Dental Politics & Pressure Groups

1. Dental Politics & Pressure Groups Dr K Hill BDS III Dental Public Health and Behavioural Science 2009-10

2. Definition “Pressure group is a group of people who seek to exert pressure on legislators, public opinion, etc.. In order to promote their own ideas or welfare” Collins concise dictionary Dental Public Health and Behavioural Science 2009-10

3. Pressure groups and political parties • Along with political parties, pressure groups are essential to democratic politics. They differ from political parties in these ways: • Pressure groups try influence the government but do not want to be government. They focus on one issue or a related group of issues, such as animal rights • Political parties try to get their candidates elected in order to win political power and have policies on a wide range of issues Dental Public Health and Behavioural Science 2009-10

4. Interest and promotional pressure groups • Interest groups, or sectional pressure groups, represent the interest of a particular group of people, for example • AA/RAC – representing the interests of motorists • Trade unions – representing the interests of workers • Professional associations – such BDA – representing the interests of their members Dental Public Health and Behavioural Science 2009-10

5. Promotional groups • Promotional pressure groups represent particular beliefs or point of views, for example • Amnesty international – campaigning against execution, torture and imprisonment for political beliefs • Greenpeace – campaigning on environmental issues • Royal society for the protection of birds (RSPB) Dental Public Health and Behavioural Science 2009-10

6. Pressure groups in dentistry • BDA • Users • Government • The national pure water Association • Sugar industry • Other dental professionals Dental Public Health and Behavioural Science 2009-10

7. Pressure groups (1) • BDA • 1990 new contract : GDPs carry out more work than expected in response to uncertainties over new contract, facilitated by new incentives to promote attendance • Substantial `overspend’ of GDS pay pool apparent by late 1991 • Cut in fees to dentists imposed 1992 • British Dental Association officially starts dispute, advising dentists to seek alternative forms of income i.e. private Dental Public Health and Behavioural Science 2009-10

8. New Contract - BDA • Disillusioned dentist Sir, I realise that as a poorly educated GDP from the north east I may be confused, but after reading through the new draft proposals for GDS and PDS it seems that they are exactly the same! Not only that, but the need to hit a target level of UDA is without doubt the best description of treadmill dentistry ever. The changes to this profession over the last years have left me feeling increasingly militant and as such I have two questions. Firstly if I hit my target for UDA early, can I take the rest of the year off, or even better save that time for early retirement, and secondly as a profession why don't we stand up to the idiots in Whitehall and call a national strike? Amazing - hopeful graduate to disillusioned dentist in five years. British Dental Journal (2005); 199, 627. Dental Public Health and Behavioural Science 2009-10

9. BDA • Call for a vote Sir, I would like to know why the BDA, which is the nearest thing dentists have to a union, is not going to ask its members to vote on the new GDS and new PDS contracts. When the government proposed a new GMS contract the BMA asked its members to vote on the proposed contract and in its original form the BMA members rejected the contract. The government did listen and change the contract. If I remember correctly, did a similar thing not happen with the new consultants' contract as well? So, why if the new contract is so flawed don't we, the people who are going to have to work with it, get to vote whether or not to accept it and make the public and government aware of our voice instead of committees who do not represent the busy, hard working GDPs committed to the NHS? Or does the BDA not care about the NHS and is only interested in private practice? Dental Public Health and Behavioural Science 2009-10

10. BDA • Editor's note: The situation faced by GMPs and GDPs with regard to their respective new contracts is not the same. The new GMS contract was available for negotiation before the relevant legislation was introduced. In the case of dentistry, the legislation came first and so the framework for the new contract was set and was never up for negotiation. In this issue's editorial, Lester Ellman explains the support the BDA is providing members at this crucial time. • This debate continues …… UDAs Dental Public Health and Behavioural Science 2009-10

11. Pressure Groups (2) • Users • Demand treatment • Demand access • Increasing numbers of people contacting health authorities to complain that can’t find an NHS dentist • Increased number of complaints direct or via MPs about availability or quality of dental services Dental Public Health and Behavioural Science 2009-10

12. Pressure Groups (3) Government HC(89)2 ‘The Future Development of Community Dental Services 1989 New GDS Contract 1990 HC(91)5 (Nisbet Report) Role of FHSAs 1991 Bloomfield Report 1993 Roe Report 1993 Green Paper: Improving NHS Dentistry 1994 HSG(97)4 Primary Care Dental Services 1997 HSG(97)38 Investing in Dentistry 1977 Primary Care Act 1997 Personal Dental Services 1998 Dental Public Health and Behavioural Science 2009-10

13. Pressure Groups (4) • The national pure water Association (http://www.npwa.org.uk/ ) • Water is essential to life. We have to drink it. • It is the business of the water companies to supply a clean, safe potable source of water • It is the business of government to enact legislation to control the water companies • It is not the business of government to use the water supply to medicate the population without their consent Dental Public Health and Behavioural Science 2009-10

14. Fluoridation • Tooth decay, also known as dental caries, is a health problem that has plagued humankind for centuries. Until as recently as 60 years ago, the damage caused by caries was an inevitable fact of life for most people. The disease often meant many visits to the dentist to have damage and painful teeth repaired or removed. Today, primarily as a result of fluoride, damage caused by this problem can be reduced and, in many instances, prevented http://www.cdc.gov/OralHealth/topics/fluoridation.htm Dental Public Health and Behavioural Science 2009-10

15. Look what fluoride did to my girl's teeth . . . I can't believe that Glasgow wants to put it back in the water Dental Public Health and Behavioural Science 2009-10

16. RUINED: Carena Smith's teeth will never recover after she took fluoride tablets DR HARRY BURNS: There are ethical and moral issues ... the views of the public must be heard Dental Public Health and Behavioural Science 2009-10

17. York review • What has happen since! • Options for Change 2002 – water fluoridation safe – nothing has happen yet! Dental Public Health and Behavioural Science 2009-10

18. Southampton Fluoridation Scheme • http://www.appgaf.org.uk/ • Don’t poison our water supply Dental Public Health and Behavioural Science 2009-10

19. Pressure Groups (5) • Sugar industry • A new perspective on diet and dental caries • Looking after your baby’s teeth • Losing weight & keeping it off • Growing up with healthy teeth Dental Public Health and Behavioural Science 2009-10

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21. The Sugar Bureau • Only give sweets, sweet foods, squash or juice at feed times. For toddlers and older children, well-brushed teeth can cope with about three meals and two snacks. Dental Public Health and Behavioural Science 2009-10

22. Pressure Groups (6) • Other dental professionals • PDS • GDS • CDS • Private • Boots • Denplan etc….. Dental Public Health and Behavioural Science 2009-10

23. Key Message Pressure groups can raise profile dentistry but can have a major affect on political decisions about oral health and dental services Dental Public Health and Behavioural Science 2009-10