Trust is a word that gets bandied around a lot in dentistry.
Usually it’s in the context of creating a trusting relationship with your patients and building rapport.
However, what’s not spoken about as often is the trust, or lack of it, between the profession and those in charge of running and regulating dentistry.
It’s this very issue that has been highlighted in the recent Dentistry Confidence Monitor survey results.
Less profit and more work
More than 400 NHS and private dentists took part in the survey between April and June 2019.
The answers to some of the questions, particularly those around NHS dental contract reform and the GDC, suggest that feelings of mistrust run deep.
While most dentists from across both sectors say they aren’t confident in their knowledge about reform, they still feel it won’t work well for them (that their profitability will drop and their workload will rise) and their patients.
They do, however, think it will work well for the Government.
‘NHS strategy at work’
John Renshaw, a former chair of the BDA and practising dentist for 45 years, commented on the results.
He said, ‘The proposed new contract is totally mistrusted (not enough known about it, unlikely to produce any improvement, etc) – and rightly so – and is expected to produce more work for less profit.
‘This is the NHS strategy at work: make the job less and less attractive, let them leave the NHS or fail to join the NHS system and then blame the dentists for not sticking by the NHS in its hour of need.
‘If anyone out there has still failed to see what the NHS’s game is, I am available to deliver lectures to the innocent or stupid who cannot, for some reason, read the writing on the wall. I will of course offer these poor souls a free translation service to allow them to read the full text of that writing on the wall and see how they are being manipulated and abused by the nation’s favourite institution.’
Need for communication
The majority of respondents to the survey say that they are unconfident in their knowledge about contract reform and don’t feel they have sufficient information to make informed decisions about their future in dentistry.
This is despite so many having a clearly vested interest in the progress of reform and a desire for change to their existing circumstances (75% of private and 92% of NHS dentists think it’s important for the current contract to change).
Eddie Crouch, Chair of the BDA’s Principal Executive Committee, said this posed a real challenge for those involved in the reform process.
Eddie said, ‘What is very clear is how little detail those outside the contract reform have of what is currently being developed.
‘This poses some real challenges for the BDA, LDCs and NHS England in educating those who are perhaps disenfranchised by the little they currently do know.
‘The profession has become disillusioned, believing that any developed contract will do little to improve their working lives and be constructed to help commissioners as a priority.’
Feelings towards the GDC
Alongside mistrust about those in charge of managing the profession and contract reform, the survey showed a lack of trust in the GDC.
In answer to every question asked about their regulator, the majority of the profession showed little confidence.
Over 90% of NHS and private dentists don’t feel a complaint against them would be handled appropriately or that the GDC understand the impact of their processes and procedures on the dental profession.
More than 75% aren’t confident that the body is doing a good job in protecting the public.
Simon Thackeray, a practising dentist and expert witness, said that those in charge need to listen to the profession.
He said, ‘It is quite obvious from the results that the state of dentistry today is not what it should be, and what the profession would like it to be.
‘Since they are the people best placed to inform and advise both the NHS and the GDC, I’m not actually sure what it will take for the powers that be to listen to us.
‘The BDA obviously negotiate with the Department of Health (DoH), and have access to the GDC, but both the GDC and NHS appear dogmatic in their approach, either blaming legislation and regulatory requirements (in the case of the GDC) or government policy in the case of the DoH/NHS.
‘The only answer, as far as I can see, is to reduce your exposure as much as you can to the damaging influences in our profession. However you do that is up to you, but it’s clear that the private sector of dentistry is less damaging than the NHS.’
Download the full report
To see the full set of results from the survey and hear more from John, Eddie and Simon, and other key figures from within dentistry, download the report.