'It is the responsibility of the leadership and the management to give opportunities and put demands on people which enable them to grow as human beings in their work environment,' Sir John Harvey-Jones once said. We really need the health department to understand this concept. Their comment on the new proposals for piloting the new contract states: 'Dentists tend to be quick to respond to incentives in the contract, any perverse incentive can lead to perverse effects in practice.'
Immediately the following questions come to mind: does it really take an Oxbridge qualified Civil Servant to tell us this, if this is known why create a problem in full knowledge of the consequences of your actions, why don't they create a system that rewards good dentists for caring for their patients and what stops them asking for those who had the answers to stand up and be counted?
Clearly the smart move is to choose the smartest mix of GDPs to populate the working group who will create the new contract. However, they choose all but one of the team from a salaried background to devise the scheme for GDPs who are backing their commitment to the NHS with their many pounds of investment in their practices. The only GDP on the team is in subsidised NHS premises. None of these will feel the pain of wrong decisions. So why deliberately exclude those who will? Answers on the back of a postage stamp, please!
Rosie Winterton, the previous minister in charge of dentistry was advised by the Chief Dental Officer, Barry Cockcroft to say the 2006 reforms were: 'The largest reforms to NHS dentistry since 1948. We are confident that they will improve services for patients and make the NHS a more attractive place to work for dentists.' They clearly haven't!
The health department knew that before the reforms 2m people were unable access NHS dentistry. Within a year, another 266,000 were added to this list. This was followed by a damning report from the health select committee when they investigated the reformed dental service.
Now we have a new Government promising everyone will win from their reforms and the people who are making the judgements and recommendations have no exposure to risk of failure.
Given that the Coalition will inevitably promise that dentistry is part of the whole NHS family, consequently building up expectations for another new GDS but working with flat line funding levels, is it really unpredictable that a sense of dissatisfaction is in the air?
The Coalition knows the reality but can David Cameron promise that everyone will be registered with an NHS dentist with no more money available?
I see a poorly qualified team in charge with greater patient expectations from the dental service and no extra funding. This does not bode well or present an honest way of delivering a truly 'good' service to the public.
One has to ask if the ambition is to achieve a great NHS dental service or covertly drive practitioners into the private sector and then blame them?