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England: MPs unite against imposed targets

Blog Author Eddie Crouch

Blog Date 20/01/2021

​Eddie Crouch on the unprecedented cross-party support our members have helped generate for our campaign against targets.

 

Frustrating as it may be and despite our best efforts, dentistry rarely tops the political agenda. It therefore speaks to the scale of the challenge dentists are currently facing that we managed to secure not one but two debates in Westminster on our issues in less than two months.

 

Last week, the House of Commons met to discuss the impact of COVID-19 on dental services. The debate, which we worked with Fleur Anderson MP to secure, was granted after 36 MPs from seven different parties came together to call for it.

 

And I want to thank colleagues. Following our recent campaign more than 80% of English MPs were contacted by their local dentists, the focus of the debate was unsurprisingly the new activity target.

 

These targets are still with us, but I want to show how members are helping us win the argument, and where we can go from here in the fight against targets and for dentistry.

 

Raising concerns of NHS and private dentists

In her opening speech, Labour MP Fleur Anderson warned: “We are sleepwalking into the biggest oral health crisis since the creation of the NHS. Unless the Government begin to recognise that dentistry is an essential health service, the sector will collapse.”

 

Ms Anderson outlined her five demands, which included the development of a national plan for dentistry, in full consultation with the national professional dental bodies, funding for PPE and ventilation equipment to bring down fallow time, scrapping business rates for dental practices, and priority access for all dentists and their teams to COVID-19 vaccination.

 

“Our campaign saw over 1,000 emails from dentists land in MPs' inboxes.”

She also stressed that the activity target recently imposed on NHS contract holders was “unattainable and needed to be scrapped.” Contributions that followed echoed many of the points above, and included calls for clarity on dentists’ keyworker status, action to help with recruitment and retention, greater support for private practices, and wider reform of the failed UDA system.

 

However, following our campaign which saw over 1,000 emails from dentists land in MPs' inboxes, it was the new activity target which dominated the debate. Parliamentarians almost unanimously condemned the target, with Members from both sides of the House urging the Minister to abandon it.

 

Your voices were heard

Conservative MP Nicholas Fletcher rightly questioned how practices were to meet targets with the population being told to stay at home. He urged the Minister to delay the introduction of the target until 1 April, and to include remote triage as activity counted towards it.

 

“Targets effectively force NHS practices to prioritise volume over need.”

Labour MP Stephen Morgan was spot on in highlighting that the targets “effectively force NHS practices to prioritise volume over need”, warning that this “creates an unsustainable situation, in which patients are unable to access the treatment they need while practitioners are in a race against time to maintain their financial viability”.


Judith Cummins MP, who is the Vice-Chair of the All-Party Parliamentary Group on Dentistry and Oral health to which the BDA provides secretariat, said it was “unbelievable that the Government have decided to enforce a system based on UDAs in the middle of a pandemic”. She called on the Minister to think again and move away from “flawed UDAs” for good.


Following our campaign calling on members to contact their representatives, many MPs quoted testimonies from their local dentists, stressing how the targets threaten patient safety and the stability and the viability of practices.


Conservative MP Peter Aldous voiced concerns of dentists in his constituency who described the targets as “completely irresponsible”, “disrespectful”, “neglectful”, “unsafe” and “inconsiderate” and urged the Minister to drop them. Labour MP Paul Blomfield summed it up quite well for me, when he said “Frankly, to choose this time to impose new targets, without warning or consultation, shows either a lack of understanding or a lack of regard for the consequences”.

 

Achieving cross-party consensus on dentistry

Conservative, Labour and Liberal Democrat MPs were almost unanimous about the damaging nature of the new targets and the need for them to be abandoned.

 

One notable exception was Sir Paul Beresford, the only dentist in the Commons, who defended the targets and dismissed dentists’ concerns as “scaremongering”. Sir Paul claimed 60% of dentists were already meeting the new targets – something that is not borne out in any official data.

 

I have written to Sir Paul to express my disappointment that despite being Parliament’s only practising dentist, he chose to cite inaccurate data in defence of a policy most colleagues would deem indefensible. I have asked that he makes a statement to the House correcting this error, and I sincerely hope he looks at the facts and reconsiders his position.

 

Closing the debate, Shadow Health Minister Alex Norris MP called the imposition of the target a “failure of leadership”. He quoted the results of our latest member survey, pointing out that eight in 10 practices have seen an increase in cancellations and missed appointments, and three quarters of practices have experienced staff absences just in the last couple of weeks alone.

 

“It simply will not do that such a crucial part of our health service has working arrangements that discomfort it so greatly”, he summed up.


Building on this momentum

Despite the rare cross-party agreement on this issue in the Chamber, the Minister for Health and Social Care Jo Churchill MP failed to reassure the profession that the activity target would be scrapped.

 

“The Minister’s desk has been flooded with letters raising dentists’ concerns.”

She instead asked practices to record staff sickness, DNAs and any other circumstances that might mitigate against the inability for practices to hit their targets, and assured them this would be taken into account as part of the exceptions process, and reiterated her commitment to long-term reform of the NHS dental system. This is clearly not enough.

 

The debate was hugely oversubscribed and many MPs who applied to take part in it did not get the chance to. The Minister’s desk has been flooded with letters raising dentists’ concerns. I would like to thank all colleagues who took the time and wrote over a thousand emails to their representatives urging them to speak up on this issue. By mobilising in this way, we have clearly demonstrated to the Department that we will act when the profession is threatened or when oral health is not prioritised.


This debate marks a new beginning, not the end, of our campaign to get a fair deal for dentists. We will continue to build on this momentum to fight not just the immediate threats posed to our profession by COVID-19, but also the longer-term challenges we have grappled with for years.

 

Eddie Crouch

 

Eddie Crouch
BDA Board Chair