Following the release of the results of the third NHS Confidence Monitor survey, Simon Thackeray shares his views on what they reveal about moral within the profession and shares his views on the future of NHS dentistry.
The results of the third NHS Confidence Monitor survey are a pretty solid indictment of the current feeling within NHS practices, but I’m not particularly surprised by them. The results revealed that 26% of respondents are confident that patients will still be happy with the outcome of their NHS treatment in the future which is slightly heart-warming to see, despite the dire prospects that the profession see for the future of the NHS. That’s unfortunately still a very low number, but tells me that teams will continue to try to paper over the cracks that they feel will result from having yet another poorly funded and remunerated contract. That’s the majority of our profession all over, acting as apologists and trying to make the best of a system designed by ‘Whitehall Mandarins,’ so they get what they want.
I don’t think dentists are wanting to stay in the system until they’re 61 out of choice; it’s more likely going to be an enforced stay. Less single-handed practices are around than before, especially available for younger practitioners to purchase with a view to being a retirement fund. Coupled with a lower likely wage expectation, then it’s inevitable that less spare funds are going to be made available for investment in private or top-up pensions, and the lower NHS remuneration will affect their NHS superannuation accordingly.
In truth, if anyone thinks a new contract is going to be better than the current one then they are either deluded, have an exceptionally entrepreneurial streak, or have ‘flexible ethics’ when it comes to patient care; however, these results show that the majority of the profession are ethical and realists and are not expecting an improvement in any new contract or system.
Recommending the profession
One of the most telling results though for me is that over 70% of the profession wouldn’t recommend dentistry as a career to family or friends. I personally think that is the TRUE indicator of the morale within the profession. We can argue the system is wrong (and 91% have), but there are alternatives out there such as private practice, but to actively discourage people from entering in the first place is far more serious to me than a system being wrong.
The future of NHS dentistry
With regard to the future, even if we get clarity of what a new contract will include (which I bet we don’t), my money is on the contracts being fixed term and up for renegotiation after a fixed period of time (like they are in the rest of the NHS), which is going to be a huge challenge in our industry with its largely self-funded and personally invested business models. How the banks will feel about lending considerable amounts on the back of three or maybe five year fixed term contracts remains to be seen.
The corporates will drive down the wage expectations of those working within the system still further, which will make it even more difficult for the traditional type of practices to compete on a level playing field. There will be winners in the corporate and mini corporate sectors (who are probably in the 2% who believe dentistry will improve), but I can’t see the general morale of those currently in the profession improving unless they make every effort to broaden their income streams and become far less reliant on the NHS for their remuneration. Younger practitioners will need to up their game in order to single themselves out in an increasingly competitive employment market.
The current stance taken by the Government over the junior doctors contract should give us ample warning of how we are likely to be treated. Our profession has to be placed into perspective alongside theirs, so we will get no favours from a Government looking (nay needing) to reduce spending. We have the huge advantage though of having a more flexible pathway in our careers and working practice to achieve what we want, and what is best for our patients.
I sincerely hope NHS dental practices are not going to be like the Titanic, heading full speed for an iceberg they’ve been warned about without the right number of lifeboats for everybody to survive. It might be time to get off.
To read the full results of the Third NHS Confidence Monitor click here.
Simon has been a GDP since qualifying in 1991, initially in the NHS, and since 2005 in private practice in Nottinghamshire. Simon sits on the Gdpc committee of the BDA and is also a past BDA Branch President for South Yorkshire.