Is it safe to come out from my cave now? Can we talk politics? It is tempting to be cynical and use that worn phrase, Plus ça change … [1]
To those of you with connections in Nepal, my sympathy and best wishes - coping with such a series of natural disasters is never easy. The Nepalese Governments rejection of the UK's Heavy Lift helicopter offer suggest that politics can rear its ugly head in any circumstance.
In a small way, I suspect UK dentistry will prove no different.
Unfinished Business
The election has been and gone. [You have noticed, haven’t you?] As revolutions go it was typical – the outcome was unexpected, although change was assured. Everything is up in the air, and yet already the dust is settling and the view of the future challenges is clearing. There is a sense of unfinished business in many respects, allied to concern that reform, be it to Regulatory Bodies or or Contract Reform, is going to suffer Mission Creep
In the space of a month for all its abject lack of mention during the election campaign, there has been a series of small seismic shifts in dentistry.
Tremors of Change
The new CDO was appointed [2] and Colonel Dr Sarah Hurley's name was confirmed; although announced on the NHS England web site, it is strangely absent from the DH Portal. NHS England stated:
Sara will ….. champion the role of dentists and dentistry within the health system.
I look forward to that because it was for sure absent under the previous incumbent who even now is espousing the increased use of Dental Therapists. Her military experience should stand her well in trying to wrench the proud profession of dentistry away from the red braced bean counters.
The BDA Conference, following on the heels of the UK wide Vote, was a successful venture, multiple stages and speakers offering a cracking breadth of topics to hear about. Big Dr Mick issued his rallying call, [3] and if anyone can lift an Agincourt like salute to the DH, he and his PEC are your ‘archers’.
The election threw an unpredicted outcome of a moderately strong Government, albeit with a large degree of SNP oversight.
The former CDO has already hit the lecture circuit and interview network, the glossy big magazine from Practice Plan being the one to catch the early eye, but with what agenda in mind it remains to be seen, except perhaps to self-aggrandise the achievement of the 2006 UDA contract. A strange retirement project I would suggest.
Jimmy Steele, the ubiquitous Toon Professor of all that is good, has spoken about the new Prototypes in guarded terms [4] – suggesting that we are heading toward a sensible format for NHS funded dental delivery. The nature of his caution suggest that money will be the driver or the deal breaker. Model Two appears to win his tentative vote at this time
Perhaps most interestingly, the FGDP, in a move to assist beleaguered dentists, has made their standards Open Source, [5] as well as criticising the GDC and its appointed ‘experts’ for constantly placing the bar too high in FtP cases. The GDC it must be said have publicly challenged this respected professional body. [6]
So what now?
We now face the prospect of proper austerity, with a new budget in July. Further real cuts are forecast and I for one would not bet on dental funding under the NHS increasing to ensure proper delivery of any new contract. Suddenly massive promises are on the horizon for 24/7 operation allied to an increase of 5000 WTE GMPs – and you can see dentistry as funded by the Government being parked up a narrowing alley.
So the rallying call is very simple –
We must expose the lack of clarity of the NHS offering which looks to be similarly present under the new contract proposals.
We must drive increase dental funding to be directed at child dental health
If ever the case for fluoridation should now be put to bed, it surely must be now – the cost effectiveness alone must appeal to a newly empowered Chancellor.
And the GDC are still awaiting the HSC Report, but our regulator is hardly a reformed body despite their strongly worded rebuff to the FGDP
Dental revolutions are often subtle, like slow burning fuses. I think there are a number of fuses smouldering here. The summer should be interesting because at some stage there will be a loud bang.
Enjoy your long weekend
[1] http://en.wiktionary.org/wiki/plus_%C3%A7a_change
[2] http://www.england.nhs.uk/2015/04/27/new-chief-dental-officer/
[5] http://www.fgdp.org.uk/content/news/fgdpuk-launches-the-open-standards-initiative.ashx