In 1999 I was lucky enough to be Chairman of the Nottingham Local Dental Committee. During my 2 years as Chairman, there was much discussion about the possible future onset of “local commissioning”.
It was not quite clear what this was to be but it was understood that we would possibly be moving from a model of National funding to local funding where local health boards had the ability to deny or approve funding for local dentists. At the time this seemed frankly, ridiculous, and many people said that it would never happen, it could never be managed and it would be worse for patients.
As I look back now in 2011, local commissioning seems to have come and almost gone. There is no question that funding issues lie in the whim of local organisations and no one is exactly sure who holds the purse strings. This makes providing NHS dentistry extremely difficult and makes the funding extremely unsafe. I was able to watch the developments of all of the local commissioning from inside the dental political system including National committee’s. I watched the slow realisation from people who denied this would ever happen become sick resignation as they realised that the massive changes in their working way of life had come to fruition.
Things have changed a great deal in the past 11 or 12 years, both nationally and in my professional life. I now sit in a situation where people are starting to suggest that the face of dentistry is going to change forever. Not only with the expansion of corporate dentistry but also with the expansion of supermarket dentistry. It seems that many of the old rules still apply and many people are denying the fact that supermarket dentistry will ever work. The usual nonsense about ‘it didn’t work for Boots so it won’t work for anyone else’ still seems to apply in many people’s eyes but I am sure that in 5 or 10 years time everything will look entirely different again.
What’s the solution to this?
I believe the only way to deal with these things is to ride on the wave of change, to embrace the fact that everything will be different in 5 years time and look for the opportunities within that. If we all sit back and think that we can work in the same old way with the same old things we are simply going to be swallowed up.