We speak to Simon Thackeray, following our Dentistry Question Time evening, to find out if he thinks there is a future for NHS dentistry.
My personal view is there’s going to be some form of contractual change.
It’s all well and good for the NHS to have these fantastic ideas about oral health. I was on a meeting with the chief dental officer, and they’ve got some fantastic ideas about integrated care, but there isn’t any money.
So, I wouldn’t be surprised if it becomes a core service by stealth. My thoughts are that they’ll make it into a different kind of service, but it will be by stealth. They won’t call it a core service.
You just have to look at what happened in the Budget. There’s no money for lots of things, and if there are any easy gains anywhere, such as putting a core service in with core money for the NHS, they’re going to take it.
It won’t create huge savings for the Treasury, but they need to make the savings where they can. That might be an easy one for them to justify to themselves.
What do you think a core service would look like?
This is the problem. Everybody’s version of a core service is different.
My idea of a core service would be a basic examination to look at your oral hygiene.
I would want to make it very clear what was on the core service. So there isn’t any ambiguity about what is or isn’t available.
I think you’ve got to have some very defined things in it. Maybe you have just an examination, and extractions rather than root treatments – you get into a bit of a grey area when you talk about restorations and fillings.
Are examinations in that grey area? Because they become an advert for private treatments
Well, yes. Some people will use it as an up sell.
But it’s clearer if it’s all available or all unavailable. If you cannot get X on this new NHS, then you know you’ve got to pay for it privately. There’s no grey area for that.
It’s where you draw the line of what’s reasonable to provide for people who can’t afford private dentistry. I think that’s where the moral dilemma is, and most dentists will have that moral dilemma.
It’s probably why they don’t want to see an absolute core service.
If you’ve got just extractions, that’s an ultra-core service, and I think you’re almost looking there at, dare I say it, a service that you’ll find in certain developing countries. We can’t go to that.
From a private dentist perspective do you think that a core service is a good idea?
The way I fall, I think it’s a good idea if it has enough things in it. I’d want to know what was in the core service to be able to say yes that’s a good idea.
In some areas you could argue that it’s a core service anyway, because people aren’t doing things like chromes on the NHS. I know a lot of practices are doing them, but I know a lot who aren’t.
In certain respects, it’s already a core service anyway but it’s not a clear core service, so it needs clarity from the patient’s point of view. Then there’s a standardisation across the country.
So, I’d agree with a core service if it had the right things in it. But I’m not the person to say what should be in it. The NHS needs to robustly clarify and clearly write out what’s included.
Hear more about what the challenges NHS dental care will face over the coming months and years by watching Dentistry Question Time here.