July 2018 marks the platinum anniversary of the NHS and there have been many changes over the past 70 years. It seems apt at this milestone to look at the history and evolution of dentistry within the NHS, and what the future might hold.
To explore this, we asked Stuart Allan, who qualified as a dentist in 1978 and is Chair of the Greater Manchester Federation of Local Dental Committees, to share his thoughts on the past, present and future of NHS dentistry…
Stuart: ‘It is often useful on an anniversary such as this to speculate where we might find ourselves in another 70 years; although I am aware that a colleague in 1948 would have been amazed at how materials and some techniques have progressed, he (and it probably would be a ‘he’) might have been shocked at how some of the same issues remain.
We still spend most of our professional time treating two diseases which are almost completely preventable, our 1948 colleague observing a country rebuilding after the catastrophe of a world war would be amazed that we have chosen to adopt a more cariogenic diet!
He might not be so surprised to find our contribution to the health effort continually downplayed or even disregarded; although there are often statements contradicting the sentiment, we do always seem to be semi-detached from the rest of the health service. Where further integration is suggested, as has been the case with ‘Devo Manc’ (the devolution of transport, housing and skills budgets as well as health and social care to local councils), there seems to be a very one-sided view. For example, the suggestion that we could weigh and measure our patients, calculate BMI, take their blood pressure and sugar level, but there would be little or no funding as ‘we were seeing those patients anyway’.
“Society in general will have to realise that there will always be a limited budget for healthcare and decide whether this is best spent on frontline treatment or funding an army of people telling others what to do. Yes, standards need to be upheld, and yes, patients should be compensated when things go wrong…but the pendulum has not just swung too far in one direction, it seems to have got stuck!”
Two unwelcome trends would be the geometric growth in regulation and litigation, although this is an issue wider than dentistry. Society in general will have to realise that there will always be a limited budget for healthcare and decide whether this is best spent on frontline treatment or funding an army of people telling others what to do. Yes, standards need to be upheld, and yes, patients should be compensated when things go wrong…but the pendulum has not just swung too far in one direction, it seems to have got stuck!
What might a colleague in another 70 years be contemplating? Not restoring teeth, as if decay is present it can be removed and another grown in its place? Or not restoring as implants have become so developed that they are the first line? Caries and most periodontal disease is rare as a vaccine has been developed? Well, with the exception of implants, all of these were being touted when I was studying in the early 70s by lecturers telling us we were entering a dying profession. Dream on!’
If you are an NHS dentist, or a former NHS dentist now working in private practice, and want to share your views on working within NHS Dentistry, please take part in our NHS Confidence Monitor Survey
About Stuart Allan
Stuart qualified at Sheffield University in 1978 and entered practice whilst undertaking doctoral research, later lecturing in restorative dentistry before entering practice full time. An elected or co-opted LDC member almost continually since qualification, he led the local negotiations over the GDS contract introduced in 2006. Appointed Dental Practice Advisor to Manchester PCT in 2008 and asked to continue as Advisor to the Greater Manchester Area Team and now to the Greater Manchester Health and Social Care Partnership. Whilst continuing as secretary to West Pennine LDC, he was and remains the inaugural Chair of the Greater Manchester Federation of LDCs.