Healthy teeth, happy smile

Interesting one in the Impartial Reporter (incidentally surely the best name for a newspaper ever) about the lack of dentists in Fermanagh. Of course this problem is not confined to Fermanagh and there are difficulties seeing dentists throughout the UK.The gradual collapse of NHS dentistry has been an ongoing crisis in slow motion. To begin to understand it one must remember that dentists are not employed by the NHS. They are private professionals who traditionally did most of their work for the NHS. The old NHS dentists’ contract was based on payment for work performed. This led to the so called “Drill and fill” culture which dentists had become highly dissatisfied with. There had been warnings about this problem for many years and it is interesting that Blair having promised that everyone would have an NHS dentist within two years, had by 2005 recognised that he could not achieve this.

A new contract for dentists was introduced which was supposed to allow them to take more time on education. This was, however, unpopular with dentists and many voted with their feet opting to do partly or wholly private work; a situation which has continued up to the present.

The essential problem is that there are too few dentists, the government contract was not attractive enough and people are willing to pay privately to attend the dentist. As such if the dentists leave the NHS there is absolutely nothing the government can do. Recruitment of overseas dentists can have some effect but obviously these new dentists can then simply set up privately. The government is trying to train more dentists but each one takes five years at university and usually a year or two before becoming an independent practitioner. Also of course unless there is a vast over supply of dentists, these new dentists can simply enter the private sector.

The only solution would be to offer the dentists much more favourable terms to completely re enter the NHS. However, since the population has become somewhat used to having to pay for dentistry one could argue that this suits the government as within a few more years for relatively little political damage the government could abandon NHS dentistry and essentially wash its hands of the problem. Such a strategy whilst somewhat Machiavellian would save them money and just might prepare the population for the possibility of having to pay for other services which the NHS currently provides for free. Remember that GPs are also privately employed persons who contract to the NHS.

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