Monday, January 14, 2008

British dentistry meltdown

The crisis in NHS dentistry is rapidly worsening because dentists are switching thousands of patients to private treatment, figures show. NHS treatment is in free fall with a 16 per cent collapse in the proportion of dentist's earnings made from the NHS from the years 1999-2000 to 2005-06. The figures, published by the NHS Information Centre, highlight the challenge facing the NHS after a survey, disclosed in The Independent yesterday, revealed that dentistry in England was the most expensive in Europe. The fall in NHS earnings has accelerated in the past two years and is most pronounced among young dentists who are the future of the profession.

NHS incomes fell by over 20 per cent in a single year from 2004-05 to 2005-06, as a proportion of total earnings, among dentists aged under 35. Young dentists now earn on average only just over a third of their income (36 per cent) from the NHS.

Patients' organisations said the decline in NHS dentistry was alarming and could lead to the eventual collapse of the NHS dental service. Surveys show patients are having increasing difficulty in finding an NHS dentist and the Government admitted last year that two million patients who wanted access to an NHS dentist had failed to get it. Anthony Halperin, chairman of the Patients Association and a practising dentist in London, said: "There is no question that dentists are switching patients to private treatment where they can because they feel it is the long-term future for them. They don't want to do run of the mill work, they want to do quality work and that is very difficult under the NHS."

The NHS Information Centre's report into dentists' pay showed that dentists in multi-partner practices who own their surgeries earned 114,000 pounds on average in 2005-6 from NHS and private work. Single-handed practitioners with their own practices earned 94,000. Dentists earned 58.2 per cent of their income from the NHS in 1999-2000 but that fell to 41.9 per cent in 2005-06. Among those under 35, the proportion of earnings from the NHS fell from 63.8 per cent to 36 per cent in the same period, a decline of more than a quarter in six years.

Dr Halperin said the new dental contract introduced in April 2006 had made matters worse. The contract replaced the fee-for-item payment system with three payment bands to encourage a preventive approach. "Dentists are really unhappy about the new contract. They are worried they are going to be asked to do more work for less money. If the contract turns out to be uneconomic, they will switch more patients to private work because it is a safer option and if that happens it will lead to the collapse of NHS dentistry."

The British Dental Association said the decline in NHS incomes reflected a wider malaise in the profession. Peter Ward, chief executive, said: "The dental workforce as a whole is looking to a future in which they feel less and less able to rely on the NHS and are adjusting the balance of their work accordingly." Implementation of the new contract had resulted in up to 1,000 dentists leaving the NHS and 266,000 fewer patients accessing NHS dentistry, the association said. Mr Ward said: "These statistics offer further evidence that the Government's reforms to NHS dentistry aren't achieving their stated aims. This contract has failed to improve access for patients and failed to allow dentists to deliver the kind of modern, preventive care they believe their patients deserve."

The Department of Health rejected suggestions that NHS dentistry was in decline. A spokesman said: "It would be wrong to take this shift in the share of income as evidence that dentists are turning their backs on the NHS. It simply reflects the ever-increasing demand for purely cosmetic dental work which, quite rightly, is not provided on the NHS." He added: "Access to dentistry has remained broadly stable in the past two years and we are doing all we can to make further improvements."


Britain has changed but its values must endure

Britain is now a pluralist society: it is a country of people who have come from many different traditions and backgrounds, and who espouse different religious beliefs or none at all. But Britain still remains a liberal democracy governed by a single set of laws - laws whose roots lie in the Christian tradition that helped to form our moral values and culture.

There is much to celebrate in the diversity of the people who make up today's Britain, and in the dynamism and richness that diversity has brought to this country. But does it also pose a threat to the primacy of the Christian tradition, and even to a single, unified set of laws based on a liberal, tolerant political outlook? Michael Nazir-Ali, the Bishop of Rochester, believes that it may have precisely that consequence, and he expresses his forthright views in The Sunday Telegraph today.

Bishop Nazir-Ali's concern that the rapidity and scale of immigration, together with the policy of multiculturalism, threaten Britain's Christian heritage are echoed by the Church of England General Synod, a majority of which worries that large-scale immigration is "diluting the Christian nature of Britain".

It is not necessary to endorse all of Bishop Nazir-Ali's analysis to recognise that the scale and speed of immigration into Britain in recent years has indeed caused some serious social problems. Although those problems have long been at the top of voters' concerns, it has, until recently, been almost impossible to raise, let alone discuss, them in public: to do so risked being labelled "racist", a charge that has worked very effectively to shut down any further debate.

We believe that the root of the problems that have been caused, or at least exacerbated, by rapid mass immigration - including stresses and strains on the availability of publicly-funded goods, such as education, health and council housing - is less the scale and speed of immigration itself than the way Governments of all stripes have dealt with it. The policy of multiculturalism, which for decades has been the officially-sanctioned policy for immigrants, has actively worked against integrating new arrivals into British culture, traditions and values.

The model has not been the melting pot but the mosaic: instead of co-opting newcomers into the values of toleration, secular democracy and respect for the law as made by Parliament and interpreted by the judiciary, multiculturalism has encouraged immigrants to form their monocultural islands of belief and tradition, in which they reproduce their own values, regardless of whether they are inimical to the British way of doing things.

In 2008, it is not necessary to be Christian to enjoy the full liberties of the British subject (and it has not been for at least 150 years). Although it may be the result of a Christian heritage, the British way of doing things today has little to do with commitment to a specific religion: those of different faiths, whether Muslim, Hindu, Jewish or whatever, are of course full members of any British society that is worth having and preserving. What is required, however, is commitment to the democratic procedures by which law is made in Britain, and to the laws those procedures produce.

That is not a commitment that excludes much - but it does exclude the idea that all "man-made", as opposed to "God-made", law is illegitimate. So it excludes, for example, the narrow theocratic extremism of the Islamist sects that insist that only laws which derive from the Koran or Islamic tradition should be obeyed or enforced, and that they must be allowed to rule their own communities by Koranic law.

Multiculturalism allowed narrow theocratic extremism of that kind to flourish in Britain. The Government has finally realised that this was a mistake, and has promised new policies based around inculcating "British values". That is a huge improvement on multi-culturalism, which did not even insist that immigrants learn English. But it has yet to dismantle the enormous bureaucracy dedicated to promoting multiculturalism, or the jobs of the thousands of officials that depend on it.

Until it does so, separateness will continue to flourish - as will its potentially calamitous consequences for the integration of immigrants into Britain.


Pupils to get lessons in good manners in one prestigious British school

The article below is from the Daily Telegraph so they retain the old British usage of calling private schools public schools! "Independent" school is the preferred modern British usage but readers of the "Tele" understand

A leading public school has launched a campaign to revive etiquette and manners by training its pupils in the art of polite dining and helping the elderly. Brighton College will educate all its new starters over the year with lessons in a variety of practical skills

As well as learning how to iron a shirt, sew on a button, boil an egg and write formal letters, 140 pupils aged 13 and 14 will be taught how to waltz at weddings, use cutlery and glasses and tie a bow tie. The year-long compulsory course, which consists of one 45-minute class each week, also covers erecting a tent, monitoring heart rates, making a pizza, using a cash machine and taking digital photographs. Pupils will learn to help the elderly and the etiquette of giving up seats on buses and trains. The headmaster, Richard Cairns, said the skills would make them more attractive to potential employers.

Last month, a survey by the Institute of Directors found that a quarter of company directors think graduates display "impoliteness and poor table manners". Mr Cairns said that after seeing the survey, the teachers made a list of 30 useful skills. He said the course was not a crusade to stamp out bad manners among the young. "Young people these days are polite," he said. "What has happened is that some haven't been told about what other people expect of them."


British science chief criticizes Greens

The scientist credited as being the first to convince Tony Blair of the urgency of the climate crisis has accused green activists of being Luddites who risk setting back the fight against global warming. In an interview with the Guardian today Sir David King, who stepped down last month after seven years as the government's chief scientific adviser, says any approach that does not focus on technological solutions to climate change - including nuclear power - is one of "utter hopelessness".

He says: "There is a suspicion, and I have that suspicion myself, that a large number of people who label themselves 'green' are actually keen to take us back to the 18th or even the 17th century." He characterises their argument as "let's get away from all the technological gizmos and developments of the 20th century".

"People say 'well, we'll just use less energy.' Come on," he says. "And then there's the real world, where everyone is aspiring to the sort of standard of living that we have, which is based on a large energy consumption."

King calls global warming the biggest challenge our civilisation has ever faced, and famously, in a 2004 article in the journal Science, berated the US for its inaction, describing climate change as "more serious even than the threat of terrorism". But his vocal support for nuclear power and genetically modified foods has led to tensions with environmental campaigners.

In a new book, The Hot Topic, he invites further hostility, arguing that aviation has been unfairly scapegoated, and that a localist approach to grocery shopping, aimed at reducing food miles, may sometimes result in bigger carbon dioxide emissions than purchasing food transported from overseas.

Making people feel guilty about their energy use, the book argues, "makes them less likely to act, not more". "What I'm looking for are technological solutions to a technologically driven problem, so the last thing we must do is eschew technology as we move forward," says King, 68.

His book prescribes a barrage of technological measures based on nuclear energy, wind power, cutting emissions from cars and buildings, increasing the global area of solar panels by a factor of 700, and capturing and storing emissions from fossil fuel power generation. Only with a nuclear component, he argues, might Britain "just about manage" to reach its commitment to reduce CO2 emissions by 60% on 1990 levels by 2050.

He recalls how he sparked fury at a meeting of Blair's ministers when he refused to agree to stay silent in public about his pro-nuclear views, even though the cabinet had, at the time, opted not to press ahead with plans for new power stations. "Let me say that John Prescott's reaction was almost violent," he says.

John Sauven, executive director of Greenpeace, said it was King, not green activists, who was living in the past. "We need science to get us out of the climate change hole we're in - that's why Greenpeace wants to see research funding piled into the cutting-edge low-carbon technologies that can deliver deep emissions cuts in a very short timeframe," he said."We're talking about technical solutions that can also be safely spread to every country in the world, no matter how unstable. Nuclear power isn't that technology, but Sir David wants to take us back to the 1950s, the last time we were told it would solve all our problems."


1 comment:

Marilyn said...

Keep up the good work. Cheers:-)