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I promise you total commitment, and endeavour to project the British Dental Association into the next century, whilst wearing this jewel with pride

Above: Stuart Robson.

I thank you for the honour and privilege you bestow on me as your President for 1999-2000. These personal sentiments are tinged with some trepidation when reviewing the previous luminaries who have held this prestigious position. However, I promise you total commitment, and endeavour to project the British Dental Association into the next century, whilst wearing this jewel with pride.

It would be remiss of me in thanking the Association, not to express my appreciation of the Yorkshire Branch. Without their encouragement, participation at a national level would have been very difficult. That same help and encouragement also applies to my practice colleagues and my family. The Yorkshire Branch nominated its first President in 1899 — one by the name of Dr George Brunton. By a happy coincidence the Branch started and finished this century with a National President.

The tradition of excellence of service to the profession by my predecessors, has been exemplified by our retiring President, Dr Geoffrey Garnett. Colleagues from the length and breadth of the United Kingdom remind me of his profound knowledge of dentistry and this Association. If I may quote from a now famous diary — not that of Samuel Pepys (although he did have some pithy comments about painful extractions by an eminent tooth-drawer in Wimpole Street) — but from Geoffrey Garnett's published diary.

'The great pleasure of attending branch meetings in the country, is that Pat and I [his wife] feel at home amongst our own kind — that is supporters of the dental profession and of the BDA in particular'.

This tells us volumes — a man not only vocationally devoted, but also one to whom his profession is a way of life and who has a genuine concern for people.

It gives me enormous personal pleasure to thank you, Geoffrey, and your wife Pat, for the distinguished way in which you have conducted your Presidency. We wish you both well, and you can relax, fulfilled in the knowledge of a year completed with your customary aplomb, enthusiasm and good humour.

Approaching the end of a millennium, it is tempting to do some historical retrospection. However, little is chronicled about dentistry in 1000 AD. Some references do exist from two millennia ago, during the Roman Empire. Archaeologists have discovered that the rich and fashionable members of society had appreciably poorer dentition than the slaves and workers. Maybe an early comment on affluent rich diets? Celsus at that time wrote a treaty on how to extract teeth, with advice on forcep design. He also commented that artificial teeth were frequently worn by the 'seniors'. These prostheses were usually gold, but during a period of high monetary inflation, when cheaper alternatives were sought, their popularity declined as the alternatives were not so satisfactory — a philosophy I have encountered more recently!

Taking a leap through history, it is fascinating to observe how the Association has evolved. Following the Dentists' Bill receiving Royal Assent in 1878, one of the consequences was that dentists would be registered with the General Council of Medical Education and Registration of the UK, for the princely sum of five pounds. As part of that registration, the question arose 'as to the conduct of dentists on the Register, and the occasional need for an individual to come off the Register, which would probably involve a complicated and disagreeable process'.

A result of this legislation was that in 1879, the Representative Board was formed under the title of the British Dental Association, 'the object of which was to watch over the general interest of the profession, especially with reference to carrying out the provisions and spirit of the Dentists Act'.

It is interesting that the profession coalesced into a professional body as a result of changing circumstances.

A further major initiative was in 1948 when the National Health Service was launched, causing radical changes in the delivery and funding of dental care. At that time there were also two other organisations representing dentists — the Incorporated Dental Society and the Central Committee of the Public Dental Service Association. With careful nego- tiations defusing vested interests, the three bodies amalgamated into the BDA as we now know it. The meeting that approved the amalgamation was held on April 29 1949 — exactly 50 years ago on this very day!

Again it is fascinating to see how the profession adapted as a result of changing circumstances.

During the last two years, changes have been coming at an ever-increasing rate, more rapid responses are required to legislative changes, and the development of information technology and increasing membership. In order to address these and many other difficult issues, to which I shall refer later, the Association has been reviewing its modus operandi. From January 2000, the Representative Board will become the policy-making body, meeting twice yearly, whilst Council will be replaced by a smaller executive body to undertake, in co-operation with our excellent staff, a more streamlined executive role.

Once more it is interesting how the Association, representing our profession, is adapting to cope with changing circumstances.

These changes, which I believe are wise, and are essential for a forward-looking professional society, have been approved by the Representative Board. What is illuminating is that other professional bodies have been taking an active interest, maybe to help them facilitate changes. I believe the Association is becoming more pro-active and as a further example, would draw your attention to substantial investment in information technology. Tomorrow at the trade show on the BDA/BDJ stand, I urge you to visit the launch of the new interactive website.

Turning to international affairs, the Association is increasingly influential in Europe, the FDI and the Commonwealth Dental Association, as testified by visitors from all around the world requesting help and information at Wimpole Street. Within Europe, whether we as individuals agree or disagree on certain aspects of the Community, the fact is, despite recent problems, the EU is a political reality within which we live and work. This does create opportunities and problems. The creation of the public health component in the Maastricht Treaty could signify an opportunity for equalisation. Currently, training is perhaps the most significant problem; associated with the mutual recognition of qualifications, with equivalence of standards and with specialist registration. This leads to the issue of manpower, and I do welcome the initiative of the Chief Dental Officer in instigating the Manpower Review Group for this country. Having been involved in the previous manpower group eight years ago, I know this work will be difficult, and I wish them every success.

One of the most perplexing issues that dentists raise with me, is that of European graduates being able to enter the UK and work within the NHS, where 70% of dentistry is undertaken, without having to obtain a vocational training qualification, or having to demonstrate a capability in the English language. This is not to criticise the VT scheme. On the contrary, I applaud it and only wish that the whole of Europe had similar schemes. Standards of education vary enormously throughout Europe, and I believe it is essential that all dentists practising in this country should have a common grounding in the delivery of care, ethical considerations, the understanding of UK law, and of course the language.

A President can have themes, and the two I want to develop are interrelated — unity within the profession and membership of the Association

Presidents do not have policies — the Association has policies which the President advances. However, a President can have themes, and the two I want to develop are interrelated — unity within the profession and membership of the Association.

These themes are particularly appropriate during the next year because many changes are imminent, all of which will affect and influence the profession and patients. Some examples would include:

  • Primary care groups with parallel organisations to undertake dental advisory functions. These new bodies will be very influential in the organisation and delivery of care in both the community Dental Service, and in the Hospital Services. But who knows where this may eventually lead? PCGs have as part of their agenda Clinical Governance, National Institute for Clinical Excellence and Health Improvement Programmes. These Government initiatives will affect the dental profession, which must be fully conversant with the implications. An even closer working relationship will have to be fostered with our medical colleagues who form the membership of primary care groups.

Within general practice the development of corporate bodies continues to give food for thought, whilst the movement between the NHS and private sectors can, and does, create tensions locally. It is most encouraging to see the closer working relationship between the GDSC and the BDA's Private Practice Committee.

  • The auxiliary staff, be they technicians, hygienists, therapists or dental surgery assistants, are also facing tensions concerning education, qualification, and possibly registration issues.

  • Devolution will have its effects on all four United Kingdom countries - particularly in education, funding and legislation. I was extremely pleased to hear that at a conference of Scottish LDCs a resolution wholeheartedly supporting the British Dental Association was passed unanimously.

These topics illustrate the escalating options, opportunities and problems this profession has to consider urgently, be it within the community, hospital, university, armed services or general practice disciplines. The close working relationships that have continued to develop between the BDA, the GDC and bodies representing auxiliary staff have been demonstrated in the dialogues formulating the amendments to the Government Health Bill, currently going through the Parliamentary process. This Bill has to be carefully monitored, as the concept of Order making powers means that changes can occur without primary legislation.

Negotiations, discussions and debates will continue to be vigorous. Solutions will frequently necessitate compromises, which will inevitably create tensions. The opportunities for division and fragmentation within dentistry are even more acute. We are not a large profession, and our strength lies in unity. The Association membership is at a record high level of over 19,000 — so we can manage these changes from a position of strength. The retention and increase in membership is vital to maintain this Association as the credible, authoritative voice of dentistry. I am mindful of the Latin phrase carpe diem (seize the day).

During the next 12 months, in order to pursue my theme of unity, I intend to visit all parts of the UK to listen very carefully, and whenever, wherever, diffuse tensions in order to maintain a united collective purpose within our profession.

It was Francis Bacon who wrote 'Every man is a debtor to his profession'. I believe this is as apposite now as it was when he wrote it in 1596.