A delegation from the BDA’s Northern Ireland Dental Practice Committee met on December 3 with representatives from Department of Health, Health and Social Care Board and the Business Services Organisation. The substantive issue on the agenda was the future sustainability of Health Service dentistry in Northern Ireland, at the request of BDA.
A comprehensive BDA NI paper has been compiled and shared with the Department that evidences just how much pressure GDPs are under after approaching a decade of cuts, wholly inadequate pay uplifts and rapidly rising expenses in delivering Health Service dentistry. Pay is down an estimated 38 per cent in real terms; morale is at rock bottom, with 68 per cent of practice owners and 52 per cent of associates having ‘low’ or ‘very low’ morale. We cannot continue to go on at the current trajectory.
Cuts imposed by the Department of Health, for example the removal of Commitment payments alone has taken £3m a year out of dentists’ income, not to mention the damaging signal this has sent to the profession at large. The landscape has changed rapidly since then, from GDS overspend to year-on-year underspend expected to exceed £7m this year. There ought to be significant bandwidth to address the crisis that is building within GDS.
According to a recent NHS Digital report, “it is evident that NHS/Health Service share has a strong negative association with the motivation of dentists… the scale of the negative relationship between motivation and Health Service work for dentists in Northern Ireland is particularly marked.”
In summary, the BDA is calling for:
- Full implementation of the DDRB recommendation 2018/19 immediately backdated to April 1 with an additional uplift to address the non-payment in 2015/16.
- Reinstatement of commitment payments as an important psychological step to begin to address the low morale and motivation of dentists committed to the Health Service and arrest the pay pressures which dentists in Northern Ireland have experienced over the period 2008/09 to 2016/17.
- Reinstatement of an annual Quality Improvement Scheme to allow practices to re-invest in patient care.
- Simplification of the practice allowance to enable practices get the money they are due without unnecessary barriers being put in place.
- Money earmarked for dentistry within the GDS to be retained within dentistry for example, a suite of measures including:
- Reinvest the underspend back into dentistry via a grant scheme similar to the Revenue Grant Scheme January 2018.
- Practices have to ensure they have emergency dental kits and life support equipment. Equipment essential to Health Service dentistry must be fully funded for all practices delivering Health Service dental care.
- A mechanism put in place aimed at ensuring GDP remuneration is adequately protected from all essential costs of delivering Health Service dentistry, including the cost of any new regulation.
BDA NI are urging the Department to consider the range of options we have put forward as a matter of utmost urgency, in seeking to address the deep issues of sustainability within Health Service dentistry. The department’s response in turn will demonstrate what commitment they have towards NHS dentistry.