Fast forward 30 years
After attending the 30th anniversary celebrations of Independent Care Plans, Robert Donald looks at what has changed in that time.
The 30th anniversary celebrations of the launch of Independent Care Plans (ICP) were held at Cameron House on Loch Lomond on 6 September. The event was attended by 80 colleagues and partners from all over Scotland, including those who have been closely associated with ICP over the years. These included members of Highland Dental Plan (HDP), Lothian Independent Dental Practitioners (LIDP), Fife Dental Care (FDC), Moray Firth, Grampian, Tayside and other individual dental practices throughout Scotland.
It does not seem that long ago since Highland dentists set up their own, locally controlled private capitation scheme against a background of crippling NHS funding cuts and mounting bureaucracy. Some of my more senior colleagues will remember 8 July 1992 when the government imposed the now infamous 7% NHS fee cut. This was the catalyst for Highland dentists to take a concerted action in setting up HDP. It came about following the introduction of the UK Government’s ‘new’ dental contract in 1990. More patients had registered, and more work had been done – about £200 million more than government had budgeted for.
In order to balance the books, fees were slashed by 7% and, following a hastily arranged ballot of British Dental Association (BDA) members, 58% voted not to accept new NHS patients of any age and 80% voted not to accept new NHS charge-paying adult patients. On the back of this advice, the Highland Local Dental committee organised an emergency meeting of General Dental Practitioners and the foundations were laid for the setting up HDP. From humble beginnings, it grew and prospered and in 1995 Independent Care Plans was launched following the recommendations of the HDP expansion committee, enabling other like-minded dentists throughout the country to set up their own dental plans. These plans are now administered from a spacious suite of offices at River House in Inverness by 11 friendly, efficient and dedicated staff.
The strengths of the company are that it is run by dentists for dentists with minimal third-party interference, Scottish-based, including Dental Emergency Assistance support (DEAS), and locally controlled, allowing close monitoring of quality and DEAS claims.
But fast forward 30 years and here we are still facing the same issues of ‘real terms’ NHS funding cuts and mounting bureaucracy. I recently came across a media briefing that the BDA produced in 1999 on NHS dentistry. It stated: “Dentists don’t leave the NHS for ideological reasons. They leave because they are finding it more and more difficult to provide an acceptable quality of care and spend the appropriate amount of time with each patient under the present fee structure and still maintain a viable practice.”
What has really changed in the intervening years? The Scottish Government’s approach to funding NHS dentistry continues to be unrealistic, unsustainable and creates a fundamentally flawed baseline for future funding arrangements. Access to NHS care is as much a postcode lottery as it ever was. Add in the workforce shortages sweeping across the country and the outlook looks bleak. In response, more of my colleagues understand the benefits of having a dental plan which allows their patients to budget for their care and at the same time reduce financial pressures for the practice.
While the profession in Scotland continues to face difficult times ahead, I am convinced that putting patients first is the only way forward. All dentists should be allowed to provide care in an environment where they are able to put patients’ interests first without having to worry about whether the system that is funding the care provides adequate resources for the treatment or the care that is needed. It is no surprise that the demand by dentists for dental plans advances apace. Here’s to the next 30 years!
Robert Donald is a director of Independent Care Plans UK. Formerly a GDP and practice owner based in Nairn, he retired from clinical practice this year.
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