The surprise, shock even, at the General Election result has now sunk in and we are at the start of a new Parliament. What to expect in the dental sphere?
To start with there were a number of commitments set out in the Tory manifesto so, despite the fact that dentistry was not mentioned by any of the three (former) leading parties, we can be fairly certain that those will be fulfilled.
Eight billion extra in NHS funding was promised during the long, long, election campaign, but of course that is a drop in the ocean unless NHS England can itself come up with £22bn in “efficiency savings”.
Many independent experts, including the Institute for Fiscal Studies and the Kings Fund, have expressed concern over whether savings of that order can be achieved. The best recent performance has been around 0.4 per cent per year, and the task now before them is in the region of 10 times that amount, every year. However, they will have to try their best and that probably means that dentistry will shoulder its share of the burden.
Along with a further wave of GP pilot sites, there was also a promise that seven day working in medical practice would be achieved by 2020. Does this mean that other primary care services will have to follow suit?
Some have wondered whether the planned programme of NHS dental pilots-to-prototypes will continue, and at what pace? It seems unlikely that there will be any further ‘root and branch’ reform in the NHS as a whole, as the shadow of the Lansley reforms has dogged the Conservatives’ agenda since 2010.
So although the pilot programme was initiated under a Labour administration and progressed by the coalition, as far back as 2007 former Health Secretary Stephen Dorrell was calling, in a Conservative policy document, for an ‘intelligent’ system with the dentistpatient relationship at its core. Political speak for registration and reform?
My view is that the programme will continue, but so will the relative austerity within the service.
There is some room for optimism; with a new chief dental officer about to take up her post, there will, be a renewed engagement between the profession and the NHS. A new incumbent with a strong and recent experience in both practical high quality dentistry and effective management has the prospect to bring a breath of fresh air to a long-running atmosphere of mistrust.
I believe that there is now an unprecedented opportunity – at least over the past decade – for the profession to truly engage with both the public and policymakers. We need to be proactive, strong and - difficult though it is - united.
Think of the benefits that as a profession we have brought, and, even more significantly the benefits we can offer to the population. I see and hear constantly of examples ranging from early screening for diabetes and hypertension, through to individual education on smoking, alcohol and diet. We have the leverage to have a major impact on the health of future generations.
As a profession, we may have 700 years of adverse history to live down, but what a positive story 21st century dentistry has to tell, and what potential for greater impact still.
Maybe the first thing we need to agree on is our objective as a profession. We seem to have concentrated on tactics, but until we know what we spent all those years training, developing and gaining experience for, what’s the point?
In practice, my objective was to “secure our patients’ optimal oral health for a lifetime”. What’s yours? Once we know what the mission is, we can begin to develop a strategy to achieve it. Of course negotiating with governments is one tactic, but so is communicating with patients - and potential patients and resistant nonpatients.
Is it time to dust off a renewed debate on fluoridation? Surely the most costeffective way to reduce inequalities in oral health (look at Birmingham, the Irish Republic and most of the top 20 cities in the US)?
Let me go back to that 2007 announcement on dental policy by the then Conservative opposition. David Cameron concluded: “We are proud of the NHS and we’re optimistic about its future. Instead of helping a few [dentists] to leave the NHS and go private, we want the private sector to come and help improve the NHS for everyone.”
I’m an eternal optimist, but to me that’s an open invitation to the whole spectrum of dentists to be positive and to address the big questions. What do we want? And how can we (all) get there?