Blame Game and Reality Check for Commons Dental Select Committee
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- Published: Thursday, 04 January 2024 10:20
- Written by Peter Ingle
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It was announced with some gravity earlier in 2023, took oral and written evidence in the summer, reported in July, and then left on the shelf for five months before receiving a response from the Government.
The Health and Social Care Committee Inquiry into NHS dentistry was in some ways a rehash of the Committee’s previous inquiry into dental services, which was held in 2008. Dental teams had reason to ask if the government response to the Committee’s report would be any different a second time round.
The initial published government response to the report was mixed, accepting some of the recommendations but baulking at fundamental contract reform and rejecting outright the reintroduction of patient registration. The Minister and BDA, though, had more to say.
Perhaps aware of the collapse of the promised ring-fence intended to keep clawback money in dentistry, Minister for Health and Social Care, Victoria Atkins turned her attention to ICBs. Speaking to the Health and Social Care Committee shortly after the report was , she told MPs that she wanted greater transparency on ICB activities. Boards expecting dental underspends, she said, should be asked “why aren’t they spending that money on local dentistry?”
Perhaps the Minister should also ask NHS England who had previously told ICB’s that they could reallocate unused dental funds to help plug up holes in other areas of the NHS. According to Healthwatch there were “perceived mixed messages” about ring-fencing with some finance directors working on the basis that it had been dropped.
This has not been a universal approach, with other areas such as West Yorkshire looking to fund projects targeting deprived children, asylum seekers and the homeless. As the Minister told the Committee: “There are some ICBs who have no underspend, who have been able to find innovative ways of dealing with dentistry, over and above their usual ways of working. That’s what NHSE is trying to encourage. But for those that haven’t yet found that, they are permitted to keep it in their local area.”
Moving the problem on, she added: “If your ICB is not spending money on dentistry that it has received, then I think you as a constituency MP and your constituents deserve to know that. The question then for the ICB is why aren’t they spending that money on local dentistry? That’s the question.”
Speaking to the Committee, the Health Secretary declined to give a date for the publication of the much promised, but long overdue, recovery plan for NHS dentistry.
Later, other parts of the discussion about the broader NHS give an insight into the Minister’s approach, for example during later questions on waiting lists. Here, Ms Atkins admitted that, “as we’re investing in our NHS, as we’re employing more doctors, more nurses, there is a question here about productivity.” Ominously, the Health Secretary said an upcoming McKinsey review commissioned by NHSE, that is thought to be examining why activity levels have not risen would make, “very interesting reading”.
The BDA was unimpressed, their comments on the Governments response, being short and to the point. On Twitter they wrote:
“Ministers claim to want access for all.
But offer no commitments that could achieve that.
If they won’t fix a failed contract NHS dentistry will remain built on sand, and risks being swept away.”
The most damning response of all came with the publication of the Nuffield Trust report on the state of NHS dentistry, a few days later. BBC News had a typical headline in their story on the report; NHS dentistry as we know it ‘gone for good.’ Unlike the Health Committee which still held out for the revival of a comprehensive service, available to all who want it, the Nuffield report described scaling back with various core service options offered as possible ways forward. According to Chief Executive Thea Stein, “Difficult and frankly unpalatable policy choices will need to be made.”
The Health Committee report read even without with the government’s half-hearted response, is now left looking like the product of a political system in denial.
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