The CDO & Reputation Management
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- Published: Thursday, 04 May 2023 07:43
- Written by Peter Ingle
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“I am not doing nothing, I am a woman with a plan.” These were the words of the Chief Dental Officer (CDO) of England, Sara Hurley, at the recent House of Commons Health Committee hearing. Indeed the CDO has been a prolific provider of plans. What the best laid plans of this CDO have actually achieved, rather than whether or not she is included in the Coronation honours list, will be her true legacy.
The CDO’s preoccupation with plans predates her NHS appointment. As Chief Dental Officer for the Army, she instigated Project MOLAR, which, in her words, sought to achieve a reorientation of the force’s strategy. It was then taken up by the RAF and Royal Navy. The CDO cited it as part of her pitch to the Committee: “I do system strategy and reform.”
At the same Health Committee hearing, Dr Caroline Johnson, MP (Con. Sleaford and North Hykeham) revealed that the MOD had informed her that as of March this year there were over 22,000 members of the forces requiring treatment to achieve optimal dental fitness, and that some had such poor oral health that they were not deployable. These problems are not new. More troops in Iraq and Afghanistan were incapacitated by dental problems than enemy action, and helicopter runs were required from remote bases for urgent dental treatment.
This is not the only area where the CDO’s assessment of her projects is not universally shared. At the same hearing, Paulette Hamilton MP (Lab, Birmingham Erdington) started by confirming that the CDO took ownership of the phrase “putting the mouth back in the body.” She then went on to summarise events during the CDOs term. These included; an “exodus of dentists” from the NHS, reduced Government contributions in the NHS dental budget, the now universal access problems, the BUPA closures, and a halt in improvements to child oral health with potential widening inequality. The MP then asked her to outline just how far OCDO and NHS England had come in achieving their headline objectives.
The CDO described the benefits of the Starting Well and the DCby1 programmes. Revealingly the CDO herself said that she hoped to see a restart of Starting Well, and to “reinvigorate” Dental Check by One.
The CDO also spoke about Mouth Care Matters (MCM) which targeted those in care homes and acute care, along with pilots aiming to support those providing care providers in basic oral health issues. Asked by Paulette Hamilton if these were continuing now. The CDO replied that “the models are there.”
Citing MCM as one of the successes during her tenure the CDO told the committee “We worked very effectively with Health Education England (HEE) to develop a programme called Mouth Care matters.” Yet, according to Sam Shah who was a director in HEE, it was Stephen Lambert Humble, Mili Doshi and himself who set up the programme before the CDO had even been appointed.
No one investigated the contradictions in the, apparently now latent, DCby1 programme. Here was a laudable preventive aim described by the CDO as being about “gums on seats” primarily to deliver oral health advice to carers of under ones. Under the prevailing NHS system this was a health education programme that had been designed from the start to be delivered using scant UDA’s and equally scarce dentist, DCP and surgery time. Despite this, later in the hearing the CDO spoke about making capacity by reducing “discretionary or possibly even an unnecessary check-up, which is some 70% to 77%.” It would seem that some discretionary check-ups are more equal than others.
Another of the CDO’s projects that was mentioned was her controversial involvement with the University of Suffolk, which has been previously reported in GDPUK. Recent Freedom of Information enquiries have confirmed that despite receiving £1.5 million from HEE that, “Neither the University or the CIC hold any contracts for dental services.” The same FOI confirmed that, “It has been agreed that Sara Hurley will be the inaugural chair of the board, which is a remunerated position.” It added that no remuneration had been paid at the time of response.
After seven years in the post it might be time for an independent assessment of the CDO rather than having her mark her own homework. The Health Committee sessions have confirmed that there is remarkably little data on workforce or oral health needs assessment, which should be the bedrock for planning and advice to ministers. Some memorable catchphrases and cleverly named but dormant minor initiatives, are scant compensation for the absence of dental expertise on ICB’s.
The CDO has nailed her colours to the mast, through advocacy and paid involvement with Community Interest Companies that hope to provide NHS care with salaried staff. It will make sense for them to cast an eye on clawback money for their funding. Time will tell how this vison works out, but by then the key decision makers are likely to have moved on, along with many of the remaining NHS contractors.
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