Michael Watson reviews the letter published in the Daily Telegraph

Michael WatsonOn 2 January the Daily Telegraph published a letter signed by over one hundred dentists, a new version of the letter printed in the same newspaper on the same day last year, organised again by Yorkshire dentist, Tony Kilcoyne.

It was published a year to the day after a similar letter from the same stable was published by the paper, since when the authors claim that the situation has worsened.

The letter said that dentists cannot provide the best care while ‘under pressure’ to meet the NHS units of dental activity (UDA) targets.

It quotes the example of the recall of 22,000 patients of Nottingham dentist Desmond D’Mello, who it said ‘huge volume targets, commissioned and supervised by NHS management’, which compromised care and ‘left no time to clean properly between patients’.

But I ask was this a good example, as it implies that D’Mello was forced into accepting a burdensome contract that shouldn’t have been awarded.

I am sorry but commissioning of public services does not work like that, think back to the 2012 Olympics and the failure of G4S to fulfil a contract to provide training and management for the 10,000-strong security workforce.

Did those who commissioned the work get the blame?

No the company had to take responsibility for what was recognised as a fiasco.

Neither his primary care trust nor NHS England held a gun to D’Mello’s head and insisted that he accept too high a UDA target.

What, in effect, they said was ‘if you want to earn all this money (and by all accounts it was considerable) then this is the number of UDAs you must provide.’

He, not the NHS, was responsible for managing all those who were to provide the care and make sure they did it to an acceptable standard.

The recall shows that he failed to do this.

The letter then pointed out that the ‘number one medical reason that any primary school child aged 10 or under is hospitalised in England is rotten teeth’.

This is 100% preventable, the letter says.

But who refers the patients for extractions and who fails the provide the prevention?

Sorry its dentists not the NHS, not the Government.

Tempting though it is to say that, when the Government promises the public that all their dental clinical health needs will be met, this is a lie, the public will blame the profession.

The letter – signed off as it is by many who practise in the private sector – reads like a thinly disguised attack on the professional standards of those hard-working dentists who practise in the NHS.


  1. 1

    Once more Michael interprets things from a slant he usually adopts. The failings are with local commissioning so trumpeted by the retiring CDO as the success of 2006. Local contract management failings and many other reasons including poor quality inspections and lack of patient monitoring with the scrapping of DROs.

    Not easy to provide prevention to a patient who on presentation has multiple unrestorable deciduous teeth needing GA extraction.

    Wrong again Michael



  2. 2

    ‘who fails to provide the prevention’……. ermm parents, Dr Watson. Plus of course some HMG responsibility for not fluoridating the entire national water supply.
    Blaming the GDP’s is like blaming GMP’s for cardio-vascular disease.
    So, wrong again Dr Watson.
    I’m private, not NHS BTW.

  3. 3

    Sorry Michael, but unless you are just being deliberately provocative, by saying it’s not the imposed failing NHS dental system’s fault at all, then YOU are effectively attacking the ” …professional standards of those hard-working dentists who practise in the NHS,” thus you are leaving them with all the blame publicly!

    That is simply wrong and is typical of the public blame-games played centrally in the NHS Mid-Staffordshire scandal too :(

    You and Dentistry magazine should be applauding those who have been brave enough to speak out in the Public interest so clearly and raise serious concerns for their well-being – the fault lies with POOR STRATEGY Centrally and an even POORER SYSTEM imposed that is chronically failing the Nation :(

    Those signing have many years current/past experience of NHS services and CARE enough to DARE to be FULLY open and transparent about problems/limitations publicly, in line with the Francis report recommendations.

    Can we get those centrally to demonstrate a similar level of ‘care’ to the public interest by also daring to be FULLY open and transparent about their failings too?

    Yours still clearly,


  4. 4

    Unfortunately the current problems are a toxic mixture of a very difficult contract to work with, mismanagement by some ( not all) former PCTs, and a minority of dentists being unrealistic & accepting ( and sometimes demanding) very high contract values with high numbers of UDA’s.
    On the other side of the fence are some dentists who have been given very poor contracts with low UDA values which they felt they had to accept or lose their livelihood.
    Since the introduction of the current contract in 2006, regulation and admin has increased massively, yet there has been no recognition of this in NHS dental contracts. With our clinical notes and treatments now judged by faculty standards, it’s near impossible to work on a crude target driven treadmill system which takes no account if the above factors.
    Regarding the prevention aspect, the attitude towards dentistry & dentists in this country by the general public is quite frankly appaling. Patients on the whole do not want to take ownership of their dental problems but put the blame solely on the dentist.

  5. 5

    I wonder if Dr Watson would still blame his colleagues for the lack of providing preventive dentistry if he was still practicing dentistry within this shambolic “Nectar Point” system?
    This system is not worthy of a European country in the 21 Century.

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