Despite the likely date of the general election being four months away, the Conservatives celebrated the arrival of 2010 by publishing their draft manifesto for the National Health Service. There is a short section on NHS dentistry. They claim that their policies ‘will allow us to give one million more people access to an NHS dentist’. They also promise to give every five-year-old a dental check-up, by re-introducing school dental inspections.
It was last May that they published their reform proposals in a document entitled Transforming NHS dentistry. Judging by the manifesto most of their ideas remain unchanged, despite considerable criticism being levelled at their policy by the profession at some of their short-term reforms. More hopefully they promised in the longer term to reintroduce patient registration, a move that was broadly welcomed.
The draft manifesto promises to introduce the unpopular short term measures, but makes no mention of restoring registration. The Conservatives, if elected, will ‘introduce a new dentistry contract’. They say they will ‘tie newly-qualified dentists into the NHS for five years’. Leaving aside the ethics of forced labour, one can reasonably ask how many this would affect, whether EU graduates would be exempt and whether there are enough jobs in the NHS. Dental graduate unemployment is on the horizon if not here already. So has the proposal been costed? Is there available money?
It will also allow dentists to ‘fine’ people who consistently miss appointments. Is this a return to the days when dentists were allowed to charge for broken appointments or will it be a matter of the money received going back to the PCT as a patients’ charge, with dentists once again cast in the role of unpaid tax-collector?
Finally, they will ‘stop paying dentists to carry out unnecessary appointments’. This is expanded in their policy document to mean ‘perverse incentives whereby patients are recalled for routine check-ups just weeks after treatment and without clinical need’. It is difficult to know which ‘NHS data’ they used which apparently showed that when these unnecessary slots are freed up, we can create enough capacity to achieve, at the very least, access to care for a million extra patients.
The draft manifesto is a poor thing, the reforms it indicates are unlikely even to deliver their stated objectives of one million more people being seen, let alone addressing the defects in the NHS contract and its variations that have so irked the profession for nearly four years. There is no indication that they have even read the Steele report let alone taken any of its ideas on board. Those dentists who were hoping that the likely demise of the Labour Government would lead to a change for the better will be greatly disappointed.