Departmental officials were requested to brief the committee in response to the oral evidence we gave to the committee in June and our associated warnings about the future of the service.
Members questioned officials on a range of issues including timelines for dental payment reform and a new General Dental Services (GDS) contract; failure to consult with us ahead of the £9.2m Dental Access Scheme launch; patient access to high street dentistry; and regulating dental tourism.
Various members of the committee voiced their concerns regarding dental access issues and the shrinking of the service as a result of a failing contract model which clearly is not sustainable. They probed the Department of Health (DoH) on what work had been done to cost up the Scotland model for a Northern Ireland context; they also warned of, “an urgent need for clarity on the future of this service”.
Members set about effectively scrutinising the work of the Department in relation to the GDS:
- Diane Dodds MLA warned against continued delay on the contract, saying “As long as this continues, shrinkage of NHS dentistry will continue”
- Vice-Chair Danny Donnelly MLA asked for a clear timeline for a new contract. He quoted from the 52nd DDRB Report which states, “the current contractual arrangements are not enabling NHS dentistry to be sustained or to grow”, and that governments must embark on contract reform
- Questions were raised about the regulation of “dental consultations” by non-domiciled overseas companies meeting in hotels in Northern Ireland
- There was a question on inconsistency around maternity pay eligibility for Health Service dental earnings
- There was also an update sought on oral health improvement and tracking progress in relation to inequalities.
Responding to committee questions, Gearoid Cassidy, DoH, said there is no timeline for a new contract. He referred to, “an iterative process” with “incremental” changes to the GDS, learning from British models and focusing on maximising benefit to population with existing budget.
Liz Kimmins, Committee Chair warned “we don’t have time to lose” as delay is costing us Health Service dentists. Members were unanimous in the need for action.
The meeting concluded with members summing up what they had heard from DoH officials, and expressing their concerns. Diane Dodds MLA described the lack of a timeline as a “difficult” and a “negative message”. Essentially the DoH approach is “more of the same”and “work around the fringes e.g. DAS” (the Dental Access Scheme).
Colin McGrath MLA urged that the committee should write to the Health Minister as no commitment was given on timelines for contract reform. He highlighted how the DoH message was at odds with what we at the BDA and dentists are saying, that high street dentistry is “close to collapse”. The committee also agreed to write to the Regulation and Quality Improvement Authority (RQIA) on the regulation of dental tourism. Other asks included sharing of performance data of the Dental Access Scheme.
The Chair asked that the committee be kept updated.
Committee for Health meeting - Thursday 3 October 2024 (Timing: 13:10 - 1:18:00)
Analysis by Tristen Kelso, Northern Ireland Director
The significance of this session is that it happened in the first place at a time when there are so many competing issues within health and social care.
Secondly, the Health Committee deployed clear and effective questioning, fully informed as a result of the engagement work we have been doing and the issues they are seeing at a constituent level. They want to see action around remedies.
Thirdly, in its scrutiny role, the committee has identified an obvious shortfall in the Department’s approach to addressing GDS issues to what is so obviously required to sustain the service according to the profession. It is precisely because of this that they felt compelled to write to the minister.
The voice of dentistry has been heard by the Health Committee. It is clear that members from across the entire party political divide are very concerned about the future of this service; and crucially, it is not just the BDA making the case for significant dental payment and contract reform on our own.
A powerful statutory committee with significant powers to hold the Northern Ireland Executive to account is advocating on behalf of the service.
We will continue to press for urgent and meaningful reform of this important public service, and we will keep you updated at every step of the way.