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MonopolyThe dental profession should focus on moving forward rather than the change itself, Kevin Lewis says.

Let me start by acknowledging that it is probably something to do with the time of year. No sooner had the final New Year’s Eve firework faded into the night sky, and we were being exhorted to set off in search of a ‘new you’ or perhaps ‘a new us’.

First, the sneak preview of an upcoming report and recommendations from the chief medical officer that the so-called ‘safe limits’ for alcohol consumption were being dramatically reduced. Then, just as the New Year opened its doors to us, and the last few unselected Quality Street exhibits rattled forlornly and unloved in their box, the media was suddenly awash with more ‘hidden sugar’ revelations. Children aged four to 10 are reported to be consuming 22kg (5,500 lumps) of sugar a year – in many cases without their parents realising it. The fact that many of the four-year olds are being transported in wheelbarrows rather than pushchairs is a clue, I would suggest.

But help is at hand. January 2016 sees the release of a new Change4life app (part of the Sugar Smart campaign), which allows consumers and parents to scan the barcode of products to discover the amount of sugar contained in the product before they buy it.

Excess baggage

If ever there was a reason to plan for a healthier and more active 2016, The Guardian took us into the New Year with a bang. It reported that many hospitals are having to refer obese patients elsewhere because they are either too large or too heavy for their scanning equipment. By the time today’s 10-year olds reach their mid 40s, obesity is predicted to affect 60% of adult men and 50% of adult women.

All this talk of a healthier 2016 brings me to the perennial issue of tobacco, and the prospect of e-cigarette devices being made available on NHS prescription. It seems paradoxical therefore that the EU could yet ban them outright if three or more member states decide they are harmful enough to be made illegal – although the more likely scenario is new legislation to control their manufacture and supply much more stringently than has been the case up to now.

These are either a revolutionary health boom that could save millions of smokers’ lives (and a lot of NHS money) or another marketing gimmick for the smoking industry to make money out of, propped up on wafer-thin evidence.

Reasons to be cheerful

It was both refreshing and encouraging to see that two recent studies that have tested the waters of British business for their perspectives of the prospects for 2016, have both detected distinct signs of optimism.

The international accountancy firm Grant Thornton surveyed more than 10,000 companies around the world and found that businesses in the UK and Ireland were the most upbeat in Europe on almost every measure that you care to choose. In the UK three out of four of the surveyed companies expected their profits to improve in 2016.

In a separate survey the Confederation of British Industry (CBI) found that a significant proportion of UK companies were already reporting an upturn in fortunes in the closing quarter of 2015 after a mostly dismal third quarter. One interesting feature of this continued and perhaps (at last) accelerating economic recovery is that UK consumers are leading the way. Their spending appetite is gathering pace, no doubt fuelled to some extent by low interest rates and cheap credit.

The months ahead will be a waiting game and a delicate balancing act for George Osborne who will not want to choke off the main areas of the economy that is driving the recovery, nor blunt the strength of the pound.

The golden fleece

So what does all this mean for dentistry? The ravages caused by sugar and tobacco have contributed in no small measure to financially supporting generations of dentists, so a self-serving view would be that bearing down on sugar and tobacco consumption may not be good news for the profession. But health improvement should always be a desirable goal in any healthcare profession and anything that contributes to that should be welcomed with open arms.

The elusive golden fleece of dental health has always been to find a way to align the needs and best interests of all three parties – the patients, the dental profession and the state. Paying dentists to keep patients healthy (rather than for treating and repairing disease) makes perfect sense to everyone except the treasury, and we need look no further than the lost industries of coal mining and ship building to convince ourselves of the harsh realities of economics.

This is one reason why the developments regarding the new arrangements for the delivery of primary care dentistry in England and Wales need to be watched closely. After all the convoluted piloting and lesson learning, we seem to be setting off in a different direction over which we have little control. This year will be crucial in addressing that risk.

Burying bad news

In my December column I managed to extract my tongue from my cheek just long enough to ponder how convenient it would be if the long-awaited and much delayed report from the Professional Standards Authority (PSA), the General Dental Council’s own regulator, happened to be published in the immediate run up to Christmas – when nobody was around to comment or to be challenged on the findings. It was published on 21 December and relates to the PSA’s investigation into the GDC’s handling of a whistleblower’s disclosure about the workings of the Investigating Committee, which forms part of the fitness to practise procedures. This is of course where most of the problems are known to have been concentrated in recent years.

But this report goes some way further than that because the PSA has taken the opportunity to look at the extent to which the GDC has learned from the events that were given a public airing as a result of the complaint raised by a previous whistleblower, the former chair Alison Lockyer. It looks at the internal management and organisational culture of the GDC in a general sense, and how that impacted upon the treatment of the whistleblower after the concerns were first raised, and it poses some serious questions about the relationship between the GDC staff and management, and the appointed council.

I will report in more detail on this latest report shortly – but for now it leaves a question hanging in the air of whether the GDC worked a lot better and with far fewer problems when the council itself consisted of a majority of dental registrants, many of them elected by and therefore accountable to the profession. The GDC certainly enjoyed the confidence and respect of the profession in those far-off days and while I understand that the current vogue is for robust and transparent governance processes, allowing greater public scrutiny and accountability, I wonder if all this change has achieved even that?

Perhaps the American author, Ellen Glasgow, had it right almost 100 years ago: ‘All change is not growth, just as all movement is not forward.’

We will all change during 2016, just as the profession and world around us will change. Let us focus on the moving forwards rather than the change itself. I do hope that 2016 is kind to you and those that are close to you.

One comment

  1. 1

    Kevin Lewis raises some key issues about the GDC. Dental regulation can only be successful if the regulator has the support and confidence of the Dental Profession. Peter Ward CEO has made the position of the BDA clear in a recent BDJ Editorial; that it is not fit for purpose.

    And if it is not fit for purpose to carry on business as usual will only confound issues if its rulings are subject to successful legal challenge’s, with reference to its lack of competence.

    We could be heading for a jurisprudence crisis in Dentistry of monumental proportions

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