Nigel Jones responds to the news that the government will calculate the true cost of delivering NHS dentistry.
The decision of the Department of Health and Social Care (DHSC) to conduct a survey and research project on the cost of running dental practices seems long overdue given the arguments that have raged in recent years about the level of expenses uplifts in dental contracts. They could be in for a shock if the stats produced by the BDA are anything to go by.
This shouldn’t just be about the finances. After all, there can be a dreadful cost to mental health, physical health and relationships of trying to balance the demands of the NHS with the requirements of the GDC, the mitigation of the risk of complaints or litigation, and the provision of patient care to an appropriate standard.
What is the real goal of ‘going private’?
To be fair, there is a reference on the gov.uk website to the project aiming to improve government insights into not just the costs but also the pressures involved in running a dental practice. Perhaps this was what the chief dental officer was alluding to when he spoke earlier this year at the Public Accounts Committee (PAC) inquiry about making sure NHS dentists can ‘provide safe care and feel safe doing so’.
To my mind, these are very important points. The PAC inquiry also heard a couple of references to NHS dentistry having to compete with the more ‘lucrative’ world of the private sector. I suspect the use of that word was simply to do with the level of profit available to private dentists. However, I will cling to the hope that it was used in accordance with one definition of lucrative that talks of wealth ‘acquired without burdensome conditions’.
For the hundreds, if not by now thousands of dentists with which I’ve worked during my career, this has been the real goal of ‘going private’. It’s rarely, until recently at least, been about having a higher level of taxable earnings. The goal has nearly always been to earn a living that befits the skills and experience of a healthcare professional and doing so without the personal cost to health, family and friends.
Pull and push
In the past, governments have been able to rely upon a combination of NHS dentists’ loyalty to their patients and their fear they might not make a success of private practice. With so many stretched to breaking point, dentists are finding that the loyalty is best served by finding a sustainable way to provide care for their local communities. Also, the workforce issues that have been building for decades mean that the step into the private sector is no longer as daunting.
If the current government really wants to ‘fix NHS dentistry’ so that a universal service is available to all, it will have to come up with pull factors as well as dealing with the push factors, and they will be expensive. Otherwise, it will have to grasp the nettle and work out how to use the finite resources available to NHS dentistry in the optimum way to reduce oral health inequality, and that’s a debate worth having.
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This article is sponsored by Practice Plan.
