Even in a world of text messages and emails, the spoken word is an essential ingredient in communication and here, Stephen Hancocks explores the importance of having a ‘voice’ individually and just as importantly, as a group

It often happens that in attempting to explain or describe something to someone, you accidentally hit on a meaning that had hitherto been hidden to you, or that you had never thought of. A few years ago, I was trying to answer a Finnish colleague's bewilderments about Prime Minister's Questions. She was describing her amazement that the ‘mother of parliaments’ was such an unruly, apparently rude and seemingly chaotic affair, which hardly seemed to do justice to the otherwise good name of democratic debate. These sentiments are also expressed by UK citizens, but coming from the external eye of an overseas observer, it seemed to need a greater explanation than ‘Oh, that's politicians for you’.

In the process of attempting to explain the history and background to Prime Minister's Questions, I found myself researching the word parliament, which has been derived through Middle English from the French ‘parlement’ or speaking, from the verb parler; to parley, or speak. A talking shop is what parliament is often dubbed and this makes perfect sense. In a debating chamber, what do you do? You talk—that is the raw material which you use for your work.

Talking you down

In the party political system, the side with the majority has the greatest number of people in the chamber and, therefore, the greater number of voices; in theory at least, it has the strength to literally talk down, shout down or drown out their opposition. The temptation is to say that this really is not fair; yet in order to have achieved the majority, a party has had to attract more people to its policies or philosophy than anyone else. It is also commonplace to protest that it is not the best way of running a country, and were it not for the other pieces of the parliamentary jigsaw, such as the Committees and the House of Lords, one might be inclined to agree.

We also often speak of the need for various people, causes and organisations to have a voice; to be heard, to be taken seriously. Dentistry is no different. We too recognise from time to time that someone needs to hear what we have to say. Indeed, in recent years, the British Dental Association (BDA) has made great strides in creating connections within Westminster and establishing a presence in parliamentary and political circles. This proved to be very advantageous in the debacle of the General Dental Council's (GDC) unlawful actions and the consequent Select Committee hearing in 2014. The BDA's voice was used to great effect during the annual retention fee (ARF) outrage, and it was only because of the BDA's collective strength and its ability to speak up about how unfair this was, that the GDC—the profession's regulator—ended up being answerable in the High Court, and losing (BDA, 2015).

Who speaks for us?

However, as a group of dental professionals, who does speak for us? Perhaps the clue to the answer is in the description of us as a group. Rather than being unified by the interests of our profession, we are separated by our professional interests. Given that the BDA mounted the ARF campaign with a membership in the region of 20 000 dentists, when one considers that the total number of registered dental professionals is nearer to 100 000, it helps to put this into perspective. The wiliness of the GDC in exploiting and exacerbating that divide by lowering the ARF for dental care professionals (DCPs) while increasing it for dentists serves only to highlight the fissures that run through the professional world of dentistry. Consequently, there is an ease with which even the body charged with regulating ‘us’ to protect the public can drive chasms between the different professionals within the ‘us’.

DCPs similarly have their own associations, some of which are very successful and supportive of their members. But there is no sense of a cohesive whole, each enclave wishing to maintain its own identity but also its own separateness from the other categories of colleagues. What might the answer be? Some have called for a College of Dentistry, indeed with the ultimate dream of a Royal College of Dentistry, as in nursing and other fields of medicine. While a very laudable vision, it is hard to comprehend how our profession as it currently sees itself could even begin to agree on a representative structure to form the foundations of such an organisation, let alone raise the necessary funding and infrastructure. ‘Why would we want yet another organisation within dentistry?’ the cry would go up, which at one and the same time identifies the problem and highlights the need.

A common enemy

Another clue may be one the emerged with the ARF campaign: the fact that for once we had a common purpose. Unfortunately in this instance, it was a common enemy that helped to galvanise us into a cause; adversity breeding unity. Perhaps in dentistry we do not have a sufficiently strong adversary against which we feel the need to unite, or perhaps we feel that such a construct would, at best, not be worth the trouble, or at worst, be awkwardly ineffective.

What unites dental nurses? Is it to do with wages? Is it to do with conditions? Is it a hatred of having to be registered? What is it for dental hygienists and dental therapists—direct access? What is it for dental technicians? The list goes on.

Would we be able to go further, reach higher and be heard more often and more distinctly with one voice? If so, where do we begin? Does it start with a whisper or does it die with a cynical aside? Why not have your say? Parley.

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