In the continuation of the new theme and approach for The Campbell Clinic patient newsletters, I would like to use this month's newsletter as a story of what we see, as a group of people in our organisation, as the direction of travel and the future for healthcare in the NHS. 

This would be our view of where we think things are going based on our connections and our integration into the overall health system in the United Kingdom. You may agree or disagree on these. Still, we have an interesting perspective on this, which we would like to share with patients, which informs the direction of travel for The Campbell Clinic and The Campbell Academy and its future aspirations.

I want to start this little tale with my own career. I qualified in Glasgow in 1994 as a dentist and decided that I wanted to 'save the NHS single-handedly'. 

I felt very proud to have qualified as a dentist, being the first person in my family to successfully navigate university. I then started working in the hospital services (not general practice) to gain further qualifications and experience. 

This road took me through Glasgow Dental Hospital and School for the first year of work. Then I moved to Nottingham to work in head and neck surgery at Queen's Medical Centre (I met a wonderful young student nurse while working in Nottingham, who is Alison, my wife of more than 25 years). 

I also worked in head and neck surgery in Derby Royal Infirmary before entering into practice in a full NHS practice in Ilkeston in Derbyshire in 1997.

It was well working in this practice (for nearly 11 years) that I was awarded the first NHS contract for oral surgery in a practice in the United Kingdom, but I also integrated private dental implants into that practice, which was a service not available to any of our patients as it was not funded by the NHS. This is where the confusion and the complexity begins.

The NHS does not provide some aspects of care and certainly does not allow care to be provided to certain levels of quality due to the funding system in place, particularly in dentistry.

This is a considerable reason why dentists step out of the NHS or step out in part in their practises out of the NHS in order to be able to provide services to the level to which they are trained and to the standard that they feel is most appropriate.

For 11 years, I provided dental implants in Ilkeston (and Bilborough and Wollaton) for the same partnership under private arrangements. I continued to provide all my general dentistry and oral surgery procedures under NHS arrangements.

In 2008, the husband and wife partnership, which owned the business I had been working in for another 11 years, sold the practices to a large corporate dental organisation. I left at very short notice, as I did not want to work for what became an American investment fund. 

It was at that point that I had difficult choices to make around my future career prospects, and I, therefore, decided to take my implant service or, as much as I could, work in a wholly private practice in West Bridgeford in Nottingham, which was owned by a gum disease specialist.

At that stage, though, the NHS commissioners returned to me and asked me if I would continue to provide NHS oral surgery in North Derbyshire instead of South Derbyshire (My boss had sold my oral surgery contract to the American Investment Fund). 

It was at that stage that I opened an NHS specialist practice in Alfreton in Derbyshire with my former practice manager as a 50% partner, and I provided private arrangement Dentistry in Nottingham and NHS Private Dentistry in Alfreton.

This is where the story takes a twist and a turn for people to understand how complex and difficult it can be working in NHS environments.

We had a very high-quality oral surgery contract running in North Derbyshire, which was provided at a 70% reduction in the cost of the service as it had been provided within the hospital.

Our job had been to take oral surgery out of the local hospital and provide it for much less cost in practice while maintaining high standards.

We were able to do this at a huge saving to the NHS, and I believe a huge increase in quality and this service ran for a significant period of time.

Due to contract arrangements, we were limited in the number of people we were allowed to see in that service, so waiting lists started to build.

There was no funding to reduce the waiting lists.

My business partner at the time was undertaking an MBA at the University of Nottingham, and we set up a project where we provided independent oral surgery for people who wanted to pay for it to allow them to come off the waiting list, be treated quicker and with more convenience while opening up spaces on the waiting list for other people to enter.

This is one of the aspects of the provision of private dentistry that the public does not always understand. If people decide to access care privately, it leaves more space in the NHS for other people to be seen.

This was done as a project on the MBA for my partner, and the satisfaction across the board for patients, both NHS and private, was enormous. It was a huge success, and we were delighted with the way the practice was running.

Then, out of the blue, in 2012, NHS commissioners returned and told us that our contract would be cut in half.

This is one of the aspects of the provision of NHS dentistry, which the public perhaps has little understanding of and is almost impossible to navigate.

The commissioners wanted us to treat the same number of patients under the same arrangements and at the same timescales for half the cost they were currently providing.

This would have necessitated us completely changing our staff, reducing the skill of our workforce, and providing lower quality services under enormous pressure for much, much less return (perhaps even a loss). 

This was not something I could countenance as a practitioner, and it was at that stage, I left the NHS entirely and concentrated my efforts in the Nottingham practice.

The reason for this long and rambling story (and I hope you've been able to keep up and read it) is that in 1999, Tony Blair, our then then-prime minister and leader of the Labour government, promised at the Labour Party Conference 100% access to NHS dentistry for patients within two years. By 2008, Tony Blair was admitting that that had not been achieved, and, in fact, less than 50% of patients in the United Kingdom were gaining access to NHS dentistry and registration.

Fast forward to 2024, some 16 years later, and a recent report by the British Dental Association showed that up to 96% of practices in the United Kingdom are unable to take on new NHS patients.

NHS dentistry in the United Kingdom is worse than it has ever been in terms of access and quality of provision, but it's not just NHS dentistry. 

My wife, Alison, continues to work at Queen's Medical Center in Nottingham, and the conditions are extremely challenging and worsening, it seems, on a month-by-month basis.

And so, what is the solution in the United Kingdom to these problems?

It will be difficult in the current economic situation to expect people to pay more taxes and invest further in the NHS, which seems to be an impossible problem for any government to fix.

What has happened, though, is that there has been a move for patients to access their care outside of the NHS, like some of the patients started to do in Afton to remove themselves from the NHS waiting list and have treatment carried out more quickly and more conveniently but also leaving space for others.

If we at The Campbell Clinic are able to provide extraordinary private healthcare in terms of general dentistry and orthodontic treatment for Children (both things which were historically always provided in the National Health Service), not only will we allow, will we be able to help people who are trying to access care but we will also create space within the NHS service where those people were previously treated.

There is a catch to this, though, for the practices seeking to provide private healthcare where they were previously providing NHS healthcare, or for any of us trying to attract patients to then pay for their dental treatment, where before their dental treatment was provided free under NHS arrangements.

I recently travelled to Oman in the Middle East to educate an extraordinary group of volunteer practitioners as part of my International Team for Implantology work, the not-for-profit foundation I work with worldwide.

It was an extraordinary trip to Oman, and I was given the privilege of flying business class with Emirates as that was the ticket purchased for me. 

The experience of flying business class with Emirates and travelling through the airport in Muscat and Oman is extraordinary.

Muscat has a set of check-in desks for business class passengers, which allows them to check in away from the main hubbub of the airport and go through their own security section into a lounge. You then board the plane through a specific jetway into your business class seat (First-class passengers have an even higher level of service). 

If people are deciding to pay for business class or first class, Emirates and the airports in Oman feel that the experience should be much, much better, and they do live that value.

If healthcare practitioners in the United Kingdom, both hospital services and dental services and GP services, hope to provide treatment privately for patients, therefore opening up space under National Health Service arrangements, then they must be prepared to offer a level of service and experience that is worth the money that people pay or greater.

This is one thing that healthcare in the United Kingdom has never done well; they have never, ever invested in the outside of the healthcare area experience for patients, how they get to the hospital or dental practice, what it's like when they get there, how well they're looked after and valued.

If we move to a situation where, in private healthcare, patients are treated in a much greater way with a much greater level of service, then they would be more likely to invest in this, more likely to move out of the NHS service for certain aspects of their care and more likely to leave space behind and greater funding for people that need the NHS the most.

This, of course, is just a point of view; I still have many close contacts and interactions, both with NHS hospitals and NHS dental practises, but I firmly believe (and may have staked my business future on it) that people will continue to access alternative provisions for healthcare in the United Kingdom more and more as the challenges and difficulties in the NHS grow greater and greater.

It's for this reason that this year, we launched our general dental service, the Total Care Club. 

This provides patients with an extraordinary level of service and an extraordinary experience in preventative dental management, but with many other benefits associated with it, not least the patient information evenings at the Clinic, which we were beginning to roll out in 2025 to be able to give people better control and agency in their own healthcare.

Our orthodontic service for children provides access to orthodontics and teeth straightening, which has been reduced dramatically in NHS services. It's less and less likely that any children who are not in the most severely affected groups will be provided orthodontics. Therefore, people will now be forced into a situation where they have to access care outside of the NHS if they wish this treatment for their Children.

If this is the case, the experience of having that treatment should be as good as it possibly can be.

I realised in 2012, when the commissioners changed the contract at the Alfreton Practice, that my time, my quest, and my dream of saving the NHS was gone; I would not be able to do that, certainly not in any way by the means that I had set out to do.

By having an excellent private healthcare practice, though, and allowing patients to access care out of the NHS, we can independently positively affect the NHS (I've seen this through general healthcare in many guises). 

Having a successful private business, which donates 1% of its turnover to social legacy projects to fund the charity ball that we had a few weeks ago and to raise over £450,000 for social legacy projects over the past 10 years is also an indirect way of utilising our business to make the wider world a better place.

The future of healthcare in the United Kingdom is uncertain, but as Einstein said, "Insanity is doing the same things over and over again and expecting different results". 

We are currently collecting donations for the local food banks this Christmas, so if you would like to contribute to this, you can either donate via the link here for us to purchase items they need or bring in any non-perishable items to the Clinic!