The state of NHS dentistry is in the news courtesy of the BBC. Trying to register with an NHS dentist in large swathes of the UK is akin to drawing out your own teeth (an action to which many have resorted).
It is an article of faith here at We Need To Talk About Bevan that healthcare must be free at the point of use. Thanks in part to a certain Mr Hugh Gaitskell in the 1950s the dental aspect of healthcare is not free (though partially subsidised) and as the BBC reporting indicates seemingly impossible for many to access the point of use. We would weep and gnash our teeth in rage but for the worry of what it would do to our bicuspids and in turn our wallet.
However this was not always the case and dental care was as much a part of the NHS as any other at its inception. As Bevan stated in a speech to the House of Commons in 1946
"In addition to these defects, the health of the people of Britain is not properly looked after in one or two other respects. The condition of the teeth of the people of Britain is a national reproach. As a consequence of dental treatment having to be bought, it has not been demanded on a scale to stimulate the creation of sufficient dentists, and in consequence there is a woeful shortage of dentists at the present time."
Recognising a fundamental need in society Bevan sought to alleviate suffering through collective measures. This should form the creed of all those in the labour movement.
"All these disabilities our health system suffers from at the present time, and one of the first merits of this Bill is that it provides a universal health service without any insurance qualifications of any sort. It is available to the whole population, and not only is it available to the whole population freely, but it is intended, through the health service, to generalise the best health advice and treatment. It is intended that there shall be no limitation on the kind of assistance given - the general practitioners’ service, the specialist, the hospitals, eye treatment, spectacles, dental treatment, hearing facilities, all these are to be made available free.
There will be some limitations for a while, because we are short of many things. We have not enough dentists and it will therefore be necessary for us, in the meantime, to give priority treatment to certain classes expectant mothers, children, school children in particular and later on we hope adolescents. Finally we trust that we shall be able to build up a dental service for the whole population. We [...] will be some time before the Bill can fructify fully in effective universal service. Nevertheless, it is the object of this Bill, and of the scheme, to provide this as soon as possible, and to provide it universally. Specialists will be available not only"
When Hugh Gaitskell brought in charges for spectacles and dentures Bevan resigned on a point of principle (with many pointing there may have been a degree of political expediency as well) alongside a young Harold Wilson (the latter of which sporting a decidedly chappish moustache). Bevan's resignation speech warrants further scrutiny.
"I now come to the National Health Service side of the matter. Let me say to my hon. Friends on these benches: you have been saying in the last fortnight or three weeks that I have been quarrelling about a triviality—spectacles and dentures. You may call it a triviality. I remember the triviality that started an avalanche in 1931. [...]
The Chancellor of the Exchequer in this year’s Budget proposes to reduce the Health expenditure by £13 million—only £13 million out of £4,000 million.[HON. MEMBERS: “£400 million.”] No, £4,000 million. He has taken £13 million out of the Budget total of £4,000 million. If he finds it necessary to mutilate, or begin to mutilate, the Health Services for £13 million out of £4,000 million, what will he do next year? Or are you next year going to take your stand on the upper denture? The lower half apparently does not matter, but the top half is sacrosanct. Is that right? If my hon. Friends are asked questions at meetings about what they will do next year, what will they say?"
Those of a Bevanite disposition are perfectly willing to negotiate in good faith and compromise where needed but not when being asked to accept the thin end of the drill which will bore inexorably into the very purpose of our politics. "If my hon. Friends are asked questions at meetings about what they will do next year, what will they say?" a maxim which should be clasped close to the hearts of all those in the political sphere. The expectation that they are held to account and that such queries warrant a substantive principled response.
The cost of dental care (and its optical equivalent for that matter) should be dubbed the Gaitskell Charge (e.g. "Nice glasses - what was the Gaitskell Charge on those?" or "I've had to have another filling - don't know what hurt more the injection or the Gaitskell Charge."). As a point of clarity I bear no ill will to individual dentists (despite what my garbled cries may indicate when I'm under the drill) I save that for my mate who sent me Steve Martin's rendition of Dentist! while I was in the waiting room...
The painful extraction of dental services from the NHS proper throws up those curious edge case scenarios which could be bypassed by maintaining a proper functioning health service. The liminal space betwixt tooth & jaw serves as a sort of no man's land between fiscal charges & the principle of free at the point of use healthcare. It is perhaps surprising that Tony Blair et al failed to bring in a PFI deal for all UK citizens' gums.
If we are truly to be the heirs of Bevan then calls for dentistry to be incorporated fully into the NHS (& be free at the point of use) must form part of our policy platform. I do not regard the 1945 Labour Government as the apex of political thought but rather as a foundation - on the matter of dental care we have sunk to depths below that. Now is the moment for the Labour Party to be bold and announce an NHS Dental Service in line with that advocated by Bevan. We seek inspiration from those who have gone before in order to inform our present and fashion a better future.
The RMT General Secretary Mick Lynch has cited James Connolly as a personal hero succinctly summarising Connolly's life as "Irish socialist republican and he educated himself and started non-sectarian trade unionism in Ireland. And he was a hero of the Irish revolution." Mick Lynch puts those principles into practice by facilitating industrial action, challenging reactionary narratives, and by advocating for a better society.
In contrast there are some in the Labour Party today who know that the right kind of leader for the Labour Party is a desiccated calculating machine that has been subsequently rehydrated by the sweat of Labour activists. One is left with the profound impression that if a leading Labour Party figure was to quote James Connolly they'd get as far as "Our demands most moderate are" and leave it at that...
