Speeches by Beales.

“That is not really my question. That is the previous point you made. Perhaps you can write to the Committee with what the options might be. My question was about a new contract. I appreciate that you are tinkering with the contract and doing other things.”

“They are, because they realise that their local system is not sustainable, so they are using their money to try and sustain it.”

“We are dancing about the issue; you bring it back to the attractiveness of private work, but is it not the unattractiveness of NHS work that is the fundamental issue? Cross-subsidy in primary care is not a new thing. Pharmacy and optometry colleagues would say the same—that, relatively, the value of their NHS work has …”

“I would just put it to you that perhaps it suggests something else to reflect on, if a parliamentary Committee and the BDA—the industry representative group—raises concerns about modelling, and yet quality assurance does not happen until an NAO Report a year later re-highlights the issue. That might be a learning point…”

“From the evidence we have heard, the Health Committee and the BDA did spot it, but were not listened to.”

“How long do you envisage that taking for a significantly new contract?”

“Will you be engaging the BDA and industry players in that modelling?”

“Are you committed—because, as you highlighted, you have not done that previously—to actually modelling what the costs of dentistry are in 2025 and going forward, looking at the actual costs of dentistry and not just incentives that might lead to more activity?”

“It is obviously important to get the modelling right, based on previous modelling failures.”

“That is not modelling related to the costs; that is modelling relating to what might drive more activity.”

“Time is tight, so my question is: what modelling informs the £28 rate, and what modelling are you doing to understand the actual costs of the dentistry? For both complex and general patients, what modelling have you done and will you do to inform what rates people actually need to earn to sustain NHS care?”

“I do not know whether anyone else wants to comment on the framework specifically. If not, I will move on. While we do not have clear evaluation, we have certainly heard about the sense that there is a lot of variation. As we heard from the witnesses earlier, there is clearly massive variation in services. Building on D…”

“That is great. Thank you. That is the end of my questions.”

“The sense you have is that the framework is still the right model. It is still what should be pursued with those barriers.”

“Is that one of the reasons that adoption has been slow? Is it that busy commissioners commissioning a range of services do not know where to look for what good looks like? As we have heard before, there is such variation in what is provided. In some places—you have pointed to Somerset—there are services that are workin…”

“That is helpful, thank you. Knowledge exchanges, evaluation and the evidence that we have seen all suggest that there is little robust evidence and no clear blueprint for commissioners and services to follow. You have pointed to a good example in Somerset. Do you feel that that is the case? Do you share the evaluation …”

“Your key ask is really an evaluation of the framework.”

“I am going to ask a bit more about the community mental health framework. You have touched on this already. In the Somerset example, you started to discuss the aspects of success. Rethink has previously described the framework as a once-in-a-generation opportunity to change care and support for the better. To what exte…”

“Thank you. Some of the witnesses in our earlier sessions talked about the benefits of social care reform for other public sector areas of the economy. Policing and housing were talked about, as well as the discharge issue and the health service more broadly. Is there anywhere particularly, outside social care, where yo…”

“Anita, do you want to come in?”