A Blueprint for NHS dentistry

The modern system of departmental select committees in the House of Commons is fairly recent. They came into being in 1979, following recommendations of a Procedure Select committee set up in 1976 which reported two years later. It recommended a series of select committees covering all the main departments of state, with wide terms of reference and the power to appoint specialist advisers to assist in inquiries as required. Suggestions were also made that committee members should be selected independently of party whips – a recommendation then ahead of its time. Committees shadow all of the major government departments – for the purpose of this article we of course are looking at the Health and Social Care Select Committee and its recent inquiry into NHS dentistry.

It was only following the 2010 election that Select Committee Chairs became truly independent of party management when they were elected by the whole house. In effect this threw off the chains of the party whips in choosing a chair as an MP could be a thorn in the side of their own party but triumph in a vote because their talents were recognised by colleagues in other parties. As a consequence, the impact of select committee reports rose considerably as they were viewed as authoritative and independent in their conclusions and recommendations. The profile of Select Committee Chairs grew substantially, sometimes viewed as an “unofficial opposition” to the failings of Government policy. Many former ministers, including the current Chair Steve Brine, now turn their hand to chairing Select Committees.

This sets the scene for the recent Health and Social Care Select Committee report on NHS dentistry published today which we see as a blueprint for the political parties General Election manifestos for the next Government to secure a sustainable future for NHS dental services.

The report describes evidence of pain and distress due to being unable to see an NHS dentist as ‘totally unacceptable in the 21st century’. MPs cite frustration that recommendations for reform made by their predecessor Committee 15 years ago have still not been implemented. They brand the current contract, which pays dentists for NHS ‘units of dental activity’ (UDAs), as not fit for purpose.

It calls for the Government to commission a dental workforce survey to understand how many full time and part time-equivalent dentists are working in the NHS alongside demographic data such as age and location. This is vital in planning for the long term workforce and also identifying more clearly the “dental deserts” where more investment in the workforce is needed. The report recognises the “dental deserts” already in the East of England where action is most urgently needed.

The Committee recognise that in the short term, more recruitment from overseas will be the solution and they give a sharp rap over the knuckles to the General Dental Council (GDC) concluding the current backlog of overseas clinicians waiting to sit the Overseas Registration Examination (ORE) is “unacceptable” and calls on the GDC and the Government to “speed up the changes to the process of international registration for new applicants seeking to work in the NHS”.

Access to NHS dentistry and dental deserts in England has become a doorstep issue cited by members of the public in the recent “triple whammy” of by elections across the country. This cross party report provides a blueprint for parties to address the issue in their policy making and manifestos for the General Election. The solution to the workforce crisis is clear – the Government needs to act now to recruit more overseas clinicians and invest in the long term in our dental schools to boost dentist numbers. They would be wise not to ignore the committee’s recommendations, or the general public, will be asking them why.

Neil Carmichael is the former Conservative MP for Stroud 2010 – 2017 and the Executive Chair of the Association of Dental Groups, the trade association representing dental groups whose members are delivering NHS and private dentistry across the United Kingdom.