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Lords press for stronger primary care voice

We are keeping up the pressure for a stronger voice for dentistry in new structures set to be created by the Health and Care Bill as it continues its journey through Parliament.

We are working jointly with four sister organisations representing GPs, community pharmacy, optical, and audiology services. We're lobbying for primary care professionals to have a voice in the newly created Integrated Care Boards, which will have responsibility for commissioning dental services.

Following our extensive briefing, the issue was debated at length both at Committee and Report Stages in the House of Lords.

At Committee Stage, Lord Hunt of King's Heath tabled two amendments to the Bill put forward by the BDA, which would require the Integrated Care Boards to consult Local Representative Committees such as LDCs when writing their annual strategic plan, and guarantee a person nominated by the Local Dental Committee in each Integrated Care Partnership. In his speech he stressed the importance of dentists, pharmacists and opticians, rather than just GPs, having a strong voice in the new structures.

Lord Crisp, who before he joined the House of Lords was the Chief Executive of NHS England, argued it was vital all parts of primary care were highly influential in the new system, and not the poor relation of hospital trusts. "It is vital that we do not disfranchise a key and currently quite largely demoralised sector or, as importantly, lose their valuable contribution" he concluded.

Liberal Democrat spokesman Lord Scriven stressed the vital role all parts of primary care played in improving health outcomes, integrating healthcare and reducing inequalities. He urged the Government to come back with amendments to give the dental, ophthalmology and pharmacy sector a key role in the new systems. His Conservative colleague Baroness Cumberlege echoed his comments, arguing that primary care was "the absolute foundation of the NHS" and that it was crucial to reinstate its primacy.

Shadow Health Minister Baroness Thornton said that without a stronger voice in the new structures, primary care would "continue to be underresourced and underplanned". She concluded: "It is about the bread and butter of people's health – their GPs, dentists, the physios and pharmacists. If primary healthcare does not work, the rest of the NHS falls over."

While the Government did not accept any of the amendments on this issue, in his response the Minister Lord Kamall confirmed NHS England guidance would be explicit in its expectation that all parts of primary care would be "crucial partners" in drawing up Integrated Care Boards' strategic plans. He said he was "open to further conversations in this area, particularly on how we hear the voices of all those in primary care, not just those of GPs but also those in ophthalmology and dental care".

We will continue to lobby for our members' interests as the Health and Care Bill continues its journey through Parliament, and as more detailed guidance is being developed.