Dear editor,
I am writing to express my astonishment and disappointment at the views expressed by Sharif Islam. I felt that the descriptions of NHS patients given in the article were grossly unfair and unkind, not to mention a gross generalisation. NHS dentistry exists to give access to treatment to the general population. This includes those who find dental treatment hard to afford or are exempt from treatment charges for various reasons including low income or incapacity. Without this vital service, many would simply be unable to afford the care they would need and the nation's level of oral health would decrease as a result. I firmly believe also, that if the NHS disappeared tomorrow, private dentistry would not be too much better off, as without a payment plan or insurance, most would be unable to afford private charges.
There is also the deeper issue that such unkind and unfair comments regarding patients are unprofessional and for a patient or member of the public reading the article in question, it would paint the profession in a poor light. I work in Rotherham in South Yorkshire, an area that was hit very badly by the closure of the coal mines. There is a large amount of social deprivation in the area, with many patients being exempt from treatment. However, none of my patients meet the stereotyped and cruel portrayal of NHS patient's that the author paints in his article. Many of my patients are professionals or have jobs that they work diligently at. The attitude of blaming patients for being exempt or non-paying is terrible. Who are we to comment on the way people live their lives? Our job, private or NHS is to protect our patients from pain and to improve their oral health. In this uncertain period of economic downturn, many patients are finding it hard to find the money to pay for treatment. It is not for us to judge on why someone might be exempt or why they are keen to investigate what treatments they are entitled to. I come across patients who have requested private treatments (implants, tooth whitening, veneers) on the NHS.I have certainly not scorned them for doing so, most simply did not realise that such treatments are not available for the NHS because they constitute cosmetic treatment. This strikes me as an issue of managing patients' expectations, not judging them for having assumptions that have obviously not been addressed in the proper manner. Perhaps the answer to the author's trouble comes from careful introspection, rather than judging patients.
I had rather a large amount of trouble understanding the point the author makes of listing his various experiences and adventures. It reminded me of the final speech by Rutger Hauer in the 1982 film Blade Runner, albeit less impressive. As an NHS practitioner, I find plenty of time to pursue professional development, as do many other NHS dental practitioners. As shown by his unprofessional and blinkered attitude, the author might reflect on this and take more time to do the same.
To expand upon the author's inspiration from the aforementioned film, we should respect and care for our patients, lest their trust in us be lost, like tears in rain.
Alexander Holden
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Dear editor
I am writing having been greatly saddened after reading the article which I feel is in danger of bringing the profession into disrepute.
Generally I enjoy the magazine and read it regularly. However I was very surprised that this article went to publication.
I have worked as a GDP for 27 years and rightly or wrongly have chosen to serve my patients under NHS regulations. I have had the choice to 'go private' but felt a professional vocation to try and provide quality care to all my patients regardless of their ability to pay. As everyone knows providing quality care and receiving high personal remuneration is an impossibility under the highly flawed NHS contracts that I have been subject to. None the less I feel the well-being of all my patients is rather more important that being able to boast of foreign holidays as Mr Islam feels the need to do.
We are allowed to call ourself a profession and expect a level of public standing because the public assume that we act primarily as a caring profession putting personal gain after patient's well being. I was therefore astonished to see Mr Islam so blatantly insulting all NHS patients in a grotesque caricture of the bulk of the British population who can't afford private dentistry. Are you really happy to let phrases like 'So what alternative is there to this masochistic exercise in serving the ungrateful plebs?' or referring to patients as 'expendable detritus' appear in your journal. The vast majority of NHS patients are like the vast majority of private patients reasonable people who when treated with respect and courtesy return the favour. I found Mr Islam's generalisation of the average NHS patient outrageously arrogant reflecting the level of his own ignorance rather than any basis in fact.
I would be very grateful if you could give me your views on my comments and explain the reason for publishing the article.
Richard Heathcote
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Editorial reply
Sharif's article 'Give a mouse a cookie...' has caused quite a stir it seems. I in no way wish to make light of the situation or appear insensitive to any offence taken, and wholeheartedly accept that printing the article was an error of judgment on the part of the editorial team. We accept full responsibility for that.
The piece was a comment piece from Sharif and in no way reflected the views of The Dentist magazine, which continually provides news and views from and for the benefit of the NHS and private sector.
There is a line to be drawn on editorial comments. Some, by their very nature, are attention grabbing as well as thought provoking to the reader. Whilst Sharif's article was intended I'm sure to be comical in its over-the-top caricature portrayal of NHS patients, it fired wide of the mark and crossed the line of acceptability for many.
All those who were offended I hope read with pleasure the reaction in these letters and the seemingly universal response of the profession (both NHS and private) that the image of NHS patients given by Sharif is completely incorrect. If any good can come of the mistake made by printing the piece in the format we did, perhaps it is that readers have questioned Sharif's interpretation of NHS system, and the vocation of dentistry itself and felt the need to defend it. The reaction given in these letters might give a sense of optimism to those who suggest the article could bring the profession into disrepute. Had the piece gone under the radar and been accepted by readers I believe there would certainly be a far greater cause for concern.
At The Dentist we aim to provide editorial content which will interest, inform and entertain our readers. Sharif's article clearly has roused some interest but failed in its attempt to entertain. We will continue to provide thought provoking comment from different perspectives within dentistry. Clearly not all the readers will agree with all the comments, in many ways that is a good thing – debate and even a level of disagreement is healthy. I encourage anyone wishing to comment on any of our content, be it articles, comments or news pieces to do so. You can write directly to us or post comments on the forum at www.the-dentist.co.uk. Having said that, we in no way want to suggest that the article by Sharif is acceptable in its current format. Clearly an error in judgment has been made as no piece should be allowed to cause such offence. It should have been heavily toned down, or its attempt at dry humour been made more explicit.
Moving forward The Dentist will continue to provide editorial we believe relevant and thought provoking, but will learn from this incident for future issues. Please feel free to contact me directly to discuss the matter further. I would like to thank all the readers who have sent in letters and emails highlighting this issue, and once again I sincerely apologise for any offence caused.
Author's reply
In response to the complaints against the article 'Give A Mouse A Cookie...'
Firstly, I would like to offer sincere regret for any upset or offence that this article caused. I realise that many people have only this article with which to judge me, but those that know me would testify to my unshakeable respect and reverence for the profession and those that practise it at all levels. I would not dream of engendering any disrespect or disrepute upon this profession that has been immeasurably good to me. I have treated many NHS patients in my time and virtually all have been thoroughly wonderful people against whom I hold no judgement or umbrage of any kind. I also personally know dentists who provide an excellent and tireless service under the NHS and deserve the highest accolades for their effort.
Secondly, the article in question was born out of discussions with fellow dentists and framed around a single, albeit marginal, issue. I imagined that an article with a humorous (read: more extreme) and tongue-in-cheek vein could be made out of this issue, and that most in the profession would understand this nature of the writing without being upset by it. Indeed, before submission, I showed the article to many colleagues (themselves NHS practitioners) who gave it their approval and understood that it was written in a humorous light. Evidently, however, this was not the case for many reading it, for that I offer my contrition. Clearly, the content should perhaps have been demarcated as humorous or simply have remained as a discussion only.
Thirdly, I have made it clear to many who have read my work that my writing is not a form of bully pulpit. I do not write to preach or sermonise or impress a personal point of view. I refer to myself in my writing not to present myself in any light, but only as a device to help articulate or contextualise the particular message. In fact, I have written many articles on a wide range of subjects, argued from both sides of their ideological spectra. My objective has always been simply to put ideas out into the zeitgeist that the reader can then debate, deconstruct or disagree with as they see fit. Even a negative response is a correct response, because if the reader even just had to think about the issue(s) raised then I realised my goal in writing about it.
And lastly, in a nation that has championed freedom of expression and a free press, I do not believe that any idea is too outlandish to be censored or muzzled. Occasional sensitivity to a commentary, however extreme or ridiculous it may be, is the price that we pay for this freedom, and indeed it allows for exactly the kind of passionate rebuke that this article has generated. And for that I am grateful. History has repeatedly demonstrated that appeasement of the status quo does not allow for any progress to be made.
Sharif Islam