Before you read the update, Kate Green (my MP) would like to circulate an update to all the MPs who showed an interest in this Campaign. IF YOU HAVE ALREADY CONTACTED YOUR MP PLEASE COULD YOU LIST THEIR NAME IN THE COMMENTS BELOW IF THEY'RE NOT IN THE LIST ALREADY. I have written the names of those I can remember but I know I'm missing loads. So if your MP is NOT on the list and they have responded favourably, can you please add their name in the comments? I only want names of those who have said they will support the Campaign! Many thanks.
Yesterday, Kate Green (MP for Stretford and Urmston) and I met with Jo Churchill (Under-Secretary of State for Health & Social Care) to discuss the Campaign. In attendance were 3 other people and I unfortunately can’t remember their titles but from memory - the Cancer Policy Advisor, Dental Policy Advisor as well as Jo’s Private Secretary. Jo and her team made us feel really welcome and the meeting (which was supposed to be for 30 minutes) actually lasted an hour.
So what happened? Jo started the meeting by explaining that there were huge constraints on the NHS and giving free dental care may not be workable. She explained that she routinely meets with people who all have their own “causes” who want funding by the NHS, so it’s a juggling act deciding where money should, and can be, spent. However, she did say that she would look at all proposals and it was clear that she’s keen to make the lives of cancer patients easier and perhaps also focus on prevention. It is in the public domain so I’m not breaking any confidences by stating that Jo herself has had cancer, so this is a topic close to home. So whilst you may have read and thought "I knew they wouldn't give us free dental care", please read on because we are literally only at the start of the discussions ...........
I explained that an overhaul of how money was allocated to NHS dentistry (for use by dentists in each region) was required urgently. For example, in Greater Manchester at the end of 2018/2019 there was the equivalent of just under £6 million of unused dental funds that couldn’t be accessed by dentists due to constraints of the current system (in 2017/2018 the figure was just under £4 million). To explain further, each NHS Dentist is allocated a yearly set amount of UDAs (Units of Dental Activity) and once that has been used, the Dentist can’t treat patients on the NHS or be paid for that work. What this means is that dental practices close their doors to new NHS patients each year once their allocation has been used (and sometimes re-open them again at the next yearly allocation). The figure of £6 million is ONLY for Greater Manchester so imagine what it would be across all areas!
Taking the Greater Manchester example, where does the £6 million go? At the end of the year, it goes back to the overall NHS “pot” for that region and is then allocated back out (perhaps where other health areas have overspent - so it usually leaves the area of dentistry altogether). That to me, is a huge issue. A dentist could turn you away because he/she has used their NHS allocation but a dentist in another nearby practice may have unused UDAs. The unused UDAs cannot be shared between dentists and any unused go straight back to the "pot" and leave NHS dentistry funding! This seems incredibly wrong that money, earmarked for dentistry, can’t be accessed and may be used to prop up other areas that can't manage their budgets. In business, if a manager couldn't manage his/her budget there would be consequences!
There are some quick wins here, by potentially offering a flexible UDA pot that could be accessed by Dentists, so they could treat cancer patients on the NHS even if they exceeded their allocation. In some areas of England, this has been trialled successfully (not with cancer patients) but on a small scale and has worked.
This doesn’t get around the problem that there are a lack of NHS dentists in some areas but it does mean where there are dental surgeries offering NHS services, they would be able to treat more cancer patients without closing their books once the allocation had been used. The problem of a lack of NHS dentists does need to be addressed and this was something we didn't touch on. However, I did have a few ideas on this subject that were presented in the briefing document. For example, a GP surgery may be given rent-free premises to operate out of but if a wholly operated NHS dental practice moves into the same premises, they have to pay usually very high fees! I honestly can't see how this right and only reinforces that dental care is often seen outside the main health arena.
We also discussed the need for the GP, Oncologist, Surgeon, Specialist Cancer Nurses and Dentists to have a joined-up plan for each patient. Currently, patients are not routinely told to have their teeth checked before cancer treatments start (and there is usually a window of around 4 weeks between diagnosis and treatment starting). The dentist is not routinely in the loop and so may not be aware their patient has a cancer diagnosis. This needs to change so that Dentists can give priority to those patients both in terms of timely appointments and also treatment. This again, is something that is a quick win and could easily be introduced. What shouldn’t happen is that the information is buried in the huge amount of information already given to the cancer patient. My suggestion was that the GP gives a form that the patient takes to their dentist (in the same way that the GP gives the patient a form to fill out for prescription exemption charges).
Education is key here – dentists need to understand the need for timely treatment and the need to prioritise cancer patients and also understand what treatments might put a cancer patient at risk (ie removing a tooth if a patient is undergoing bisphosphonate treatment). In Greater Manchester there is already a training plan that was rolled out to some dental practices last year which does just that. A copy of the training plan was given to Jo and her team for their information. There's no reason why this training couldn't be rolled out nationwide.
There is also an anomaly in the dental world whereby many cancer patients have work carried out, ie fillings, root canal treatments etc which are absolutely fine for every day life but then may present a problem once cancer treatments starts. Many of the issues seen are failed root canals and for this to be rectified, a patient may have to see an endo-dontist and there are very very very few who offer their services on the NHS – not only because of the specific skill level required but also the cost of dental equipment. This forces patients into the private sector to pay, potentially, thousands of pounds OR they don’t have the work done – which ultimately, then costs more in the long run. Whilst we only touched on this subject, it is definitely something that needs reviewing - we need to get this work covered by the NHS. For those who have paid thousands of pounds (perhaps for a failed root canal treatment), this would make a huge difference.
At the end of the meeting there was a suggestion that teams from both cancer and dental policies (and potentially a wider audience – and I’ve asked if I could be included) should meet to look at what options may be workable. That’s a great step forward because it does mean that this subject is being looked at seriously. Kate will also be looking for opportunities to take this Campaign further and involve others as needed.
Will we be able to have free dental care for cancer patients – or a hybrid system that may help relieve the financial burden? I don’t know yet, but the conversations have started and we have to begin somewhere. I did make several suggestions on how free dental care could be funded – some we were able to discuss and others we didn’t have the time to cover but suggestions were in the briefing document. I’m not giving up and as I keep saying …………. this is a marathon not a sprint!
MPs I know who have expressed an interest:
- Chris Grayling – Epsom and Ewell
- Leo Docherty - Aldershot
- Yvonne Fovargue - Makerfield
- Alex Berghart – Brentwood
- Peter Bottomley – Worthing
- Claire Coutinho - East Surrey
- David Rutley - Macclesfield
- Judith Cummins – Bradford South
- Steve Double – St Austell and Newquay
- Stephen Metcalfe – South Basildon & East Thurrock
- Catherine Fletcher - South Ribble
- Rebecca Harris – Castle Point
- Neil O’Brien - Harborough District
- Justin Madders – Ellesmere Port
- Lisa Nandy – Wigan
- Mark Francois – Rayleigh and Wickford
- Natalie Elphicke – Dover
- Alun Cairns – Vale of Glamorgan
- Sir George Howarth - Knowsley
- Robert Goodwill - Scarborough & Whitby
- Jon Crudas – Dagenham & Rainham
- Barry Gardener - Brent, London
- Sir Paul Beresford - Mole Valley Surrey
- Andrew Bridgen – North West Leicestershire
- Sir Lindsay Hoyle - Chorley Lancs
- Cat Smith - Lancaster & Fleetwood
- Carla Lockhart - Upper Bann
- Ben Bradshaw – Exeter
- Ian Blackford - Skye, Lochaber and Rosshire
- Tim Farron - Kirkby Lonsdale. Cumbria
- Sarah Dines - Derbyshire Dales
- Theresa Coffey, Secretary of State for Work & Pensions
- Jo Stevens – Cardiff Central
- Stephen Doughty – Cardiff South and Penarth
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David Morris. - Morecambe and Lonsdale
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Philippa Whitford - Ayr
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Dr Rosenna Khan – Tooting
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Colum Eastwood – Foyle, SDLP
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Craig Mackinlay - South Thanet
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Anthony Browne - South Cambridgeshire
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Johnny Mercer - Plymouth Moorview
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Robin Walker – Worcester
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Karen Buck – Westminster
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Charles Walker - Broxbourne and Hoddesdon
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Taiwo Owatem - Coventry North West
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Graham Stringer - Broughton & Salford
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Tulip Siddiq - Hampstead and Kilburn
- John Howell - Henley