Silence is golden
The lack of outcry over the reform of NHS dentistry in Scotland suggests that, possibly, it is on the right track
Ok, so the headline is not meant to suggest that we are getting all ‘happy clappy’ about the state of NHS dentistry in Scotland. We know that it still faces considerable pressures. The patient treatment backlog; a recruitment crisis; patient access to NHS care is still a significant issue; and, unfortunately, so is practitioner burnout.
A couple of months back, I was contacted by a London-based healthcare consultancy that was in the process of preparing a report about the impact of the revised Statement of Dental Remuneration (SDR) on the Scottish dental market. I qualified my willingness to answer their questions with the observation that, not being in practice day in day out, my knowledge could not possibly match that of those who were managing the reforms, introduced last November, on a daily basis.
What has been their experience? Fundamentally, were the reforms fair – to practitioners and patients? Were they resulting in increased income for practices and better care for their patients? Was the system of payment and accountability transparent? Was it working on a practical level; were there no serious
IT glitches of the kind so common in government-imposed systems?
It is to be hoped that reform has served as a starting point towards preventative care and away from the era of ‘drill and fill’
Well, the fact that I, as a journalist, have been unable to report any outcry was telling. That was my main message to the researcher. The relative silence from the profession was a sign that, well, things might be moving in the right direction after all.
But, he asked, had the reforms changed the balance of the dental market? Too early to tell, I said. There are some straws in the wind; a survey of readers we conducted in partnership with The Herald newspaper did suggest some people were finding access to care problematic because of a shift by practitioners from NHS dentistry to private. Also, some people were taking out private dental care plans to assure them access at their NHS practice. But, given the sample size, those findings were anecdotal rather than statistically meaningful. The recent NASDAL Scottish benchmarking statistics did note a rise
in associates moving to private care. But, again, this is probably just a feature of the ongoing working pattern readjustment, post-pandemic. It could be argued – hoped for, perhaps – that the recent reforms might have a contra effect over the coming years.
So, back to the headline. It was interesting to hear Tom Ferris, the Chief Dental Officer, at the Scottish Dental Show, comment: “Since the changes were introduced, it’s been kind of quiet. I’m taking that
as a positive. As I go around, people will take me aside and say: ‘It’s actually okay. You know, it’s not perfect, but it’s better than it was; you are kind of on the right track.’ People are just getting on with it. And it seems to be working. I think if it wasn’t, I think the noise from the sector would be deafening.”
In developing the reforms, the Government was obligated to engage with the British Dental Association (BDA) and the Scottish Dental Practice Committee (SDPC). But it also sought other voices. It surveyed
the profession. The CDO established an advisory group, comprising practitioners from across Scotland which, he said, had “worked really well”.
When the reforms were announced, David McColl, Chair of the SDPC, said: “Ministers cannot pretend this is a final destination for NHS dentistry in Scotland. We struggle to see how these changes alone will close the oral health gap, end the access crisis or halt the exodus from the NHS.”
Indeed, but it is to be hoped that reform has served as a starting point on a journey towards truly patient-centred, preventative care and away from the era of ‘drill and fill’. Also, that any drift to private care can
be halted. The CDO’s inclusive approach to reform and, indeed, other initiatives he discussed at the show point to a productive continuation of that journey
Will Peakin is Editor of Scottish Dental Magazine, get in touch by emailing editor@sdmag.co.uk. Follow Scottish Dental on X (Twitter), Instagram, Facebook and LinkedIn.