Step forward …… Bevan!  His National Health System was instituted in 1947 and the major part of this system was a free Dental service that would sweep  Dental Health at one step for all the poor people who for one reason or another could not afford to pay for Dental services.

 This created a large boom in Dentistry and soon the number of Dentists increased dramatically to fill the huge demand for the new services; new careers in Dentistry followed, such as Dental Mechanics, Dental nurses etc.

 Now is must be understood that the vast majority of work done at that time on the NHS would have been extractions, fillings and denture making and fitting as this would have been the greatest need.  A School service was also set up for children and the remnants of that service still exists as an emergency Dental service at most major Hospitals today – more on that later.

 The standard of work on the NHS at this time (1947 to about 1965) was mostly acceptable – dentures were still being made on the premises usually by a Dental mechanic who would work closely with the Dentist and ensure that a good quality product was provided.   Denture work was a major part of the NHS dental provision and the murky dental laws ensured that no enterprising Dental mechanic could set up an alternative (cheap) denture making facility “off site”

 A small revolt by certain Dental mechanics in the 1960s did result in a more production orientated system by groups of mechanics setting up their own companies and running larger commercial Dental laboratories, and the system we have today was born.

 Now it is a rare occurrence for a Dental technician, as they are now called, to be working in close proximity with a Dentist.  These commercial laboratories were illegal.  The Dental law stated that only Dentists could conduct the business of Dentistry and here was a group of people not dentists, conducting the business of Dentistry.

 How come they weren’t all prosecuted? Lets see.  Having a few commercial laboratories did something for the Dentists, something that they liked, something that they soon discovered had a positive effect on their bottom line.

 They had a choice where they sent their work, they could also choose how much they paid for work because the new system introduced competitiveness in the labs.

 Lab prices suffered as Dentists squeezed for lower prices on the NHS and as their fees from the Government were fixed, any money saved on lab fees went straight to their back pocket.

This was the start of the race to the bottom of the NHS quality bucket.

Louis Fairman, October 2013

Photo by Renaud Camus (Painting  Edouard Vuillard)