It's 'All Change Again' at The Department Of Health

It’s ’All Change Again’ at The Department Of Health

Yesterday started with the news that Rishi Sunak had finally decided to dispense with the services of his Home Secretary, Suella Braverman. Then came that ’WTF?’ announcement that David Cameron, in a deal brokered by another former Tory leader, Lord Hague, was returning to Cabinet as Foreign Secretary. It was pure theatre.

As the day unfolded, it became clear that the government benches were in for a big shake up.  And at the Department of Health and Social Care, it’s almost been a clean sweep of the ministerial team.

Will Quince and Neil O’Brien aren’t exactly political box office, but to dental and health professionals they enjoy dubious recognition for being the departmental middle ranker and junior who, week in and week out, have fielded MPs’ relentless questions about NHS dentistry.

From "an extra £50 million" here to "the government is investing over £3Bn in dentistry" there citing "40% increase in training places",  "an additional 1.7 million appointments" and "we shall be announcing additional contract reforms" along the way, their predictable and hollow responses flowed in complete contradiction to everybody’s lived experiences.

Then Therese Coffey walked.  She was sacked actually. Seen drinking, smoking and singing karaoke at her party’s conference during her own short tenure as Health Secretary in the Truss era, the vacancy created by Coffey’s departure from the Environmental brief was filled by Steve Barclay who was, until today,  Secretary of State for Health and Social Care.  

Barclay will not be missed by the dental or medical profession.  When first appointed (July-September 2022), the editor of the respected Health Service Journal was prompted to write "never has a politician arrived in the post of health secretary trailing a worse reputation among NHS leaders".

Barclay returned for his second stab at Health Secretary in October 2022, but his team failed to reform dentistry and has alienated the Drs who are still engaged in a bitter war with the government which has seen them taking strike action at a time of waiting lists that run into the millions.

Step forward Barclay’s replacement as Health Secretary, Victoria Atkins. Her appointment is not without controversy.  Prior to health, Atkins, the daughter of former Conservative MP Robert Atkins, was Financial Secretary to the Treasury.  Although her role did not entail turning the screws on departmental spending, she will find the culture and budgetary demands of the government’s biggest spender a significant step change.

Victoria Atkins also happens to be married to Paul Kenward who is Managing Director of British Sugar. Success in his world is presumably measured by increasing sugar sales. Reducing dental caries, obesity and diabetes, however, requires a firm pull in the opposite direction.  And in 2018 she became embroiled in accusations of ’conflict of interest’ when it emerged that British Sugar had been granted a Home Office licence to grow cannabis to be used in medicine on  a huge 23-acre site in Wissington, Norfolk, in 2016. 

Ms Atkins, MP for Louth and Horncastle, has opposed cannabis law reforms and spoken out against the class B drug.  The Home Office said at the time that she had ’voluntarily recused herself from policy or decisions relating to cannabis’ according to The Times.

We now await to hear who the new Parliamentary Under-Secretary of State for Primary Care and Public Health will be. The appointment is a relatively junior one, although for the tens of thousands who still earn their living looking after the oral health of those fortunate enough to still enjoy the services of an NHS dentist, it’s an appointment of more significance than the Foreign Secretary.

Since 2017  responsibility for dentistry has fallen to MPs Neil O’Brien, James Morris, Maria Caulfield and Jo Churchill reporting variously to Jeremy Hunt, Matt Hancock, Sajiid Javid, Steve Barclay, Therese Coffey, Steve Barclay and now Victoria Atkins.  With so many ’here today, gone tomorrow’ ministers, that the dental contract has not been reformed is hardly surprising.  Those with the power to effect change simply aren’t in post long enough to grasp the basics, let alone formulate the solutions.

Neil O’Brien resigned to ’spend more time in his constituency’.   The MP for Harborough scooped 55% of the vote in the 2019 election so is not defending a slim majority.  Perhaps he’s had enough.  In his resignation letter he told Rishi Sunak “We have made some real progress during my time as a health minister. We have put more money, new technology and a lot more staff into doctors’ surgeries, and GPs as a result are now seeing about 15% more patients than before the pandemic. That’s about 23 extra appointments per surgery every working day."

His letter continued to enthuse about imminent legislation to deter smoking and vaping.  Notably, it made no reference to dentistry.

The prospect of a new Parliamentary Under-Secretary reporting to a new Secretary of State, with a general election to be triggered within a year, as good as guarantees that the much talked about ’contract reform’ is on the cusp, once again, of being kicked into the long grass.

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