‘Be careful what you wish for’, officials warned
Practice owners in Scotland might significantly reduce their commitment to the NHS and increase their provision of private care, according to an anonymous blog post on the website of the Scottish Dental Practice Owners group.
Some owners have already converted to the private sector while others are contingency planning, with independent plan providers reporting a surge in enquiries, it is claimed. Practice owners are “preparing to protect their businesses if new NHS terms are not attractive or sustainable, or if the current ‘holding strategy’ is left in place for too long,” it says.
The writer cites an anecdote relating to a government official and a representative of a dental organisation sharing a journey on public transport. The government official, apparently jokingly, asked: “How bad do we have to make NHS terms before you guys will leave?” The author of the blog post continues: “Although said in jest, maybe the position we’re in now, is the tipping point the government official speculated about.
“Years of government indifference to growing problems within the profession, a failure to modernise the service, chronic under resourcing and a complete lack of concern for the wellbeing of dental workers are long standing problems. But now beleaguered NHS practice operators face further challenges,” they write, listing a series of pressures and concerns.
“So, perhaps the hypothetical threshold for an exodus from the service has been reached. But what of the good ship NHS Dentistry? Perhaps the response to the government official should have been ‘Be careful what you wish for’. If practice owners walk away from the NHS, it will create a public health crisis to which there will be no ready solution. Accessible dental care in communities will fall away.
“The PDS [Public Dental Service] do not have the resources to pick up the slack. Overworked GPs [general practitioners] will not appreciate having to manage significant numbers of dental emergencies on a daily basis. Have the government and the CDO [chief dental officer] given thought to the implications across society of the collapse of NHS dentistry? The stakes are high, and time is limited. Practice owners will not tread water indefinitely. The conditions are ripe for an exodus from NHS practice. The CDO and Scottish ministers need to decide if that’s really what they want.”
A spokesperson for the SPDO said: “If new NHS contract terms are unfavourable, it is possible practices will significantly reduce their NHS commitment. This could have a profoundly detrimental effect on public health. We urge the Government to work constructively with practice owners to develop a sustainable and effective dental service, fit to fulfil its important public health role.”