Kevin Lewis column
 

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Kevin Lewis column

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Kevin Lewis column

 

Kevin Lewis column

Kevin Lewis starts his new series of columns for Dentistry with a warning that the low-key media reaction to this summer’s events may hot up yet.

Let me begin by saying that I was delighted to be offered the newly created post as Dentistry’s consultant editor. I know that the publisher and editorial team are very ambitious for the future of this publication, and what it can deliver for its readers. It goes without saying that I am very pleased to be a part of this and look forward to working closely with the team at FMC and Dentistry.

I have been writing a column in the UK dental press for over 25 years now. On reflection, that’s a lot of columns, and I know from this experience that a fortnightly column is easier than a monthly in some respects, not least because you are less likely to find yourself overtaken by events during periods of intense activity and change. But it is more difficult in other ways, because the copy deadlines hit you quicker than MRSA in an NHS ward.

While I will be writing a lead column such as this in every issue, I will also write other, longer pieces from time to time, where a more detailed analysis of a particular subject seems appropriate. As ever, I look forward to receiving any feedback as to how the formula seems to be working.

Meanwhile, the long, hot summer is drawing to a close. Similarly, the temperature of British dentistry is starting to fall, and the ridge of high pressure is drifting away. This year’s political and regulatory storms have passed mostly over England and Wales, leaving Scotland and Northern Ireland relatively unscathed, at least by the NHS reforms. Their turn will come, but by that time many useful lessons will have been learned (on both sides) from the experiences so far of local commissioning – first in PDS, and now in nPDS and nGDS.

Despite the criticism she received, I actually thought Rosie Winterton showed some admirable bottle in having pitched up to give her keynote address at the BDA Conference in Birmingham back in May. Many others might not have done, just eight weeks after the April 2006 watershed, but her slot, which came immediately after a virtuoso performance from Michael Portillo, was never going to be the easiest one.

The assembled throng gave her a pretty respectful welcome, in fairness, which reflected rather better on the profession than some had feared likely. The BDA’s impressive Susie Sanderson had as tight a grip on proceedings as Barry Cockcroft had on the Minister’s briefing, and a sizeable audience listened intently – even if a touch sceptically – as the Minister announced £100 million of new money to help NHS practices to ‘modernise’.

Lightning is said not to strike twice in the same place, but since June’s LDC Conference was due to be held in an altogether different place – overlooking Tower Bridge and the Tower of London – she wisely decided not to push her luck, and she sent her heartfelt apologies for absence instead. The story of Edwina Currie’s ill-fated trip to the LDC Conference many years back is legendary, and Rosie probably didn’t fancy a reprise of Patricia Hewitt’s mauling at the Nurses’ Conference a few months earlier. Smart lady.

More eminent people than Rosie Winterton have lost their heads at Tower Hill, of course, and visitors can still see an impressive bridge, and no shortage of crowns (many of them gold ones) in evidence, which is more than can be said for NHS dentistry in recent months.

But it still strikes me that the most remarkable feature of the first five months of the new NHS contract has been the eerie silence. The TV and newspapers have not been full of ‘horror’ stories about an access crisis, or of desperate patients removing their own teeth with pliers. Even the dental press has hardly been alight with the braziers of revolution. It has all had the windless aroma of business as usual. Perhaps that’s because it is business as usual?

Could it be that overall NHS commitment has not fallen as much as had been predicted in some quarters? Could it really be that the new patient charges system is indeed simpler to understand, easier to operate and hasn’t precipitated the anticipated fire and brimstone at reception? Could it simply be that there is nothing to ‘spin’ because the Government has got what it always saw as the top prize – a certain, secure budget for NHS dentistry after more than 50 years of waiting? Could it also be that dentists and dental practice teams are doing just what they have always done – quietly getting to grips with whatever system has been dumped upon them, and finding ways of getting it to work for them?

We shall have to wait a little while yet in order to be sure which of the above scenarios is closest to the truth, because even now it is still far too early to assess UDA output, patient charges and the rest. There has been some incredibly ill-informed comment on this topic, some of it coming as early as May and June, which revealed a fundamental misunderstanding of how the new system would operate in practice.

But what about that extra £100 million that Rosie Winterton announced in Birmingham? Some PCTs have clearly been suffering from the heat more than others, because a few of them have been surprisingly outspoken about their determination not to share any of this new money with those practices whose contracts were still ‘in dispute’. If this gun-to-head strategy is widely adopted, maybe we will yet see a sticky Indian summer of soaring temperatures and returning high pressure after all. Don’t turn off the fans just yet.

 Posted on : Thu 31st - Aug - 2006

 

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