NHS Golden Hello Says Labour
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- Published: Thursday, 21 December 2023 10:40
- Written by Guy Tuggle
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Newly qualified dentists would be offered a ’Golden Hello’ of £20,000 to work in areas deemed to be ’dental deserts’ if Labour wins the next election.
Wes Streeting, the Shadow Secretary of State for Health and Social Care said that in return for the £20,000, dentists would be required to spend three years undertaking NHS work. The incentive would be repayable if the dentist were to quit providing NHS dentistry prematurely.
The proposal has echoes of the one mooted by Rishi Sunak for a three years NHS ’lock-in’ upon qualification with Labour monetising the pill via a £20,000 ’conditional’ incentive. It is not clear whether the £20,000 is taxable nor whether it would be paid up front as one lump sum or spread across the three years.
As political sound bites go, the proposal may please a desperate electorate wedded to the notion that all problems can be solved with money. Here is a politician at last confronting the crisis in NHS dentistry and lending a helping hand to young dentists who in many cases are carrying scary levels of debt. So what’s not to like?
’Everything’ will be the response of many in the profession.
As the well structured report on NHS dentistry published this week by the Nuffield Trust shows, NHS dentistry is so broken it will take much more than a twenty grand bung to new dentists to fix it. And Labour’s own research, highlighted by Streeting, confirms the scale of the problem with over 82% of practices not accepting new patients - 99% in the West Country - and 71% turning children away.
If Labour wins the general election, likely to be held in spring or autumn 2024, Mr Streeting says his Party has a ’costed’ £111 million ’Dentistry Rescue Plan’ that will provide an additional 700,000 appointments a year. The £20,000 ’Golden Hello’ scheme is part of the Plan that Mr Streeting thinks will incentivise dentists to work in areas where NHS coverage has collapsed. Contract reform is also promised.
Mr Streeting’s pronouncements are well intentioned, however, by promising 700,000 additional appointments they contain an enormous hostage to fortune as the target becomes a ’pass’ or ’fail’ test. Wise politicians avoid setting numerical targets. Wise politicians also consider the wider implications of their words: if Mr Streeting is willing to offer generous ’Golden Hellos’ to steer dentists towards areas of need, how long before GPs, teachers and others demand similar?
Mr Streeting needs to get closer to the profession in order to gain an understanding of why NHS dentistry has become ’toxic’ for so many practice owners and clinicians.. They after all hold the keys to any turnaround. Additional NHS appointments will require a bigger workforce to provide them. Given the length of time it takes to train dental surgeons, that will require existing dentists to either work longer hours or reduce their private commitments to increase the supply of NHS appointments. Readers will form their own judgments of the likelihood of either option.
And crucially, ’dental deserts’ are so-called because of the lack of NHS dental practices. Some lack private practices too. So were Mr Streeting to persuade a newly qualified dentist to leave the buzz and the lights of a university town or city to relocate to a run down town or barren rural area, where exactly are the practices ready and waiting to engage his or her services?
Mr Streeting needs to take his ’Plan’ back to the drawing board. Dentists can’t be bought or bribed to work under a contract so many of them loathe. Nothing Labour has proposed will entice practices that have gone private to return to the NHS. That will require far, far more than a £111 Plan. Most practices that transitioned to private did so with a one way ticket and no amount of money or contract reform is likely to hasten their return to the NHS.
The conclusions of the Nuffield Trust Report, that NHS dentistry as we know it is on the cusp of being ’gone for good’ have a much louder ring of realism about them than any party political posturing.
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