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Brine’s call to action on contract reform

We don’t need more discussions on contract reform. The Government needs to press ahead with change. This was the message that Steve Brine, the outgoing chair of the Health and Social Care Committee (HSCC), delivered to delegates at this year’s annual Local Dental Committees’ (LDC) conference in Brighton.

Brine, who chaired the most recent HSCC inquiry into NHS dentistry, noted the huge media coverage of this report and thanked us for “referring to our [HSCC] report as an instruction for the way forward in NHS dentistry”.

He admitted he was not an expert in dentistry, but he follows the evidence, and this was the approach adopted in Westminster’s inquiry into NHS dentistry, which he said had received thousands of pieces of written evidence. He agreed with our view that this sets out what the Government should do to deal with the NHS access crisis.

However, following the long-awaited announcement of government’s national recovery plan in parliament last Febuary, with no mention of scrapping the Units of Dental Activity (UDA)-based contract, Brine asked Health Secretary Victoria Atkins, “How she would entice professionals to return to NHS, because even a day longer of the UDA-focused contract is a problem?” He added: “Can the secretary of state say how she plans to entice professionals to return to NHS dentistry, when so many have left, because that is key?”

Brine, who is stepping down as a Conservative MP, expressed empathy for dentists reducing or quitting NHS work, saying that he didn’t think any dentist who handed back contracts did so without a lot of soul searching.

Commenting on the Government’s pledge to deliver 2.5 million more appointments, Brine said this was based on “wrong modelling”, referring to Health Minister Andrea Leadsom’s admission in parliament that there was a “high likelihood” that these figures were unreliable.

While our surveys show that 99% of dentists rejected the recovery plan for its failure to bin the discredited UDA contact, he said he thought there were some take aways to build on and there might be a place for ‘tie ins’ for new graduates, provided there were more carrots than sticks.

Brine questioned the accountability of Integrated Care Boards, and said it was a mistake that dentists are not sitting on the boards; the Government would not accept that this should be mandatory. The outgoing HSCC chair also lamented the demise of the Tobacco and Vapes Bill, which aimed to create the country’s first smoke-free generation after Rishi Sunak announced the dissolution of parliament on 30 May and the General Election on 4 July. “It is a travesty,” Brine said, “that it wasn’t implemented.”

During a question and answer session, the former chair of our General Dental Practice Committee, Henrik Overgaard- Nielsen asked Steve Brine if he regretted not pushing through contract reform when he was health minister. The MP conceded that as a junior minister he didn’t have much sway, because, he said, the real power in government lies in numbers 10 and 11 Downing Street.

He said if Wes Streeting becomes health and social secretary, as predicted, he should focus on “pushing down demand” via prevention, “because he’s not going to have any more luck with the Treasury (securing growing health spending) than the previous secretary of state”. Brine also questioned whether it would really be at the “top of (their) inbox” and cautioned that the Treasury had been “terrified of dentistry” during his time as minister “because they could just see big, big costs”.