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More dentists no 'Magic Bullet' to fix broken systems

In what marks a first the General Dental Council has gone on the record stating bringing in more dentists will not solve problems fuelled by broken contracts.

"Improving the throughput of those from overseas who want to be registered in this country is the right thing to be doing," GDC chair, Lord Toby Harris, told delegates at the recent LDC annual conference in Harrogate, "provided we can maintain the standards that the public would expect.

"But it is not some magic bullet that will solve the problems in NHS dentistry.

"If the contractual terms by which NHS services are provided are unattractive to many dentists currently on the register, then there is no reason why those same terms will be any more attractive to new registrants – whether they are from overseas or who qualify here."

The Government has consistently championed the import of overseas dentists. Many MPs have led calls for the expansion of dental schools. We have stressed that without action on retention, specifically reform of widely discredited contracts, these approaches would amount to trying to fill a leaky bucket.

"That is not an issue that the GDC can solve" Lord Harris added. "Ultimately, it is a matter for those who are responsible for those contractual arrangements. It is in the interests of the public that they do so."

There are currently around 1,500 candidates waiting to sit Part 1 of the Overseas Registration Examination (ORE). While we support urgent action to deal with this huge backlog, it does not represent a solution to the access crisis.

Lord Harris also stressed there is a clear need to capture data on the workforce, particularly on NHS commitment, that would be helpful to inform the wider political debate on the future direction of dentistry in the UK.

While workforce planning isn't part of the regulator's remit, Lord Harris stressed the GDC is well placed to collect data on how many registrants work full-time or part-time and how much of their work is under the NHS contract. Government workforce data is, as we have long argued, essentially a work of fiction, counting heads, not commitment. There can be no workforce planning without this data.

However, there are real concerns over whether handing these duties to the GDC may lead to issues with compliance and added costs.

"This simple factual data could be collected as part of the annual renewal process," he said.  "We would have to make sure that this did not compromise the core renewal process itself, and it would have to be on a voluntary basis."  

In the last five years the number of dentists registered with the GDC have increased slowly on an annual basis, he said, but this fact does not accord with the lived experience of those struggling to access the dental care they need. Hardly a day passes without news stories or parliamentary questions about how difficult it is for many patients to access dental services, added Lord Harris. And in a nod to Mark Green, the chair of this year's LDC conference, he said, "you have warned that the business model in the NHS is forcing so many into the private sector."