GDPC As A Guide for MPs
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- Published: Thursday, 01 June 2023 07:46
- Written by Peter Ingle
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Dentistry, in particular its availability as an NHS service, is now a regular topic of debate in parliament. On a single day recently MP’s secured debates on services in two areas, Durham and South West England, with Minister Neil O’ Brien called to answer their questions. After all this commons activity we have a pretty good idea of how MP’s would like NHS dentistry to develop. But what do dentists in general practice, who hold the key to improving access, want?
MP’s wondering just what this diverse group of professionals want, would do well to look at the report of the recent BDA General Dental Practice Committee (GDPC), meeting.
The GDPC represents all general dental practitioners in the UK and seeks to reflect the mixed economy of dental practice. It is the official representative body for GDPs, and negotiates with Government and other stakeholders on behalf of them. Usually meeting three times a year, GDPC discussions give a snapshot of current priorities and ambitions.
The report from Shawn Charlwood, the GDPC Chair, of their latest meeting began with a section on media and political campaigning. The professions dramatically improved image in the media is no accident, and the barrage of dental features and their general message, has been hard for government to ignore. It was noted that in parliamentary debates many MPs were now advocating for contract reform and fair funding. Reflecting on the evidence given to the recent health committee Shawn Charlwood reprised his key points, that political will was required to make the necessary changes, as was urgent action to move from UDAs. He had little to say about the CDO or the NHS England representative’s evidence. Looking to the future, he reported breakout discussions about enhancing the campaign to maintain political pressure, “with an eye on the next general election.”
The report on contract reform confirmed that that little progress had been made, and was mainly limited to preliminary discussions. Indeed, the only area with more advanced conversations had been around high needs patients, which would be referred to a clinical reference group. There was particular concern from younger dentists that the current lack of progress was making long term career planning impossible.
The report from the devolved nations suggested that whilst specific issues varied, there were serious structural problems across the all of UK.
Considering the impending huge clawback, the heart of the problem was felt to be recruitment difficulties. This was exacerbated by post pandemic patients tending to have higher needs, and so generating less UDA’s per session. No further action to support practices for 2022-2023 was expected, despite the GDPC’s efforts. It was likely that more practices would leave the NHS as a direct result of clawback, and its management by NHS England. While ring-fencing was proposed for 2023-2024, there is still no sign that a workable way of enforcing will be available.
On remuneration, a claim for RPI plus 5% had been submitted to the review body. Countering, the Department of Health had claimed that only 3.5% was affordable. There are also issues around the failure to recognise the link between expenses and take home pay. Concluding this section, the review body process was not working, and discussion had taken place about continuing to engage with it. However, there was not an obviously preferable alternative.
The impact of Integrated Care Systems was considered. It was already apparent that even when an ICS wanted to do things differently they were hamstrung by a broken national system. The NHS Confederation had said that now was a very challenging time for ICS’s to take on dental commissioning. Moving to ICB’s, their relations with LDCs were mixed with some of them viewing LDCs as “difficult.”
In other sections, the suggestion that new graduates be tied to the NHS was not dismissed completely, possible combination with changes to student finance being a possibility. The CQC continued to generally view dentistry as low risk. On pensions, there was concern that an incoming Labour administration intended to reintroduce the lifetime allowance.
There was a lot of material for any MP wondering what would help constituents contacting them complaining about the lack of dental services. As a general concept to aid their evaluation of possible solutions, they would do well to bear in mind Shawn Charlwood’s observation, that changes are needed to “make people want to work on the NHS, not dread it.”
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