Northern Ireland: How did the Executive perform in 2020?

NI Council Chair Caroline Lappin looks at how the NI Executive performed in its first year back and asks what this means for dentistry.

No one foresaw what 2020 would bring. When the NI Executive reformed on 11 January 2020, after three years in the political wilderness, Northern Ireland once again had a functioning Government. But after just two short months a global pandemic was declared and COVID-19 came to define all our lives.

None of us have gotten through 2020 unscathed, so it might seem churlish to question how the Executive performed during its first year back. However, the pandemic has shown us how the decisions politicians make directly affect our lives. So, it’s important that we question how well the Executive dealt with the challenges thrown at it in 2020.

A mixed report card

Our briefs to Health Minister Swann and the Health Committee were clear and consistent. Help us stay open, help us to keep treating our patients, help us to stay in business. So how did our politicians respond?

Unfortunately, the response from politicians was uneven. On the one hand, guidance was often more forthcoming in NI than in some other parts of the UK. However, regarding support for mixed and private dentistry, we saw a shifting of responsibility from the Minister of Health and Minister of Economy. This amounted to a dereliction of duty and no effective support measures were introduced, putting many practices at risk.

The Executive’s uneven meting-out of support has been criticised by economist John Simpson, who said: "The delivery of financial support to people whose incomes had disappeared was uneven to the point, sometimes, of unfairness." Mixed and private dentistry were unfairly denied support, despite our best and extensive efforts.

In the area of support for Health Service dentistry, we saw some more proactive and innovative thinking from Minister Swann. The introduction of the Financial Support Scheme provided an essential lifeline for practitioners. And, through our near-constant engagement, the scheme has been improved as time has gone on. We now have a proportionate support scheme which will continue until the end of March 2021.

Winning the battle on awareness

During 2020, the BDA shone a spotlight on dentistry like never before. Our profession is rarely in the limelight. Often the Cinderella service, falling between the cracks of health care and economy and making few headlines, but in 2020 we seized the opportunity to take centre stage for your concerns.

Our politicians are now aware of dentistry and oral health. The Health Committee members have been robust in their questioning of departmental officials, other ministers, their departments and support for dentistry. An unprecedented number of Assembly questions, from Health Committee members and other MLAs alike, as well as Assembly motions, supportive party press releases and individual engagement with MLAs means that our voices have been heard.

In a recent Health Committee meeting, for example, Chair Colm Gildernew stated that the situation in dentistry was ‘fairly dire’, noting that the number one reason for hospital admissions for children in Northern Ireland is for extraction of teeth, with 23,000 teeth extracted from 5,000 children in 2018. He challenged departmental officials to not just look at income generation, but at the oral health impact as well. And I’m pleased that these messages seem to finally be hitting home.

Looking ahead

We know that dentistry is a complex, far reaching and a vital part of health care. Our politicians may not be familiar with every facet of the service, but I believe they now have a much firmer grasp on, and appreciation of, the issues involved. This bodes well for our practitioners and our patients, as we look ahead to the many challenges we face.

MLAs who are interested and engaged, coupled with a union that has worked doggedly to protect the profession, brings me some hope for the years ahead. And after a year almost devoid of such hope, it is most readily welcomed.

Caroline Lappin

NI Council Chair British Dental Association