Abstract

This paper has been developed from a version originally submitted as an assignment for the Faculty of General Dental Practice (UK) Certificate in Health Services Leadership and Management Course. It has been revised in the light of the independent review led by Professor Jimmy Steele into National Health Service dental services in England (generally referred to as the Steele Report), which has commented on many of the points dealt with here. The paper addresses issues arising from a moral tension often experienced by dentists between the professional desire to serve patients well and the necessity, as practice owners running a business, to survive financially. The need for honest and open recognition of what is truly achievable from the public purse is stressed. Rights and responsibilities are discussed in relation to professional practitioners, their patients, and society in general, in seeking the moral high ground under different funding arrangements. The paper concludes by stressing the need to offer improved health rather than palliation of disease.

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