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Published: Thursday, 08 December 2022 10:24

Written by Peter Ingle

Hits: 1981

Another week, and another parliamentary debate about dentistry. This time in the House of Lords and simply headed in Hansard as “NHS Dental Contract”.

For the government, Lord Kamal who dealt with dental issues under the last but one administration, has now moved on. He was Under Secretary of State at the Department of Health and Social Care (DHSC) from September 2021 to September 2022. He may be best remembered by dentists for his apparent confusion over the amount actually spent from the 50 million pounds that was pledged to ease access problems at the start of the year.

Nick Markham was appointed this September, also as an Under Secretary of State at the DHSC. Now Baron Markham, his elevation to the Lords was to facilitate his government work. Appointed in October, he seems to have already learned the appropriate lines to take.

The initial question was from Lord Young of Cookham, who has taken an interest in dental matters for some time. It was, “To ask His Majesty’s Government what plans they have to review the NHS dental contract.”

Replying, Baron Markham spoke of the July changes as “reform of the 2006 contract,” and that with NHS England they planned to announce further reform in 2023. Lord Young responded with the familiar list of issues including, dental deserts, and “the exodus of NHS dentists.” He then asked when there would be “the longer-term radical reform,” referred to when he had last raised the issue in May.

Baron Markham then declared an interest, as though not currently practicing, his wife is a dentist. He went on, “This is one of those rare occasions when it is a case not of announcing new spend but of making sure the £3 billion we spend is fully utilised.” In case there was any doubt he proceeded to speak of, “making sure that dentists are contracting against their UDAs” so that “we get the full use of that.”

At this point Baroness Boycott entered the debate. She referred to the numbers of children requiring extractions in hospital, largely blaming this on “sugary diets” and made a case for giving schoolchildren free toothbrushes.

Baron Markham welcomed her comments and referred to the progress of legislation on water fluoridation. Baroness Brinton enquired about changes requested by the BDA and the regulations affecting workforce, adding that reform was needed urgently. Responding, the minister returned to a previous point saying that, “central to all this is not the budget but making sure that it is fully utilised.” As regards the workforce he said that, “We currently have 3,500 in training, which is working towards that, but, clearly, we need to work further.”  This is the same number that has been in training for some time, and has seen the UK arrive at its current crisis.

There were further contributions including requests for education about healthy food and drink, which led the minister to respond that it was not just about dentists “on the ground,” but adopting a 360 degree approach.”

Possible solutions to the workforce problems included helping dentists set up in practice and a modular training system. Apparently this had been discussed with the BDA, with Baron Markham wondering if, “on the way to becoming a fully qualified dentist, might a dentist become part-qualified, allowing them to do some dental nurse treatment, thereby adding to that capacity in the meantime?”

Baron Markham would go on to repeat his enthusiasm for a 360 degree solution and added that he was “under no illusions as to what needs to be done, and we are working on it.”

NHS dentists may also be under no illusions regarding what needs to be done, and the likelihood of the government replacing the 2006 UDA contract. 

Original Image By By HelenBuckle - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=82764383

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