Caroline Lappin, NI Council Chair, outlines the agenda of the new Health Committee in Northern Ireland.
The Northern Ireland Assembly is back up and running, and we haven’t wasted a second to get our issues on the agenda of the new Health Committee.
We’ve set out the key challenges facing the profession:
1) A COVID-19 safety net
Health Service dentistry in Northern Ireland requires a lifeline during the current pandemic.
At a time when practices are already struggling to be viable, we told the committee, this outbreak could have devastating consequences.
The Scottish government – operating the same fee per item model – has been working proactively on financial mitigation measures. If this service is to have a future, we need the same treatment. That’s why we have raised these issues directly with the Chief Medical Officer.
2) We need an up-to-date oral health strategy
We want to the best possible care for our patients, but we’re often working to deliver this in less than ideal circumstances.
Nearly 5,000 children a year in Northern Ireland undergo the trauma of having teeth extracted under general anaesthetic. That’s over 23,000 teeth! Over 20,000 of these were baby teeth, three times higher pro-rata than in England.
By age 15, just under a fifth (19%) of children here can be considered to have good oral health overall.
However, the existing Oral Health Strategy for Northern Ireland dates back to 2007.
We need an updated strategy, one that is wholeheartedly focused on delivering better outcomes for our population, and which recognises that oral health is directly linked with our overall health and wellbeing.
3) Action on Pay
As independent contractors, GDPs in Northern Ireland have witnessed huge real terms reductions in remuneration for Health Service dentistry over the past decade. This is estimated in the region of 30% pay cut for practice owners and 39% for Associates.
The removal of Commitment payments to GDPs, previously worth in excess of £3m per annum, has added to the impact.
Put simply, current health service dental fees are simply not sustainable.
When you compound the situation with uplifts being applied late - in recent years, very late - this is untenable for small businesses attempting to manage cash flow. We need realistic uplifts, delivered on time.
4) Don’t forget the CDS
Community Dental Service make up only 7% of the total NI dental workforce. However, CDS are charged with caring for some of the most vulnerable cohorts in our society, not least the frail elderly population.
40% of CDS dentists are due to retire by 2025. Last October, we received draft terms of reference for a CDS Workforce Review, which we accepted. But the CDS Workforce Review group has still not met.
This work is vital, as we seek to ensure the appropriate level of skills are in place to meet the growing demand for the service, not least from a growing population that is also retaining more of their natural teeth into later life.
5) Tackling low morale
Only 14% of dental practitioners in Northern Ireland rated their morale as ‘high’ or ‘very high’. This is the worst in the UK.
Ultimately practitioners do not feel sufficiently valued by the Department of Health. This is perhaps not surprising, when on the evidence, oral health has not been a priority for the Department over the recent years. This must change.
Checking in on progress
In October, we brought our Oral Health Matters summit to Stormont. The Chief Dental Officer announced the setting up of two Oral Health Options Groups that would take forward ‘policy options’ for children, and the elderly.
However, 5 months have passed and these groups have yet to meet. Indeed, we are unsure when or if these groups will meet.
Across all these fronts, we need a clear strategy. These two groups need to be up and running. The CDS Workforce Review has to make progress.
Oral health cannot remain the missing piece in NI health policy.
NI Council Chair
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