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England: Will change at the top bring cuts or reform?

Blog Author Shawn Charlwood

Blog Date 21/10/2022

Dentistry faces navigating a new government and a possible return to austerity.


Minutes before a debate on the future of NHS dentistry was set to begin in the House of Commons, Liz Truss took to a lectern outside No 10 to announce her resignation as leader of the Conservative Party.


It’s been a tumultuous time in British politics. But out of sight and out of mind these big changes will have knock on effects for members on the frontline, and the patients they treat.


We have been working to put the issues our members face on the agenda. With the economy in dire straits, and another new Prime Minister just days away here’s what you need to know.


Reform is now a cross-party issue

In the minutes that followed the resignation of the Prime Minister, a rare moment occurred in the House of Commons. MPs from all parties were as one.


The subject was dentistry, and the failed contracts we know so well. A motion for government to set out an action plan to end the workforce and access crises was duly passed, with the government set to report back in three months on progress.


“Across the country there are a multitude of dental deserts” warned government backbencher Peter Aldous MP. “If we do nothing, if we apply the odd sticking plaster here and there, England will turn into a dental Sahara. We owe it to those we represent that this does not happen.

“The truth is that NHS dentistry in its current form is not working anywhere for anyone”

“This means that we need - as a matter of urgency - that blueprint plan for NHS dentistry.”


The same views came from opposition benches. “The truth is that NHS dentistry in its current form is not working anywhere for anyone” said Labour’s Judith Cummins.  “How did we get into this position? The answer is three-fold, a contract not fit for purpose, dramatic underfunding, and an exodus out of the NHS workforce.”


A return to austerity? 

Clearly the state of the public finances has precipitated this tidal wave of change at the top of government and anyone working in the early 2010’s will know what this could mean for dentistry.


After the Financial Crash ‘efficiency savings’ (i.e. cuts) we saw unparalleled pressure on already inadequate budgets. The same noises are being heard again today. 


31 October is a hard deadline. Only then we will get a clear sense of the scale of the cuts the new government intend to take forward.


We are not waiting for the inevitable. Fresh from his emergency statement we’ve reached out to Jeremy Hunt, the new Chancellor and former chair of the Health and Social Care Committee, that only months ago dubbed the NHS contract ‘not fit for purpose’.


"This service is already on the critical list, and any further cuts will kill the patient."

Our position is quite simple. Meaningful reform must go hand in hand with sustainable investment. This service is already on the critical list, and any further cuts will kill the patient.


We’ve reached out to ensure the same message is coming from MPs on all sides of the House. 


A return to austerity cannot be used to effectively shut down the reform process before it’s even begun. Existing funds must be protected, and new resources provided to meet the challenge ahead. 


“Cash will be crucial” noted Gloucester’s Richard Graham MP. “Nothing comes cheaply, but I think we can all agree that sorting out dentistry and making sure everyone has access to NHS dentists is a very precious cause.”


Change we can believe in? 

The hard truth is that change at the top means delay, as new faces get up to speed on our old problems.


Newly appointed Minister of State Will Quince MP was at the despatch box for the debate, the fourth minister with responsibility for dentistry we’ve seen since lockdown.


This constant churn undermines much-needed change. Who will report back to the Commons in three months’ time is anyone’s guess.

"while the current ‘A,B,C,D’ strategy may not have a future, the ‘D’ for dentists isn’t going anywhere"

We know it’s not just personnel that change, it’s priorities.


Certainly, those counting down Liz Truss’s leadership election pledge to fix NHS dentistry in 90 days may be disappointed.


But while the current ‘A,B,C,D’ strategy may not have a future, the ‘D’ for dentists isn’t going anywhere, thanks to the pressure you’ve helped us bring to bear on government. 


Deeds not words

This is a challenging time, and the hard fight for reform has not got any easier.


We’ve worked to ensure that dentistry isn’t a partisan issue. The future of dentistry is practical concern impacting on millions of constituents the length and breadth of the country.

“Dentists are doing a fantastic job. But they have both their hands tied behind their back at the moment. That has to change.”

Thanks to our members - hundreds of whom had reached out in the run up to the debate - MPs were able 

to spell out the facts about the reality on the frontline.


Bootle MP Peter Dowd put it quite simply. “Dentists are doing a fantastic job. But they have both their hands tied behind their back at the moment. That has to change.”


“We have had a briefing from the BDA. We’ve had contact directly from dentists. They are all saying exactly the same thing” he added.


“The government have to listen. But not just listen, because that’s dead easy. What we have got to do is act.”


That’s the key. Warm words, quick fixes and tinkering at the margins won’t save NHS dentistry. 

Our patients need to see fair funding and real reform. Any further cuts will condemn this service to oblivion.



Shawn Charlwood

 

Shawn Charlwood

Chair, General Dental Practice Committee