The LDCs Conference today voted in favour of a ‘CPD day of action’. But this won’t be effective, especially as dentists are already voting with their feet by leaving the NHS, argues GDPUK acting editor Jaimie Kaffash
It was a fiery day at the Conference of Local Dental Committees in Manchester today. One motion debate saw a principal telling an associate that their plea to receive fair allocations after a DDRB pay uplift could end up ‘bankrupting practices’. There were calls for the resignation of the chief dental officer. And it was dominated by fear around the complex care pathways that are being introduced as part of the 2026/27 NHS contract – which we will be covering in more depth soon.
But the debate that resonated with me was around GDPs taking some form of industrial action because of continued below-inflation NHS funding increases. It may not have been the most important debate of the day, but it was a neat encapsulation of the problems affecting dentists and – as someone who is completely new to the dentistry profession – it was a debate I recognised.
As I have said on these pages, I am still editor in chief of Pulse, the magazine for GMPs, and I have been at the publication since 2012. The debates around industrial action have been popping up regularly for GMPs in the past decade, and it is one that has particular resonance for dentists (indeed, the keynote speaker on the second day of conference is the chair of the British Medical Association’s GP Committee talking about this very thing.)
Today’s debate was fascinating. The proposer of the motion argued that a ‘national day of CPD action would provide a visible, proportionate, and professional way of highlighting these concerns and pressing for fair approach to contract offers’. He pointed out, quite rightly, that ‘no business would measure its costs using a formula that ignores its actual expenses’ – which is what the Government’s formula does.
I was taken a little bit by surprise when BDA chair Dr Eddie Crouch spoke in favour of a CPD day of action, and generally in terms of some kind of collective action. He told delegates: ‘I know that our GP colleagues - and I'm sure Katie [Dr Katie Bramall, BMA GP Committee chair] will talk about this tomorrow - are looking at elements of non-contractual breach that we can actually protest appropriately. This is one way of doing it.’
However, I have always been a little dubious about collective action. As Dr Crouch also pointed out, dental practices – like GPs – can’t really take traditional strike action that breaches their contract. These groups are not like junior doctors, who were able to take continual strike days – which was the most effective part of their action. When they do so, they are docked a day’s wages. When GPs do, the practice is docked a day funding, but all the overheads – including staff costs – still need to be paid. Dentists at least have the option of providing private work on that day, but that diminishes the vital visible element of the action.
Then there is the nature of their work. While there is a new requirement for NHS dentists to save 8% of appointments for urgent care, the vast majority is still routine. With access problems in NHS dentistry – like general medical practice – the sad truth is that a day of CPD will not have much of an effect on patients if all that is happening is they are waiting a day longer for routine case. Indeed, among GP leaders there were fears that such an action would lead to headlines about patients not knowing a difference.
The sweet spot for dentists and GPs is action that patients support, that affects government and is not a breach of contract. For GPs, they have landed on action around non-co-operation with the Government’s plans around data sharing. This hits all the sweet spots. But, I fear, the problem is that the Government wouldn’t care.
So here is the good news and the bad news for dentists (with a tiny bit of good news to finish). The good news is that NHS dentists have the ultimate form of action – although it is one that the BDA would not support. And that is giving up their NHS contract. It is a route many, including those present at today’s conference, are taking. It may even be something that they are taking with a heavy heart. But, in terms of making a point, there is no better way than voting with your feet.
The bad news is that it seems the Government isn’t really listening. The Labour Party has committed to an overhaul of the NHS contract, but there is no indication that it will come with extra funding – which is the most important part. The amendments to the contract this year have only been welcomed by the BDA (as is tradition), and even then lukewarmly.
But here is the slightly good news. It does seem as though we are hitting a critical mass. It may be because only now have I been paying major attention, but there are more stories around dental deserts, and the problems with NHS access. If there is one thing the Government definitely listens to, it is newspaper headlines.
Dentistry is unlike any other part of the healthcare system, often to its detriment. But the Cinderella service can simply stop working for the ugly sisters.