For all its tremendous achievements over the years, the NHS has created a massive problem not just for itself but for society at large.
It has bred a culture of dependence, expectation and lack of accountability.
Common comments are:
- I pay taxes so I should have a right to free health care.
- If something happens, my doctor, hospital, (dentist) will fix me.
- If the technology/drugs/procedures are there, I have a right to them.
In themselves, these sentiments are not wrong…. They are just ill thought out, and in today’s world, frankly inappropriate and probably not even possible.
Our health system is overburdened and underfunded, and this cannot be ‘patched up’ simply by throwing more money at it or employing more staff. We all know the problems medicine faces in this country and in some ways these being addressed: there is some emphasis on prevention at last and education.
What about its smaller, poorer, younger relative….Dentistry?
Yes, when the NHS Dental was set up, the intent was laudable: free dental care for all which should in time eradicate dental disease.
It didn’t, it doesn’t and it won’t.
As war time austerity and food rationing abated so diet altered, sugar returned and attempts at treating an increasing population with dental disease that in no way was reducing became self-defeating, as more dentistry (increasingly of a rather 2nd rate variety ) on a greater number of people was being provided.
Today, after years of NHS dentistry undergoing patchwork changes, the nation’s teeth are still rotting, gum disease is still rife, teeth are still being pulled and dentures are still being provided.
The practitioners are unhappy, they need to see patients every ten to fifteen minutes and generally the quality of dentistry that can be provided under these conditions (by the standards of the 21st century) is woefully inadequate.
Meanwhile, private dentistry, some excellent, some good and some less so, operates in an uneasy parallel world, attempting to provide real quality care. However, it comes at a financial cost to the patient, which, although quite ‘realistic’, many find irksome. And these are often the very people who need this attention.
What are the answers? They may not be palatable.
The government can no longer afford to subsidise dentistry: it is a heavy financial burden on an over stretched NHS, an NHS that needs to drastically cut costs. As important as tooth retention and dental health is, within the context of many other medical issues facing society, it cannot be enough of a priority for its provision to come out of the public purse.
So the bad news is that, in reality, it’s only a matter of time before NHS dentistry becomes history.
The good news is that the dental diseases of tooth decay and gum infection are almost totally preventable.
It comes down to a high level of oral hygiene, a sensible healthy diet and avoidance of substance abuse (nicotine, alcohol etc). Sounds familiar?
So yes, people need to be educated and informed that they must take responsibility for their own and their children’s teeth. However, this change in attitude, coupled with regular dental check-ups will reduce dental disease by over 90%.
Then when people do need to pay for some necessary private dentistry, they will appreciate what they are getting.
Using this model, much of the existing NHS dental funding could be more effectively utilised for pressing medical needs. That remaining should be utilised for intense public education which is woefully and almost totally lacking today.
London Clinics could be set up, and staffed by new qualified professionals before they are ‘let loose’ into private dentistry…..under experienced supervision to provide good quality basic care to those genuinely disadvantaged.
Utopia? Or a realistic and fair recipe for the future of dental care in this country?