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Some background…

Around the time of the turn of the millennium I was chairman of the Local Dental Committee in Nottingham in the discussions around development of Primary Care Groups and then onto Primary Care Trusts that ultimately became commissioning groups. At this stage, in dentistry, all the talk was of local commissioning and removal of the protection of dental funding into the main NHS budget. I remember colleagues laughing about this and saying how this could never happen and how it would be a ‘political bombshell’.

The truth lies in the fact though that dentistry is relatively insignificant or in fact depending upon your views completely insignificant in terms of overall healthcare. In the UK should you suffer a serious or significant dental infection which is life threatening or a cancer in the same serious vein you’d be brought within the care of the medical services and dealt with there.

Generally people don’t die at home alone from dental disease.

In any event following on from those discussions and inferences of 17 years ago local committee commissioning is in full flow and ring fenced budgets have disappeared.  

It’s no secret to anybody that NHS dentistry is in complete crisis as far as an organizational system is concerned. Recently I was told about how one of the largest dental corporates sold three dental practices for £1 each. Yesterday I found out that the same dental corporate had handed a contract back for a practice that they had paid significant sums of money for only 4 years ago, now no one is prepared to take the contract on due to man power issues and around 15,000 people have immediately been consigned to life without any access to NHS dentistry which they had before.

The dentists who read this will be up in arms about how serious this is but the truth is it’s the tip of the healthcare ice burg.

As I sit here writing this piece I’m waiting to take my father-in-law to the GP surgery for quite serious cardiac issues that he has which have become acute over the last few weeks.

It’s hard enough to access healthcare in these situations let alone when you want your teeth cleaned or your centre line moving 1mm!!

And so enough of the background and to the meat of what I wanted to talk about in this post.

In case you missed it the GDC’s latest update points us towards consultation processes being held by the government to healthcare regulation, promoting professionalism, reforming regulations.

This is the first step of the formation of a super regulator in healthcare to regulate all healthcare professionals in one foul swoop.

At the moment it looks like it will be the PSA (I’ve read the consultation document, all 51 pages of it and I’ll be surprised if many other people do).

The first stages look like consolidation of the current regulators hallowing a few healthcare professionals who no longer need to be regulated because they’re ‘low risk’, merging several of the other regulators together for ‘economies of scale’ for ease of over seeing the regulators by the super regulator.

This is something that has been long talked about and where many people have said ‘if you think the GDC are bad wait till you see what a super regulator looks like’. There are perhaps very small silver linings to this cloud; it may be that the regulator fees for dentists will drop as an aggregate when they’re merged with medicine (that’s what I believe will happen). It may even be that things like forgetting to take a PBE or bringing your children work might not be seen in quite a darker shade in relation to the issues that are caused and the risks that are put upon patients in relation to medicine. But it’s yet another step towards to the loss of autonomy for dentistry as a profession.

For some time now, on and off, I have toyed with the idea of whether dentistry should be seen as an absolute sub-specialty of medicine and in fact not a distinct entity in it’s own right.

The well-greased wheels of the civil service will continue to turn and the long term plans for the changes to regulation in healthcare will continue to take effect regardless (it seems) of the colour of the politicians in West Minster.

It’s my strong held belief that a path towards a single medical and dental regulator will secure the transition of dentistry into medicine and it’s overall obliteration as an individual profession.

As with all these things there are positives and negatives about that and I certainly feel that if dentistry were sucked into medicine there would be a likely improvement in the professional standards of dentistry as a result (controversial).

In a way we get to decide this because if we stood up and shouted in a unified voice and changed our behaviours and showed our worth we would, at least for a longer period of time, protect our autonomy and individuality.

That seems unlikely to me though.

Blog post number: 1449