THE DENTAL DEBATE AND THE POLITICS

“The NHS belongs to the people” (2) is a moot point – the Author of this fairytale certainly believed so in 2014 before Covid-19 struck. “Stay at Home and Save the NHS” became the order of the day and even now patients find their NHS general medical practice requirements either refused or rationed. Watching the daily BBC News Bulletins from No 10 Downing Street giving the daily death tolls from Covid-19 reminded the older population of the daily Falklands War Broadcasts from No10.

The 2014 Document (2) announces an “honest and realistic debate as to how the NHS will meet future demand and tackle the funding gap. The NHS (the people) will not contemplate reducing or charging for core services” and so the one-sided “debate” continues today. The Document contains many funding forecasts and predictions that have proved wildly inaccurate as time has passed.

The mandarins of medicine and the doctors of dentistry have spent more than 70 years poring over various NHS Reports and initiatives with no end in sight to the burgeoning illness demands. In our digital age the NHS faces record numbers of obese children and rampant tooth decay in the very young requiring a record number of dental extractions under general anaesthesia in hospital. Here is a helpless nursery of patients who are in a pandemic class of preventive failure.

We have to go way back to 1978 to experience political conditions for change when the following Conservative Party Manifesto notes were published – “Recognition and payment for preventive dentistry is urgently necessary. The present system of charges is unfair as patients seeking regular treatment pay the same for minimum attention as the casual patients requiring excessive work. Many items of work are unprofitable for the dentist.” A formal recommendation was once made in the early 1980’s to introduce a Grant-in-Aid scheme with an ironic twist – it was the British Dental Association (BDA) in the early days of the NHS that campaigned for such a scheme only to reject one three decades later!

Another “political promise” for a new approach to the NHS Dental Contract was published in the Conservative Party Manifesto of 2005 – “To change the way in which dentists are paid” only to be vetoed soon afterwards! Yet another Health Minister recently rejected the preventive concept supporting a “Dental Passport”  a concept that has since been introduced by the Republic of Croatia (5) in 2018. Spectacular reductions in dental caries in the deciduous teeth of schoolchildren have been recorded in Denmark and Sweden with similar government funded preventive services.