One year on, Dentists are not happy…
23/03/2007

Next week on April 1st, the Dental Contract will celebrate its first birthday, except that there won’t be any cake, balloons or bubbly. Even those few dentists who have managed to hit their newly imposed NHS targets spot on are still feeling their professionalism has been undermined. Most dentists that contacted 2020health for our review of the Contract said the past year had been one of uncertainty and disappointment. Underperforming, over-performing, disputed local agreements, unintended repercussions for both domiciliary providers and Community Dental Services and a growing concern over the training and placement for new dental graduates characterized the responses. It’s not just the junior doctors who have had a rough time recently.

And for those of us who are patients, the New Year was definitely not the time to have tooth ache! By the end of January, 40% of the dentists we interviewed had run out of appointments for NHS patients.

In all, we heard in detail from 43 dentists. A snapshot only of the workforce, but without exception, everyone was unhappy. Dentistry, like medicine, is a vocation and the real job satisfaction comes when the outcomes of a days work are healing, restoration and feeling valued. The new, inflexible Contract now pays dentists to do as little as possible, tries to impose central control on a largely self-employed workforce and has imposed historic NHS problems of waiting lists and postcode lotteries on a profession that had previously avoided these troubles.

Next week will see the dental representative bodies, the Dental Practitioners Association and the British Dental Association, both setting out their anxieties and the results of their own consultations with the profession. The likely message will be that there have been no winners with this contract, and that the profession is deeply concerned about it’s future and the future of the nation’s oral health. With dentists discouraged from undertaking extensive treatment, Primary Care Trusts short of patient revenue and the restricted access to NHS dental care due to too few NHS appointments, there is real cause for concern.

In the current political climate where Public Health is a top priority, the question for all politicians is what are they going to do to address this threat to oral health? The most fascinating comment of all came from a dentist who’s job it is to assess the oral health of new recruits into the forces. He said “Many are unfit for entry, training and deployment on operations, necessitating huge amounts of work to render them fit for role.” This won’t have happened overnight, but as the new Contract has made seeing a dentist harder, not easier, it seems the situation can only get worse. The sheer inadequacy of this Contract means that unless the Government initiates a formal review, there is going to be little to smile about in the future.

Julia Manning
March 23 2007