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A voice in the wilderness: Oral health inequalities from Hammersmith to Waverley

Blog Author Henrik Overgaard-Nielsen

Blog Date 20/07/2016

At the surgery I work in Hammersmith, we're an exclusively NHS practice. We have 10 chairs, so that's a lot of dentists seeing a lot of patients coming through the door. And I'm not just patting myself on the back when I say that overall, our patients are pretty happy with what we do, and often go out of their way to tell us so. It makes me feel there is some light amidst the gloom.


And so, I'm pleased to see that the latest official stats also give weight to the idea that dentists, although often condemned in the press, are actually valued by their patients.


An astounding 85 per cent of people in England reported being satisfied with their dental care, according to the 2016 annual GP Patient survey (it has a dental section). It reveals that patients experience is improving compared with the previous years and the highest satisfaction rates are found in the North of England, the Midlands and the East of England.


I was really interested to see the stats on London: attendance is lower in London at nearly 47 per cent compared to nearly 60 per cent in the North of England. The capital has the highest proportion of those who had not tried to get an NHS appointment in the last two years, either because they thought they didn't need to go (14 per cent), or they don't like going (3 per cent).


That certainly chimes with my experience, we still are seeing a lot of patients who have not been for a long time, and have a whole host of problems to sort out that could have been prevented if they had come earlier or more regularly.


The more politically-minded amongst you will have already worked out where this is going. Since I became Chair of GDPC in 2015, I've been calling for a new dental contract that puts prevention at the heart of what we do.


We've been through pilots and prototypes, we've been working to influence the Department of Health and the politicians for years, and we are now facing yet another stalling of any implementation of a new system that does what we, and our patients, need it to do.


It wasn't very heartening to hear the England CDO, Sara Hurley at the LDC Conference this June, say that any proposed new contract might not be rolled out until 2022, due to a general election getting in the way before then. And the further shifting landscape of British politics post-Brexit, also now means that we are going to have to shout louder than ever to get our concerns even onto the table.


Talking about prevention, also means we need to talk about oral health inequalities, and again the recent stats give us some interesting evidence. The South of England has the largest proportion of patients who sought private dental care, at 21 per cent and they also have the best oral health.


As we pointed out to parliamentarians at an event in June, five-year olds in the most deprived areas are almost seven times more likely to experience decay than their peers born in Jeremy Hunt's constituency, Waverley. In 2016, that is truly shocking and it's a fact we will continue to make noise about until a government really sits up and takes notice.


Several news reports this week pointed to the mammoth problems of NHS funding that only seem to be getting bigger and more urgent. Sir Simon Stevens, the NHS Chief Executive, said that 'bold and broad reforms' are needed to meet the challenges ahead. He said that if we are concerned about life chances, we need action on prevention and health inequalities. He, like us, is calling for the childhood obesity strategy to be published and action taken now on food promotion and advertising, to stem the tide of obesity, as well as unnecessary tooth decay.


A recent report by the All-Party Parliamentary Group for Health and the Health Foundation have estimated that 40% of NHS spending goes towards treating potentially avoidable health conditions, and we have estimated that the cost of extractions in 2014/15 for the over 179,000 teeth removed in children aged nine and under in England, cost the NHS up to £14 million; on something that is entirely a preventable problem.

So, we are not a lone voice in the wilderness, but these difficult times mean it's going to be harder than ever to get what we need to ensure the nations oral health isn't left out of the debate.


We are still asking you to share your stories of the impact of the current contract and we are currently surveying different groups of our membership to help us build an accurate picture of the issues facing us in practice today, it gives us evidence to take to the politicians and strengthens our case – please get engaged.


Henrik Overgaard-Nielsen
Chair, BDA General Dental Practice Committee


The official representative body for GDPs

The BDA's General Dental Practice Committee represents all general dental practitioners in the UK and aims to reflect the mixed economy of dental practice. It represents the interests, and acts on behalf of, dentists working in general practice. It is also recognised by the Government as representing NHS general dental practitioners in negotiations and consultations.