Introduction: Seeing Dental and General Health Provision Afresh From a Distance

Hello, and welcome to the blog!

This was sparked off by a number of things:

The recent near-crisis in NHS England, caused by a wicked Tory plot to underfund the NHS according to pressure groups and left-leaning English press; the concurrent crisis in NHS Scotland, not the fault of the Scottish National Party according to the loyal Scottish press and Scottish government, but all due to Scottish NHS workers not taking up the offer of flu' vaccines; the equivalent but longer-standing crisis in the private-insurance-funded health care system on Jersey; the fury of some dentists known to the blog author at policies which put colleagues in the invidious position of being "supervisors of neglect" where children's baby-teeth are literally left to rot until an emergency extraction is required, which needs a hospital bed, operating theatre and a (always risky) general anesthetic, when all that would have been needed at a much earlier stage was a lesson in how to use a toothbrush, or at a slightly later stage: a quick buzz with a drill. That's before we even consider whether tolerating dental infections in children may be shortening their lives by making them more vulnerable to things like Heart Disease and Diabetes in adult life!

We're having massive witch-hunts about sugar and obesity, when very many children and a depressing number of adults do not know how to clean their teeth, and cannot therefore pass this necessary life-skill onto their own children. 

Health policy-makers in England, Scotland, Wales, Northern Ireland and the various Crown Dependencies are ALL ignoring numerous and diverse studies showing that the incidence of a number of common serious (ostensibly non-dental) illnesses are affected by the patient's dental health, and that better dental health therefore is a cheap and straightforward path to significantly fewer people falling seriously ill between early adulthood and late middle-age, when they could be reasonably healthy. Not only does this cost the various public and private health services (not to mention local authority social care services) huge amounts of money which could be much better used: it inflicts totally avoidable misery and early death upon countless patients.

Some things are already clear:

The ideological argument between hard-right wingers who think that a totally private health care system is needed to sort things out, and hard-left wingers who think that only massive increases in spending on public health services will save the day, is completely moot:

Jersey and NHS England between them have shown that both private insurance schemes and state-funded public health schemes have exactly the same failure mode: unless a sufficient share of the available resources are spent on preventative health measures, demand for health care will always annihilate the alloted funds, regardless of whether the governing ideology is left or right, or whether health services are funded by insurance or taxation. (We'll leave aside the Liberal Democrat view: that health services should be funded by a special tax on pensioners, presumably to punish them for voting for Brexit. Unsubtle incitement to intergenerational hatred: the "Logan's Run option" is quite as bad as incitement to racial hatred and it is henceforth banned from this blog.)

Historically, the UK mainland has always had mixed health care provision: prior to the NHS being formed, there were municipal and (often ancient) charitable hospitals, and some of the latter still exist as flagship NHS hospitals. Since the NHS was formed, it has always had an essentially symbiotic relationship with private care, in that private care generates income for the NHS and, because private health care on the UK  mainland mostly focuses on performing elective surgery, spares the NHS from an elective surgery workload that would almost certainly break the service if private health care actually ceased, as some wish it to do. This blog is not solely about the NHS, and it's certainly not a polemic in favour of private health insurance. Because both public and private care share a common failure mode, the course of action this blog is intended to explore and promote has the potential to make both public and private health care systems less vulnerable to crises. So this blog is relevant to places, such as Jersey or Guernsey, which are trying (with differing degrees of success) to make a private insurance-based system work, as well as England or Scotland, where a publicly-funded NHS is dominant, but by no means an exclusive provider.

There are three strands to this blog: 

Firstly, to assemble and present the evidence that good dental health (and especially freedom from dental and gum infections) reduces patients' susceptibility to common serious diseases: most notably Heart Disease, Strokes, Dementia and Diabetes, but possibly including other diseases too: the blog author understands that dental health may affect kidney disease as well. It would also be interesting to know whether chronic dental infections can trigger auto-immune diseases, but that's likely to be a much more complicated subject where the answers won't be clear for a very long time yet. 

Secondly, to assemble evidence from practitioners and specialists as to how and why dental health is in any way deficient in Britain as a whole, whether this is materially different in the devolved parts of the union, how much this is due to policy and how much due to the habits of patients, and what needs to be done in order to effect improvements: both to make the kingdom's dental health better or at least acceptable in its own terms and to realize the opportunities inherent in the first strand.

Thirdly, based on the content that emerges from the first and second strands, to frame and word (and then promote) a Parliamentary Petition that will call for a re-alignment of national priorities regarding dental health, in all parts of the kingdom and in both public and private health sectors.

How this will be accomplished:

Not by the blog author and creator reading all the scientific literature on the subject, condensing it into a form that lay-persons can understand and copyright lawyers pass, and putting it all here in his own words, with perhaps inevitable biases and misunderstandings. 

But by the blog author soliciting articles from those in the dental and medical professions who have already read the formally-published literature (or at least some relevant select part of it) and understand it. By also soliciting articles from those who know what's going wrong in health care (not the party-political versions, please!) -and what could be made to go so much more right- and who lack a platform to express what they know in a way that will result in positive change.

Readers who feel themselves qualified -and the blog author is going to be flexible about this, providing that they say at some point what their qualifications are- can contribute in one of two ways:

If they have a googlemail.com account, preferably with a blogger profile that states their qualifications without identifying them in a way that would break professional codes or any corporate survival instinct, then they can send an introductory email via the link in the blog author's profile (Matthew Spencer) which can be found near the top left of this page. If you are using Thunderbird or another email client, just left click on the "email" link in the profile. If you use a web-based email, and most people with a googlemail.com account will, then right click on the link and select "copy email address" from the menu. Then paste it into the recipient box in googlemail.com or whatever. At his discretion, the blog author will then make you a contributor to the blog, and you will be able to write and publish articles freely, subject to oversight from the blog author, who may suggest improvements, but will usually only remove articles if there seems to be some form of funny business; breach of copyright (other than "fair use") or some form of hate-mongering. If your blogger profile does not contain information about your qualifications, put these at the beginning of your first article, but not in any way that compromises your professional standards or your employment position.

Alternatively, if you do not have and do not wish to open a googlemail.com account to publish articles through the blog directly, you may simply send any proposed article to the blog author using the "email" link in his profile, as described in the preceding paragraph for googlemail.com users. This should be an attachment in .pdf format, or a MS Word or Open Office text document format that the blog author can turn into a non-alterable .pdf file for you. It should contain an opening paragraph describing the author and her/his qualifications, subject to professional standards etc.

The .pdf articles will then be stored on a google drive and the blog author will create short posts with a brief synopsis and author description, and a sharing link to the relevant .pdf, which blog readers will be able to read online or even download and print out, if they wish. (Please make any .pdf files proof against unauthorized alteration if you can: this is the point of .pdf files!) Google encrypts such sharing links, so they cannot be used to gain access to the drive itself, and they can only access the document in the link in the manner specified, which will invariably be "read only".

Once this blog is loaded up with evidence and perhaps debate, then the blog author will compose a petition. This requires more of a legal than a medical mind, as well as a bit of engineering to make the wording "work." This can safely be left to the blog author. In all other respects, this blog will be what the learned readers make of it.