Professor Jimmy Steel in Bristol

The fact finding tour associated with the government initiated independent review came to Bristol yesterday. Jimmy Steele is an amiable host who, without doubt, has worked extremely hard on finding information and listening to opinions from all involved in the current mess that is NHS dentistry.

The audience was probably 20 or so in number with a smattering of GDPs, mostly thoroughly disillusioned by the events since April 2006. The remainder were mostly NHS/PCT people who were interesting to meet, there was one Consultant in Dental Public Health and a few “interested parties” like me. We were split into small groups of 5 or 6 with a facilitator from the COI (Central Office of Information) who listened carefully to our opinions and took plenty of notes.

The date of publication and other time frames all depend upon the severity of the swine flu epidemic of course. Or will that just be another excuse to bury bad news?

There was a lot of talk of the “NHS Offer” and “the patient pathway” which smacked of “quango speak”. Without a doubt there will be significant changes recommended by Prof Steele’s report, not least of which will be the removal of the iniquitous UDA system. There will also be a return to registration in some form or other, payment for activity and an onus to show quality systems. There was talk of the Oral Health Assessment, means of promoting continuity of care and how and where Advanced Care should take place.

I got the impression that the report was mostly written in that we were shown only one real model for change and presuming that no change is not an option. Whatever happens it will definitely be given a suitable trial, there was little talk of patient charges which will remain in spite of the NHS being allegedly “free at the point of delivery” as any change in charges or system has to go before parliament.

When asked about private dentistry Prof Steele said that there will always be a place for private dentistry indeed he practised privately himself.

My conclusion is that evolution will result in NHS clinics and private practices, an opinion that has not changed in nearly 20 years. The lesson for all dentists is that you are independent contractors and shouldn’t give that status up without a fight, you have to think long and hard about your future and what sort of business you want to work in and then go and do it because nobody else is going to do it for you.

Malcolm Gladwell on the Beeb

Author of The Tipping Point, Blink & Outliers interviewed on the BBC.

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