Dental Reform: Profession Delivers Damning Verdict On "Polyfilla Plan"

Dental Reform: Profession Delivers Damning Verdict On "Polyfilla Plan"

The great and the good of the dental profession returned to Westminster yesterday (19th March) with some stark feedback for the Health and Social Care Committee: the government’s Dental Recovery Plan (DRP) simply doesn’t cut it.

GDPUK’s Guy Tuggle watches the proceedings as dentistry returns to Parliament

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee told the MP’s on Parliament’s Health & Social Care Committee (HSCC) that the DRP might have generated some good press releases with headlines that spoke of ’golden hellos’ and dental vans that made for nice photo opportunities, but the net effect would be fewer patients being seen whilst the exodus of dentists from the NHS continued.

Mr Charlwood reminded the HSCC that last year, after its Inquiry saw probing consultation with patient groups and the profession, they had published a document that rightly cited contract reform as the essential foundation upon which to rebuild NHS dentistry. 

Instead of reforming the contract, the DRP had parked it and concentrated instead on easy headlines, pushing "contract reform, which is the only thing that will save this service, further down the line".  

Mr Charlwoood said there had been no meaningful discussions with the government since last autumn as the DRP became its (the government’s) focus.

Mr Charlwood told the Committee that following the unveiling of the DRP, the BDA surveyed its membership for their thoughts.  1104 dentists engaged, of which only 1% thought the DRP would help the government achieve its stated aim of making an NHS dental appointment available to all who need it. 

Just 3% said the measures in the DRP would keep them in the NHS long term and only 3% believed it would result in their practice seeing more patients.  Over half, 54%, believed the impact of the DRP would mean they saw fewer patients.

Mr Charlwood spoke of the ’cold fury’ expressed  by colleagues.. Over one hundred respondents used the expression ’too little, too late’.  Others described the Plan as ’inadequate’, ’rubbish’ and ’a joke’.  

"Polyfilla Plan"

Speaking of the proposals that made up the Plan, Mr Charlwood said "you cant rebuild a wall with a box of Polyfilla"

Challenged to say if any parts of the Plan were good, Mr Charlwood gave a cautious welcome to the ’Smile for Life’ initiative but then effectively doused it with cold water by pointing out that applying fluoride to 165,000 primary school children helped just 2% of the total.  As such, the Plan made a good headline, but lacked ambition.

Rebecca Curtayne from Healthwatch said that patients were still none the wiser with regard to which practices were taking on new patients as a result of the DRP.  She believes practice websites should display a digital flag to signal if they are accepting new patients who have not seen an NHS dentist for two or more years.

Ms Curtayne confessed that Healthwatch had no idea where dental vans might go or how patients might access them, adding that if  they - Healthwatch -  are not party to such information, how can the public possibly be know?

A Universal Service?

Thea Stein of the influential  Nuffield Trust  was pressed to give the DRP a score out of ten. She rated it 3 or 4..  It was simply "not big enough to bring about universal access".

Ms Stein, in comments that cut to the core of what many in the profession are openy asking but which MPs daren’t, questioned what the Plan failed to address.   "Is it a universal service for all, or is it going to be a good, gold plated service for the most vulnerable and those with the most need and a service that is means tested for others?  It goes nowhere near grappling with those issues". 

£35 UDAs Demands Charlwood

Conservative MP Dr Caroline Johnson asked Shawn Charlwood if the NHS could ever pay enough to stop dentists leaving for private practice.   He believed it could "because it used to".  But the minimum UDA rate needs to be increased to £35 said Mr Charlwood adding that this was something the BDA was pushing for and was affordable within the figure that is being clawed back.  

Vans again...

Challenged on the role ’vans’ could play, Mr Charlwood said that only between 12 and 15 vans were being proposed by the Plan.  "Optimistically", these could provide 50-70,000 appointments.  

Vans have a role in targeting specific groups like the homeless, Mr Charlwood told the Committee, but were not the right method to deliver dentistry to 12 million citizens who don’t have a dentist and vans were beset by safety issues.  

Mr Charlwood said that as the Bristol experience had shown,  news of a dental facility opening spreads rapidly and long queues form.  He invited the Committee to consider the possibility for "what do you mean you can’t see me?  I’ve been queueing for hours"  confrontations.

Where’s the Modelling?

The DRP has spawned many claims and counter-claims for the number of patients it will benefit.  Mr Charlwood quoted "2.5 million additional appointments", "105,000 courses of treatment", "1 million more patients seen. Where’s the modelling to support these claims?"

Next up was Interim CDO Jason Wong, Dr Amanda Doyle of NHS England and Minister Andrea Leadsom whose claims for the Plan have raised many eyebrows. GDPUK will report on these tomorrow.


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