State of NHS dentistry shows the challenges the healthcare system faces – Andy Brown

The vast majority of people in Britain want the NHS to be there for them when they need it. So, it is hardly surprising that politicians feel the need to assure us with great frequency that the NHS is safe in their hands and that there is no intention to scrap it and introduce an expensive US style personal insurance system.

On one level we can rely on those assurances. There never will be a day when a politician stands up and announces that they are closing the NHS, selling it off to a hedge fund or turning it into a rump service for the poor.

On another level we need to question them very closely. Because the process of removing readily available health care that is free at the point of use for all our community has already been underway for some time and shows no signs of slowing up.

The service is being weakened quietly but relentlessly.

‘More dentists are leaving the service every year making it harder and harder to get high quality affordable local care.’

There are parts of Yorkshire where it is not possible to get registered with an NHS dentist.

More dentists are leaving the service every year making it harder and harder to get high quality affordable local care.

In far too many places it is possible for those who can afford it to get dental care privately whilst those who can’t struggle on in pain.

Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, puts it this way: “Overstretched and underfunded, thousands of dentists have already left the NHS, but many more have begun severing their ties.”This is how NHS dentistry will die, a lingering decline that unchecked will leave millions of patients with no options”.

Similar creeping changes have been taking place in General Practice. The days have long gone when someone who felt sick could routinely go to their local surgery the same day.

Now more and more of us are finding that we experience long queues on phone lines waiting to start a debate about whether it is weeks or days before we will get seen.

Vanishingly few appointments are now with a doctor who plays any significant part in decision making about how the practice is run.

Most GPs are managed by chains of providers who allocate them less than 15 minutes to read complex notes on a patient they often have never seen before, consult the patient and then work out the required action.

Any falling behind or discussion of the wider health of the patient is frowned upon as ‘customers’ are ushered through at speed.

Many of the remote companies that own the practices seem more interested in returning a profit to their shareholders than in the quality of patient care.

To all intents and purposes the vast bulk of the primary care service has already been privatised.

Few people are reporting on the extra efficiency they have encountered as a result. Many are hugely frustrated by the reduction in the standard of their experience.

When it comes to hospitals the problems include endless top down reorganisations, outsourcing of the easy, cheap and predictable bits of their operations, mountains of paperwork and severe staff shortages.

Despite all this, patients still report positive experiences with remarkable frequency. Once they are actually being treated.

Reports of receiving a positive experience on entry or on exit are less frequent.

The latest data reveals that over 30 per cent of people waited over four hours to be seen in A&E. 44,000 people waited over half a day after they arrived before a decision was taken to admit them and not all of them got a bed.

Those are not the levels of service that staff joined the service to deliver. That is one of the key reasons why 34,000 nurses left their job last year – an increase of 7,000 on the year before.

It is demoralising to fight an unequal struggle with the workloads that come with 46,000 vacant posts.

One of the other key reasons is a decade of declines in the living standards of nurses.

It isn’t easy to stick with a vocation when you feel taken for granted. The cost of living is going up by over 10 per cent a year. NHS wages aren’t.

There will be many nurses who will be deeply uncomfortable with the idea of going out on strike. It goes against everything that they have dedicated their career to. Yet they face a stark choice.

Do they quietly put up with the chaos and the increased workloads as they watch experienced colleagues leaving for higher pay? Or do they try and speak out now before it is too late and the wider NHS heads the same way as dental care?

Andy Brown is a Craven District councillor representing Aire Valley with Lothersdale and the North Yorkshire Councillor for Aire Valley.

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