What can NHS dentistry expect from the election?

As the general election approaches and with NHS dentistry a hot topic, Neel Kothari shares his thoughts on the political promises we can expect to hear.

For many years now the dental profession has become accustomed to NHS dentistry being used as a political football around election times. Many will recall Tony Blair telling the Labour party conference in 1999 that ‘dentists have been scaling down their commitment to the NHS following concern that low fees made the work unviable’ and that under Labour ‘within two years everyone would have an NHS dentist no matter where they lived’.

These are laudable aims, but nevertheless completely detached from reality when the NHS budget was only ever set for half of the population. The following elections in 2010 and 2015 saw the Conservative party repeatedly promise improved access to NHS dentists, yet as is commonly the case, failed to set out detailed proposals on how they were going to achieve this – while maintaining budgetary constraints.

Growing noise

One could be forgiven for thinking that this is nothing more than a cynical ploy by political parties simply to gather votes, but increasingly NHS dentistry is gaining traction with news organisations and politicians eager to divulge how much of an issue this is at the doorstep during campaigns, and how the other side simply cannot be trusted with our precious national treasure that is the NHS.

The noise created around NHS dentistry seems louder and more vociferous than ever before, but as has come to be expected, there seem to be no sensible plans on how any political party will improve access to NHS dentistry.

So far, from what we can ascertain, the current government is banking on three main areas. Firstly, to make it easier for overseas dentists to work in the NHS. Secondly, to tie in UK trained dentists and force them to work within the NHS against their will. And finally, pushing widespread water fluoridation on a sceptical public, despite recent studies suggesting minimal benefits given the now widespread use of fluoride in toothpaste.

Perhaps these measures could yield results, but what the profession wants and needs is a longterm strategy setting out funding proposals over the following few years and explaining how the NHS will proactively help dentists provide NHS dentistry, as opposed to simply providing regulatory punishments as and when things go wrong.

NHS mess

Imagine a patient who comes in needing five fillings. Now think of the variation in claims possible between NHS dentists. Some may claim under a single band 2 course of treatment, some may phase over multiple courses, some may sell private top ups (as the recent Williams vs GDC case has now clarified is possible) and others may say that their NHS list is now full – with no organisation or professional body being able to say which option is permissible or not.

At present, I don’t think any political party gets how big an issue this is or that the stress of working as an NHS dentist is not the dentistry part, but caused by the NHS itself.

This is simply a mess that serves no one. It offers no support to the silent majority who are seeking to work ethically and providing their patients care. For sure, pay is important, but it’s my observation that the lack of support and the overall disrespect shown by NHS England to dentists is the single biggest reason dentists are opting out.

At present, I don’t think any political party gets how big an issue this is or that the stress of working as an NHS dentist is not the dentistry part, but caused by the NHS itself.

So, what can the profession expect from the upcoming election? Well, when not even the Reform party have committed to reforming the NHS contract – I suspect not very much.

What can NHS dentistry expect from the upcoming election?

Growing noise

NHS mess

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