the truth here).

Annual medical emergency training is essential. The requirement to prove CPD hours is utterly meaningless. We should be trusted to keep abreast of relevant information. What patients want is a competent, caring dentist who will deliver a good standard of dental care.

In addition, anyone who wishes to stand in judgment over my work, then they should be prepared to demonstrate how they would approach any procedure.

Change needed

The General Dental Council (GDC) is supposed to be a self-regulatory body. Instead it has become a money pit for lawyers and dentists who have rarely worked in general practice. Anyone sitting in judgment over a dentist should have been made to complete at least 6,000 UDAs in one of the last three years. That’s what we dentists are required to do to make a decent living, so only those who can do this should be allowed to judge us.

The General Medical Council fulfils its self regulatory remit for less than half the cost per doctor, compared to what dentists pay to the GDC. You can also now be called in front of a GDC hearing with no dentist on the panel. How is this self regulation?

When I bought my dental practice in 1993, I had one point of contact at what was then the Finance and Performance Committee. I could pick up the telephone, talk to her and get problems solved.

Now, there seem to be around 10-20 people doing that job. None of them can give you an answer to anything and you simply end up being passed from one person to another. The Primary Care Trusts seem to have lots of people in non-jobs, who are evidently not there to make the front line carers jobs any easier.

‘Massive problem’

I liked my patients and I was more than competent at my job. The problem was that the job became more and more about ‘box ticking’ rather than patient care, and I felt that I wasn’t trusted by the people above me in the chain of command. I simply couldn’t carry on in that oppressive working environment.

Finally, the UDA system is a massive problem. If the government of the day wants to pay ‘third world’ fees to dentists, they should at least be honest and say that they are providing a ‘third world’ system. Stop hiding behind the efforts of dentists who are struggling to make an underfunded system work and tell the truth.

To anyone who says that the same could be said about the entire NHS, I say that the average cost of removing any impacted wisdom tooth in hospital was, when last I looked, £1,100. I used to take one out (yes, full surgical, flap, bone removal etc) for £60, of which I got £30. If there were four to remove, it was just the same fee.

Bertie Napier, past president of the British AssocIation of Private Dentistry (BAPD)

As an Association born through the coming together of dentists frustrated by the lack of progress towards a realistic, practical and sustainable system of oral health care in the UK, we empathise with the current frustrations faced by many.

We remain committed to our fight for the UK dental profession to be able to work in an environment that allows the delivery of high quality dentistry, without fear and without cost to personal physical and mental wellbeing.

We also believe that patients should have the confidence of knowing they have access to world-class quality oral health care. We will continue to support our colleagues, and also engage with regulators and policymakers in working towards these goals

Nigel Jones, Practice Plan sales and marketing director

There is nothing in the dental recovery plan that is essentially wrong as you can’t argue against increases in the minimum UDA rate or the additional payments for high needs patients.

However, it doesn’t go anywhere near enough to address the exam question of whether this, or indeed any, government can afford to make contracting with the NHS sufficiently compelling to outcompete the attractions of a career focused on private dentistry.

Click here the full details of the recovery plan.

What are your thoughts on the NHS dental recovery plan? Get in touch [email protected]

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