The British Dental Association Cymru has stressed it needs to see how important concessions are reflected in concrete changes to draft legislation, following confirmation that the Welsh Government is willing to move on controversial elements of its reform package for NHS dentistry.
The professional body stress the Welsh Government has a responsibility to act on the weight of feedback to one of the largest consultation responses in the history of Welsh devolution, and ensure these changes are fully reflected in legislation before it reaches the Senedd floor.
Hugely complex reforms are set to be taken forward under the Senedd's ‘negative procedure’ for making secondary legislation that will effectively amount to a ‘take it or leave it’ approach, to pass or reject the regulations 40 days after they are tabled without any scope for amendment.
BDA Cymru had identified many of the big issues put out to consultation that could undermine the service, including the proposals to shift low needs patients from practice lists to a centralised database where they would be allocated to different practices on a first come first served basis. The professional body had warned this could undermine continuity of care and spell the end of the ‘family dentist’, with parents and children at risk of being split up and allocated to different providers.
It has said this change looks like progress, but there remain many areas of ambiguity. BDA Cymru stress a sober approach is now needed to prevent rushed and potentially flawed legislation reaching the Senedd.
Despite a headline focus on prevention there are only tokenistic measures to expand fluoride varnish application. The shift to move healthier patients to appointments of up to 24 months apart is also likely to limit the scope to act on the early signs of disease, including oral cancers, and stymie opportunities for preventive advice and treatment.
The proposals will still mean radical changes to the way dentists are paid, with rewards for delivering a ‘care package’ to patients with ongoing or complex needs. While there have been important wins on saving commitment payments for dedicated NHS dentists and an end to proposals to cap parental leave, even with uplifts the proposed level of payment to practices fails to reflect the true cost of care, and risks leaving NHS providers stuck delivering care at a loss or walking away from the service.
Russell Gidney, Chair of the British Dental Association's Welsh General Dental Practice Committee said:
“The Welsh Government says it has listened to the public and our profession, but we need to see the small print.
“There are some important wins here. But plastering over a few of the biggest cracks is just superficial repairs.
“Ministers are taking forward the biggest changes NHS dentistry in Wales has ever seen via a route that will all but rule out fixes once draft laws reach the Senedd.
“If our MSs can’t iron out the creases later, the Welsh Government must ensure real threats to this service don’t make the final cut of their plans.”