Letter: Cash squeeze on the NHS

Sir: It has been clear for a long time that a great deal of the dentistry which is possible today is way beyond the means of a state service. ("Ministers study cut in free dentistry on the NHS", 15 August; Letters, 20 August). It is also true that dental undergraduate education is expensive. I am delighted to learn therefore that a new look is at last being taken at the funding of dentistry. It is to be hoped that the review will be comprehensive.

With a limited budget it is vital that the money which is made available for dentistry is spent as effectively as possible. The calculations must start with what the state can afford in the provision of dental care and the cost of undergraduate dental education. It should finish with what patients and undergraduates must be prepared to pay. Proper provision must also be made for the dental needs of those truly unable to afford basic dental care.

In recent times there have been two Nuffield inquiries into dentistry, one into dental education and the other into the use of auxiliaries in dentistry. Although each body had lay representatives, the committees were dominated by members of the dental profession, academics and practitioners. The reports were good but not surprisingly were dentist- rather than patient- orientated.

Perhaps now is the time to commission a third Nuffield-type inquiry. This should look into what the general public wants from the profession. rather than what dentists think they want or what they think is good for them.

The proposed committee should take as broad a view of dentistry as possible. It should undoubtedly have a predominance of lay members and a minority of dentists.

RICHARD JOHNS

Winchester

The writer is Emeritus Professor of Restorative Dentistry, University of Sheffield