The BDA is pressing for clarification or change on a number of issues raised by the Health and Social Care Bill ahead of Monday’s (31 January) second reading in the House of Commons. Second reading stage, a broad debate on general principles before detailed arguments begin further into the legislative process, sees the BDA lobbying in four key areas. It is seeking clarity on where responsibility for the commissioning of salaried dental services will sit, calling for assurances that the Coalition Government does not intend to reintroduce school dental screening, pressing for local dental expertise to be retained and utilised in the new system and appealing for dentists to be exempted from Monitor’s licensing requirements. It is also seeking a strengthened role for Local Dental Committees (LDCs).
The intention for responsibility for commissioning general dental services to move from primary care trusts to the National Commissioning Board, a proposal that has the support of the BDA, has been well documented. The intention for hospital services also to be commissioned by the Board was made clear by Earl Howe, Parliamentary Under-Secretary of State for Health, in a House of Lords debate on 13 January. The BDA is calling for confirmation that salaried primary care dentistry will also be commissioned by the Board. The BDA believes this would ensure consistency in commissioning and safeguard care for vulnerable patients.
The Bill also creates uncertainty about whether school dental screening, a measure that the BDA does not believe is effective in tackling oral health inequalities, is to be made mandatory. This measure appears to be included in the Secretary Of State’s duties that are to be transferred to local authorities as part of the reforms. The BDA is calling for assurance that the Coalition Government does not intend to force local authorities to undertake school screening, arguing instead that a multi-faceted approach to oral health inequalities that targets pre-school children and their parents would be a more effective strategy for dealing with this issue.
Questions about the role of Monitor must also be answered, the BDA believes. The Bill fails to make clear what role the organisation will play in the regulation and pricing of dental services. It also lacks clarity on the issue of whether Monitor will license dental practitioners. The BDA is arguing that, with the profession already subject to a significant burden of regulation that is set to increase further, it would not be appropriate for Monitor’s licensing duties to extend to dentistry.
The BDA’s lobbying is also highlighting the importance of local expertise in making a success of the reforms, arguing that Consultants in Dental Public Health, Dental Practice Advisers and Oral Health Advisory Groups all have a vital role to play in ensuring local oral health needs are addressed. The BDA believes that the proposed Health and Wellbeing Boards should have a statutory duty to engage with clinical representatives in undertaking joint strategic needs assessments. Local Dental Committees also have an important role to play, the BDA believes. It is therefore calling for statutory recognition of LDCs, with local authorities being required to consult LDCs about health and wellbeing strategies.
The BDA is directly lobbying Members of Parliament to highlight these issues and address the concerns of the profession. Members are encouraged to do the same.