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Peers agree: Dentistry mustn't be marginalised under new laws

As the House of Lords finishes their detailed scrutiny of the Health and Care Bill this week, the upper chamber debated a series of amendments on primary care representation in the new Integrated Care Systems.

Baroness Floella Benjamin during the Lords debate

Amendments on primary care voice – which had been put forward by the BDA and supported by a coalition of primary care organisations including the BMA and bodies representing community pharmacists, opticians and audiologists – were tabled by Lord Hunt of King's Heath, and co-sponsored by other Peers from across the House. They would ensure that primary care professionals would have mandated roles within Integrated Care Partnerships, with representatives nominated by Local Dental, Medical, Pharmaceutical and Optical Committees, and that these committees would be consulted when the Integrated Care Boards draft their strategic forward plans.

In a lively debate Peers from all sides of the House voiced their support for dentists and other primary care professionals having a seat at the table when key decisions are discussed. Introducing the amendments Lord Hunt argued "local representative committees have been an important part of the NHS since its foundation – I see no reason why they cannot be assured of a presence on the new Integrated Care Partnerships. Primary care is at risk of being marginalised and that cannot be left to local discretion."

Liberal Democrat Lord Scriven argued that "having that primary care voice right at the heart of the Integrated Care Board, and being statutorily in the Bill, being able to determine what is happening" was vital if we wanted to "improve health outcomes, integrate healthcare and reduce inequalities". Conservative Baroness Cumberlege stressed that "the absolute foundation of the NHS is primary care – it is so important and we have to build its primacy."

Crossbench Peers echoed these comments, with Lord Warner highlighting that "90% of people's encounters with the NHS are with primary care" and Lord Crisp stressing that it was crucial dentists and pharmacists were represented alongside GPs in the new structures.

Shadow Health Minister Baroness Thornton bemoaned the fact that primary care continues to be underplayed and underresourced, and argued the importance of "putting primary health care professions in the driving seat". She lamented in particular the "the poor state of dentistry" and expressed hope that problems facing the dental sector specifically would be debated in more detail in due course.

Responding to the amendments Minister Lord Kamall said he expected that the NHS guidance which will follow the Bill will indeed dictate that Local Dental, Medical, Pharmaceutical and Optical Committees must be consulted when Integrated Care Boards formulate their strategic plans. He assured the Lords that he would discuss further with his Department how they can make sure that "primary care is better represented and not dominated by acute trusts".

Concluding the debate he said "I am open to further conversations in this area, particularly on how we hear the voices of all those in primary care, not just those of GPs but all of them, including those in ophthalmology, dental care and others."

We keep lobbying the Government and Parliamentarians on the importance of dentists having a strong voice in the new structures as the Bill continues its way through Parliament.