High street health hubs
Scottish Government should view dental practices as community wellbeing centres and actively support their transformation post- COVID, says a leading practitioner
“My concern is the general health of the population,” said Atif Bashir, Clinical Director of the BE Dental Group and Principal Dentist at Falkirk Dental Care.
Atif is known for describing the United Kingdom as “the best country in the world”. His father, Bashir Ahmad, the UK’s first Muslim councillor and Scotland’s first Muslim MSP, emigrated here from Pakistan in 1961.
Bashir arrived in Glasgow, aged 21, on a rainy evening with just a few words of English and a family friend’s details on a piece of paper. Standing forlornly in Buchanan Street Bus Station, a driver noticed his bewilderment, motioned him aboard, drove to the street written on the paper, which was off his route, got out and took him up to the door of the flat.
“This was a huge act of kindness,” said Atif. “When I look at my father’s journey, the way he was treated, what he got from here, the opportunities he had, it says to me that Scotland is the best place within the United Kingdom. I’m biased, I was born here, I live here. But I believe it. I believe the Scottish people are more accepting and embracing of other people. They are many great things about Scotland that make it that little bit more special.”
On that note, Atif begins to speak about the Scottish Government’s plan, published in 2011, for integrated health and social care, called 2020 Vision.
It stated: “We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self-management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.”
In 2013, the Government followed this up with Everyone Matters: 2020 Workforce Vision. That document stated: “Together, we will create a great place to work and deliver a high-quality health service which is among the best in the world”.
“I very much agreed with the vision outlined in these documents,” said Atif. “As a health worker, I completely buy into the ambitions that were being expressed. The Scottish people deserve a health service that is amongst the best in the world.
“Now, the Government will say things have been improving – they will point to statistics to make their case. But this doesn’t mean they we are delivering the world class level of service to the Scottish people that they deserve. If there is anything we learn from this pandemic, it is that we need to work much harder improving the general health of our population. Working in the dental sector, my view is that the health service needs a complete overhaul.
“So, what could the Scottish Government be doing within the dental sector to make it better for the Scottish people? It’s not always about putting more money into something. We need to shift the way we are working. The whole delivery of the dental service in Scotland is a disease-centred approach, which is a completely ineffective way of managing the health and wellbeing of people in Scotland. I am passionate about this; I feel responsible. People’s taxes helped put me through university to become a health care worker.
”But who’s going to speak up for the people of Scotland in terms of the delivery of their healthcare system? It’s not the politicians because they are not the people on the ground. It’s the people on the ground who need to turn round and say: ‘Actually, I don’t think this service is being effective in what we want to achieve – which is a healthier population’.
“But we have this disease-centred approach; we treat the person, they leave, they get the disease again, they return, and the cycle goes on. So, certainly in terms of dentistry we have fallen short of the vision. The model is wrong; we need to fix the model.”
Atif was born in Glasgow in 1968. He has a degree in chemistry from Strathclyde University and a degree in dental surgery from Glasgow University. During his time at the latter, he used his first degree to explore the role chemistry plays in cariology.
“I look at things from a scientific perspective. We have been hit with a pandemic and experienced a far greater number of deaths per 1,000 of the population than many other countries. Again, I come back to my earlier point that we need to work much harder at improving the general health of the population. We have an outdated dental delivery system, that was ahead of its time at inception but now we need to be brave and overhaul it.
“The model has been tested and for me it doesn’t work effectively for the people of Scotland. You always need to test the model; it’s been tested and it’s simply not good enough.
“When it comes to the healthcare system in Scotland, the most medically qualified people aside from doctors are dentists. But when they qualify, dentists are not really health care workers; they become ‘tooth mechanics’. You drill, fill. Drill, fill. The Government needs to use dentists better.
“My practice in Falkirk has15,000 registered patients. Some of them will be coming in twice a year for check-ups and twice a year for the hygienist; many more times that someone might see their GP in a year. The Government needs to be engaging dental practices. Why? Dental practices and their teams up and down the country can play a huge part in improving the overall health of the population.
“How? When a patient comes to see me, they may have a tooth problem, which I fix – and get them dentally fit. Dentists are one of the few healthcare professionals that patients will then return to the practice for regular check-ups, this is when the patients should be engaged to help focus on improving their general health. Encouraging patients to have healthier diets, smoking cessation and alcohol reduction.
“By doing so we would help improve the overall health of the Scottish population. None of this requires a great deal extra resource; it just requires a shift in approach by the Government. If you look at the 1,100 or so dental practices in Scotland; transform them into hubs of general health and wellbeing and that would lead to a healthier population which would take the pressure off the rest of the health service and support the work of our GP colleagues.
“We don’t need to build these hubs; the practices are already there. We don’t need to register patients; they are already registered. We need to lift our heads, look at the landscape, not continually look at the floor and let’s show the same innovation and courage that we showed when we set up the NHS.
“Let’s lead the way for other countries to follow and make the Scottish population the healthiest, with the best and brightest smiles in Europe. It’s time for change.”