The Dental Professions and the 2015 General Election
I write this at a time when I'm a dentist, and a candidate for what will be the most unpredictable General Election that most people can remember. There are just so many factors in this election that only a fool would even attempt to predict its outcome. With such unpredictability also comes power. Power to the voter. The voter can now expect every candidate to work hard for their vote. I never liked the two party state or the disgusting reality of safe seats. The very idea of safe seats is so disempowering! Imagine a seat which is so predictable that your vote doesn't change much locally, that your MP takes their seat for granted and never really has to fight for your vote! The sad reality is that there are too many such seats. But, 2015 could change that to some extent, with the arrival of a multi party democracy like we haven't seen before. Where every candidate and every party will have to fight for every vote. I welcome this new era.
Now how can dentists benefit from this? What is it that makes dentists vote one way or another? Dentists are a very well educated, articulate and intelligent lot! There will not be one or two issues that sway them, but a range of issues and not always dental issues. But dental issues are important, and not just to dentists who predominantly work in the NHS.
Here are some issues which face dentistry over the next five years:
1. What do we do about the General Dental Council?
The GDC is now viewed as being draconian and out of touch with the profession. I can't see any world where it would be acceptable to demand such an extortionate Annual Retention Fee. I have discussed this with many politicians, patients, and other people whom I meet on the campaign trail, and every last one of them is alarmed at the figure of £890. I have contacted the health team of my party and requested them to include a line about reform of the GDC in our manifesto. Obviously, there will have to be further discussions about this and I am hopeful that we can do something about this in the next parliament. Reform of the professional regulator is something on which almost all dentists agree!
2. What do we do about NHS dentistry in England?
I have worked with the Unit of Dental Activity ( UDA) system in England. I worked in the North of England ( Middlesbrough, and then Hull ), areas of high dental need where this system just did not seem fair to performer dentists. My bigger problem with the system was a lack of transparency and fairness. With the fee per item system in Scotland ( which was the system in England prior to 2006) the fees were clear for all to see and distribution between owners and associates was visibly fair, also patients knew exactly what they were paying for . But with UDAs, associates having no Idea what the real value of a UDA was, it was easy for them to be squeezed! I struggle to see fairness in the system. Fairness for the patient who does the right thing and may need the occasional filling or crown , but finds themselves paying a lot more under this system for that filling or crown. Fairness for the conscientious dentist who would like to practise the way they were taught dentistry, the way it is to be practised, with emphasis on prevention. There doesn't seem to be any provision for prevention to be done properly! Fairness for the provider who may be in an area of high need but who may be stuck with a lower UDA rate than the needs of the area demand.
I'm not saying that fee per item is the best system. I currently work in this system in Scotland and it has its disadvantages, but it is transparent and it is generally fair to all parties concerned. ( Obviously we would like to see higher fees for certain items of treatment, but that must be tempered by the fact that I'm yet to meet a dentist who would ever say that any particular fee was high enough! )
There are many pilots in operation and we must study them carefully. I believe that healthcare planning and delivery in England must be devolved. The needs of the Home Counties are very different from the needs of Wales or Northern England. A one size fits all approach just cannot and does not work! I really hope the BDA takes this change very seriously! It is easy to accept a new system, but when the system doesn't work very well, it does take an awfully long time to change it as we are all seeing.
If there is one reform to healthcare in England that we must achieve in the next parliament, it must be devolution of planning and delivery ( with protected budgets for areas of high need, and/or deprivation )
3. What can all dentists look forward to in the next parliament?
NHS or private, we can all agree that regulation of all forms has gone insane! We are over regulated! It just appears in some cases to be regulation for regulation's sake! We must review the regulation that currently strangles the profession and do away with unnecessary regulation, definitely with double regulation ( it just doesn't make sense for the same criterion to be regulated by multiple regulators! ) Simplification of Regulation! Another thing that I will bring up with my party's health team.
In general terms, dentists as citizens care for the same things that most other citizens do. A strong economy, a just and fair society, an environment where we and our children can thrive happily. Whichever party or combination of parties as is more likely the case in this era of coalitions, delivers all that will deserve our votes.
© Pramod Subbaraman, GDPUK Ltd 2015