Review of Oral Surgery Services and Training: a case of prescription without a diagnosis

In the Review of Oral Surgery Services and Training, the Oral Surgery Review Group supported the development of the specialty of oral surgery and some of the arguments put forward to support it concerned finance and quality. We argue that their analyses of the present situation are flawed. The economic argument and issues concerning skill-mix are very simplistic, but more importantly, the rationale given for the increase in referrals did not explore the myriad of likely reasons why in any substantive detail. These reasons include shortcomings in undergraduate training and a poor NHS primary dental contract including the arrangements for charging patients. Before implementation, the policy makers should consider a wide range of available options to address the failings, and take a “whole system approach” before they embark on developing a specialty, which may cause problems that exceed those currently facing the system.