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Where does dentistry in Northern Ireland fit into this General Election?

Blog Author Tristen Kelso

Blog Date 04/12/2019

Tristen Kelso and Roz McMullan 

BDA President Roz McMullan and BDA Northern Ireland Director Tristen Kelso (c) BDA

You could be accused of fanciful thinking to suggest the outcome of a Westminster General Election could have any impact whatsoever for dentistry in the UK, never mind here in Northern Ireland.

Brexit is the obvious backdrop to why the election has been called; health powers here are devolved, while oral health is but one of many important issues competing for the next government's attention.

And yet, while Brexit may have been the trigger for us going to the polls, much of the focus of the campaign has been around the growing sense of decisive action needed to breathe life back into the NHS.  

The 'Missing Piece' is the key theme of the BDA's manifesto for oral health.

The overall emphasis of our manifesto is that dentistry can no longer be the missing piece in our health service.

The key asks within this manifesto are applicable to dentistry across the whole of the UK – from greater action to improve the oral health of the children and elderly – to valuing the dental workforce better by addressing a decade of pay cuts resulting from successive below-inflation pay uplifts – and tackling over-regulation.

These are messages that are important to dentists working anywhere in the NHS or Health Service across the UK.

The BDA has been working to get media attention for dentistry, securing interviews with some of our key representatives – which is no small feat during a general election campaign.

Difficulties accessing NHS dental services in England, as well as the increasing difficulties practice owners have filling short-term vacancies, including in Northern Ireland, have featured prominently.   

We've seen new pledges in response to this media attention from a number of the political parties: Labour has proposed introducing free dental check-ups and say they want to eventually provide free NHS dental care. The Tories and Liberal Democrats have said they will invest more money in the NHS to improve services.

So, is this likely to have any bearing on the situation for dentists, and oral health in Northern Ireland?

Addressing the significant waiting lists in Northern Ireland could easily swallow up any extra money for the Health Service here, estimated to require anywhere between an extra £700k and £1bn.

At the same time, the Permanent Secretary is faced with making meaningful pay awards for HSC staff and contractors in a climate of widespread industrial action.

And our dentists continue to await a determination being made on their 2019/20 pay uplift, following the DDRB recommendation of 2.5% made in July.

Three years on from having a functioning Stormont Executive and Assembly, there is a growing sense that civil servants tasked with 'keeping the machinery of government operating' are running out of road, despite their extraordinary powers to make decisions ordinarily made by Executive Ministers they deem to be, 'in the public interest'.

The unprecedented reality of widespread strike action by nurses and other health staff across Northern Ireland over the next weeks and months could yet prove to be the tipping point in forcing our civil servants to relinquish controls to Westminster.      

Contrary to what you might expect, Westminster has shown itself receptive to oral health matters. In the last Parliament, the House of Commons Northern Ireland Affairs Committee assumed more of a 'hands-on' approach to scrutinising Health Spending in Northern Ireland in the absence of having a Health Committee at Stormont.

We engaged positively with this committee, and we succeeded in getting oral health included as one of six priority areas in the subsequent Health Spending in Northern Ireland report that was published in November.

Also included was a recommendation from this influential committee that the Department of Health commits to a new Oral Health Strategy for Northern Ireland, to be devised in collaboration with the dental profession. This is something we have long been calling for, as our current oral health strategy is now over 12 years old, and is hopeless out of date for the needs of our patients, and our workforce, today.

Having a degree of political pressure and oversight brought to bear is extremely helpful, as we continue to lobby on behalf of the profession. 

So long as our devolved institutions continue to be stalled, we face the likely prospect of MPs playing an increasingly important role in relation to 'devolved' matters such as Health, not least when it equates to half of the total Northern Ireland budget.

While less than ideal, it's been at Westminster where we have succeeded in having our issues heard, and resultant pressure applied - on why we need a new Oral Health Strategy for Northern Ireland; our campaign to have the HPV vaccine extended to boys; and what ultimately led to our securing a recent meeting between BDA Northern Ireland representatives and the Permanent Secretary.

I can only see that influence becoming increasingly important in the foreseeable future, and we will work to make sure your issues get heard.

Tristen Kelso, BDA Northern Ireland Director

BDA Northern Ireland

BDA Northern Ireland supports, represents and promotes, the interests of all dentists working in Northern Ireland. Working with elected committee members, we negotiate on behalf of the profession on terms and conditions, pay and contracts. Join us.