Interview with Nairn Wilson
What would you say are the key influencing factors which have caused such a decrease in confidence levels across the board?
Morale amongst dentists is widely considered to be at an all-time low, caused, at least in part, by the limited confidence in future involvement in the provision of NHS services, especially if the arrangements for the provision of the services remain in their present form. Key factors, considered responsible for the substantial fall in confidence, include diminishing return, both financially and professionally, with the prospect of ‘more for the same’ or possibly even ‘more for less’ (at least in real terms). Furthermore, many dentists do not feel valued, let alone important in NHS endeavours to enhance general health and well-being and, in turn, quality of life and longevity. Other factors include anxieties over anticipated changes and, from time to time, possible perturbations in NHS commissioning and contracting arrangements, and the continuing political stance that NHS dentistry is a comprehensive service, offering patients state of the art dental care. In this regard, a major issue for, in particular, younger dentists, is not being able to put into practice the dentistry they were taught in dental school.
What do you believe the Government will make of these results?
It is hoped that government response to the unequivocal findings of diminished and falling confidence will be decisive action to rethink and possibly re-invent NHS dental services. More of the same, which is unpopular with many dentists and fails to engage <45% of the population, is very unlikely, albeit under some hybrid of recent pilots, to inspire the dental profession, which is presently suffering high levels of stress, and susceptible to burnout and conditions such as depression. There would appear to be a lack of appreciation that one of the keys to future success is arrangements, including regulatory arrangements, which engage, motivate and enable the workforce to enjoy applying its many different skills, talents and considerable knowledge in the delivery of high quality, cost effective services. If the government makes nothing of these results and persists with ‘more of the same’, commitment to the provision of NHS services could suffer a significant setback.
What's your opinion on the actions that can be taken, if any, to instil confidence back into the profession?
A fresh, evidence-based approach to NHS dental provision, designed to meet the future needs of the (growing and ageing) population and which creates a suitably resourced, stable (albeit evolving) service which all stakeholders can provide and defend with pride, would, it is suggested, transform the present circumstances and instil new confidence across the profession.
What do you think the Government's long-term aim for NHS dentistry is?
Any government’s aim for state funded dental services should, as an ideal minimum, be local access to emergency services and regional access to essential specialist services, provisions to address health inequalities, arrangements to meet at least the basic needs of special category and vulnerable patients, give children a good start to hopefully lifelong oral health, and encouragement and provide essential support to the rest of the population to assume personal responsibility for the maintenance of oral health. Such a modern, forward looking aim, if adopted and implemented, could realise huge benefits, contributing to the health (and wealth) of the nation.
How do you think these results contribute to the idea of creating a core service, if at all?
If the vision set out in response to question 4 is considered to constitute a ‘core service’, then the possible response to the findings could include considerations of such an approach, through the development of a new style NHS dental provision, according to priorities and greatest needs.
What does the profession wish for its leadership to do in representing them to Government to bring about swift negotiated change for the better?
It could be argued: ask not what more, hardworking leadership of the profession can do; ask what more the profession can do to further empower its leadership – no better time for the profession to engage and unite, individually and collectively across the UK, and be stronger together.
The above answers to the Practice Plan questions are my personal opinion; they do not reflect BDA or King’s College London Dental Institute policy or thinking. If used in the proposed publication, I would be anxious that it is made crystal clear that the views and opinions expressed are personal, and that no reference is made to my affiliation with either King’s College London or the BDA.