National Service Is Back - Only For Dentists

National Service Is Back - Only For Dentists

The media narrative of dental deserts appears to have been replaced by dental detention centres. The government announcement on healthcare workforce development, NHS Long Term Workforce Plan (england.nhs.uk) , contains a plethora of promises with one aim. That is to convince the electorate that the NHS can be somehow be kept in its present form, and also manage to meet their 21st century expectations.

One of the most contentious aspects for dentistry is the intention that new dental graduates will be tied to working in the NHS.

Using the slogan, ‘Train, Retain, Reform’ one of the key 6 bullet points for ‘retain’ is:

  • Explore measures with the government such as a tie-in period to encourage dentists to spend a minimum proportion of their time delivering NHS care in the years following graduation.

Reaction has been swift.

An initial comment on twitter from BDA Chair Eddie Crouch was: “This workforce plan is government’s latest attempt to fill a leaky bucket.

Failed contracts and underfunding are fuelling an exodus from this service.

There’s little point in training more dentists who don’t want to work in the NHS.”

A couple of hours later, and having seen more of the plan, his assessment had hardened:

“Tie-in’s” or minimum terms are now on the menu.

Ministers need to make the NHS a place young dentists would choose to work.

Not handcuff the next generation to a sinking ship.”

One of a minority seeing a carrot as well as the stick, Chris Groombridge, Director of the Association of Dental Groups, tweeted that his local ICS was considering debt relief in return for years spent working for the NHS, as well as sponsorship and bursaries.

Tie-ins have been mooted for some time, and seem to have support across the political spectrum, all the way from MP’s such as Rachael Maskell who is to the left of Labour, to the Daily Mail. Under the headline, “Dentists will have to work for NHS” it continued with, “They’ll be forced to treat health service patients in exchange for their taxpayer funded training.”

It is not just new BDS graduates who might be tied to the NHS. While the Mail reported The Prime Minister as saying that two in three left the health service “straight after qualifying,” it appears that this figure related to speciality training. Given the sacrifices involved along this path, compulsory NHS service might see numbers of specialist training applications plummet.

Needless to say, no mention was made of the typical student debt that new graduates incurred, nor that the FD scheme most participate in, already involves delivering mainly NHS work.

The Telegraph did not share the Mail’s enthusiasm for the promised transformation in healthcare. In its comment section it took a somewhat calmer and more considered view of the workforce plan. It observed that after the promised growth the NHS workforce would be approaching the Chinese army in size, but doubted that the plan would improve performance. It concluded that “it does the NHS no good to ignore its problems and maintain that all is well.”

It may be that talk of compulsory dental service is intended more as a distraction to please the tabloids than a serious attempt to improve dental access. Interestingly, according to the Mail, when asked if a similar approach might be taken with newly qualified doctors, the Prime Minister said that it was not currently planned but might be introduced if the numbers leaving the UK increased.

The threats and coercion are in stark contrast to the style of the NHS England document in the “Retain” section. Here paragraphs are headed by statements including; “We are compassionate and inclusive”, “We are recognised and rewarded,” “We have a voice that counts,” and of course, “We are a team.”

There is a great deal more related to dentistry in the plan and GDPUK will be looking at some of the other proposals.


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