The dental profession has spoken out in response to government plans to abolish Public Health England (PHE).
Yesterday, it was revealed the agency would be scrapped and replaced by a new body.
This reportedly follows criticism from ministers and government figures over the way PHE handled the COVID-19 crisis.
As a result, the dental profession has voiced a number of concerns over the future of the country’s oral health.
Robert Witton is a consultant in dental public health working part time for Public Health England (PHE). He is also the director of community dentistry at the University of Plymouth and chief executive of Peninsula Dental Social Enterprise CIC, the NHS clinical arm of the dental school.
He says oral health is an already neglected specialty, adding that vulnerable groups are likely to pay the price.
Hidden role
‘Firstly, it’s a shame it was leaked to the press without a formal briefing to PHE staff,’ he said.
‘My worries are that it was always difficult to prioritise oral health in PHE anyway. We’re a small speciality but we’re highly specialised. We work as system leaders – although we’re based in PHE, we work across the health and social care spectrum.
‘We work a lot with partner organisations and much of the time our role is quite hidden. As a result, some of the benefits that we bring are not actually tangible to many in the dental profession.
‘Rather, our work is happening in the background and making things happen. My worry is that it’s a very easy opportunity for PHE to de-prioritise oral health further.
‘We’ve had a number of consultants retiring over the past few years and so we have a depleted public health work force. When posts become available, PHE often do not actively recruit to them. In my region, my colleague retires in one month’s time and then that leaves me – and I only work part time for PHE. I work at the dental school for the rest of the week. We had plans to recruit but I have no idea what this means now.’
A real risk
He added: ‘It’s been a challenge to prioritise dental public health pre-COVID. So for me, there’s a real risk the public health workforce will deplete even further.
‘We don’t really know the full impact of COVID or the impact that’s going to have on oral health inequalities. Or on access to care. To potentially put public health at risk now when we don’t know the full impact of these things, is actually quite worrying.’
Also chair of the British Dental Association Public Health Committee, he is urging all health and social care bodies and organisations to band together to keep dentistry on the agenda.
‘I think we need all of our partners to come together – that spans NHS England and Improvement, local government etc,’ he said.
‘I think we need everyone advocating on behalf of dental public health. It’s a small specialty but it’s an important one, and without it we will not be able to progress the dental agenda. But also, we won’t be able to address oral health inequalities. There are big concerns from dental practices and teams about patients not being able to access care for a long time.
‘One of my interests is advocating for the vulnerable. It’s been really difficult to get an appointment for urgent care, even if you’re registered with a dental practice. If you’re homeless, or a family living in poverty, or an asylum seeker or refugee, it’s almost impossible. And it’s these groups that I think will be the hardest hit.’
Urgent clarity
Similarly, the British Dental Association (BDA) is calling for ‘urgent clarity’ on the future of public health provision.
The organisation penned an open letter to Secretary of State for Health and Social Care Matt Hancock warning that health inequalities are likely to widen as a result.
It fears it will lead to the disruption of priority work areas in dental public health, including guidance for local authorities, commissioners, practitioners, and epidemiology.
BDA chair Mick Armstrong said: ‘Any loss or disruption to dental public health work will have a material impact on communities across this country. We now risk leaving policy makers without evidence to base plans, practitioners without guidance to operate in unprecedented times, while losing vital expertise from a committed and highly skilled workforce.
‘Effective management of the pandemic response is a clear and national priority. But meaningfully protecting the public long term hinges on an effective approach to public health. Oral health is not an optional extra.
‘We have greeted signals from the Department of Health and Social Care on prevention. As Matt Hancock has noted, scaling up these approaches has the power both to transform lives and save money.
‘A pandemic is not the time to cast aside that logic, but to double down. This vital agenda demands both proper resourcing and organisational commitment.’
PHE has been approached for comment.
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