GDPUK readers and forum contributors believe that this contract was and remains extremely flawed, it has been proven to be detrimental to patients in changing the way dentistry has been delivered. It may have created some cost savings but has also created problems of lack of access to dental services. This lack of access has led to increased spending and costs in some areas of England to raise levels of attendance by patients. It did wrest control from the profession and planted this firmly with the DH. They will not give that up easily, or ever!
My thoughts for this blog are about the uncertainties that the profession faces again in England in 2013-2014-2015. There will be a new dental contract, perhaps in around one year from now, perhaps 2015, the Dept of Health says they are piloting some elements of this now, but the profession does not know which elements are being piloted. Unless this is a bluff.
What seems to be the pattern for the 2014 or maybe 2015 change is there will be a carrot to encourage further use of other dental care professionals, which will mean less work for expensively trained dentists, and possible raised unemployment of dentists. I have written this in the past and write again that the BDA, through the GDPC under John Milne's leadership continues to engage with the Government to try to make this next new system workable in some way. But we still do not know. And the risk I see is that our dental trade union will have led us into lower employment for dentists, for its members. How many trades unions would allow this to be the outcome?
The GDC will pronounce on Direct Access on 28th March, but this will then impact on the "Scope of Practice" - this must mean more uncertainty.
A further uncertainty will be a General Election in 2015. Her Majesty's Opposition is gradually lining up to be ready for this date, but must also be keeping some of their powder dry.
For dentists, any small pronouncement from the shadow teams must be taken with some gravity, it gives us clues as to the personnel for the future, and the direction of travel. This Parliamentary question and comment by Jamie Reed MP might be a small slip, but it tells us this MP has no idea of how the land lies now, he certainly does not know the history [which may mean we are doomed to repeat it]. The recent style of government in the UK to impose and not negotiate with the professions; this means we have a greater risk of impending disaster if the potential leadership has no idea, as illustrated this week.
With our advanced democracy, and our high state of civilisation and communication, why cannot we organise smooth transitions between governmental systems, without dramatic unpiloted changes leading to unforeseen circumstances? We lurch from one bad system to the next, disadvantaging the public, the voters, who pay for it all through their taxes facing uncertainty at all times, it seems to me.
Who will make a change or a compromise in dental contracting which will make all sides demonstrably happier, and better off with the result achieved? It's a tough task.