Dentists warn 'rescue plan' will fail to end crisis as 60,000 sign our petition
The Tories’ dentistry “rescue plan” will do nothing to make more dentists available on the NHS, the Government has been told.
Dentists lined up to blast the “sticking plaster” plan as Health Secretary Victoria Atkins refused to rule out whether it will actually mean more budget cuts. Funding cuts have led to an exodus of dentists going private amid a collapse in access to NHS care.
It comes as almost 60,000 have signed a petition we have launched with the British Dental Association on the 38 Degrees website calling on the Prime Minister to save NHS dentistry.
Under the long-delayed plan the minimum amount paid to dentists for NHS treatments will rise from £23 to £28 for a minority of practices receiving below this rate. But experts said it does nothing to change the NHS contract which results in an effective cap on patients a dentist can see and often claws back tens of thousands of pounds at the end of the financial year.
British Dental Association chair Eddie Crouch was outside a dental practice in Bristol where hundreds of people have been queuing for the last three days. He said: "There is nothing in the plan to draw dentists back into NHS services to enhance workforce capacity.”
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Sign our petition HERE to save NHS dentistry and make it fit for the 21st century
Also speaking outside the Bristol practice, Shadow Health Secretary Wes Streeting said: "What this doesn't do, and what the dentists are crying out for, is reform of the dentist contract so we can recruit and retain the NHS dentists we need." He added: "It has just gone quarter past seven and there is already a queue of people. Those people have been told that the practice isn't enrolling new patients today, but people are still queuing already on a very cold morning because they're desperate.”
The Association of Dental Groups said the plan did nothing to increase the number of NHS dentists and warned many practices will close in the coming years. ADG chairman Neil Carmichael, a former Conservative MP, said: “The ultimate success of the plan depends on whether we have enough dentists to carry it out. There are currently more than 5,500 dental vacancies in the UK and per capita we have among the lowest number of dentists in the EU.”
Steve Brine MP, chair of the Health Select Committee, which deemed the NHS dental contract “not fit for purpose”, said: “We welcome the plan’s focus on prevention and a short-term recovery. However our report urged the Government to implement a fundamentally reformed dental contract which would move away from the current payments system to one which rewards dentists for the work they do, rather than increasing payments but keeping the same system in place.
“Without a truly reformed contract, the crisis of access to NHS dentistry which has seen people resort to removing their own teeth is unlikely to be resolved.”
The Mirror has launched a campaign demanding access to an NHS dentist for all.
Victoria Atkins refused to answer when asked five times on BBC Breakfast whether the dentistry budget in England will now be lower than it was. The plan had promised "an additional £200 million" but the British Dental Association insists this will be a reallocation from within the existing £3 billion budget - which has already seen a £1 billion real terms cut over the last decade.
When asked repeatedly by broadcasters whether the budget would be lower, Ms Atkins repeated that “it’s a £3 billion budget” before adding: “A lot has happened in those ten years that you talk about.”
Sign our petition HERE to save NHS dentistry and make it fit for the 21st century
Lib Dem health spokeswoman Daisy Cooper MP said: "Seeing a minister duck and dive on the reality of dental funding cuts will be hard to swallow for millions. The reality is they've left our dental services to rot and now think they can rebuild it with a handful of toothpicks.”
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Mr Crouch said the £200 million was "not new money", adding: “This 'new' money is a drop in the ocean for a service cut to the bone. Creative accounting might make for a nice headline, but not decent health policy.”
One in six children now have rotting teeth by Year 6 - rising to a quarter in poorer areas. Recent data from the House of Commons library suggested 40% of children are not getting regular NHS dental check-ups.
Dr Nilesh Parmar, former UK Dentist of the Year, said: “What I have seen of this proposal is a sticking plaster at best, without addressing the main issues. The dental contracts need redesigning.”
Dr Simon Chard, former president of British Academy of Cosmetic Dentistry, said: "The contract as it is currently is really inadequate... it's leading to a complete lack of clinicians who can work within the service comfortably. The system itself doesn't work.”
A video posted on social media on Monday showed police community support officers telling patients in Bristol the queue had "finished" as they urged them to try their luck another day. Mr Crouch added: “There are towns across this country where any new practice opening would see a repeat of scenes we saw in Bristol. The police might want to thank the Government that budgets are so tight we won’t be seeing many grand openings any time soon.
"We've got 12 million people looking for access to NHS dentistry. So what that (queue) visualises is just the sad state the service is currently in."
Speaking in the House of Commons, Ms Atkins said: “Over a million more people saw an NHS dentist last year than the year before. But we know that too many, particularly those living in rural or coastal communities are still struggling to find appointments. This recovery plan will put this right by making NHS dental care faster, simpler and fairer for patients and staff."
Sign our petition HERE to save NHS dentistry and make it fit for the 21st century
What is in the Dental Recovery Plan for England?
A New Patient Premium will see dentists receive a bonus of between £15 and £50 for treating someone who has not had a check up for two years. The minimum amount paid to dentists for NHS treatments in England will also rise from £23 to £28. However only 900 of the 8,000 practices in England are not currently getting a £28 minimum so a minority of practices will benefit from the uplift. The plan states “around 240 NHS dentists” will also be paid a £20,000 'golden hello' to work in under-served areas for three years. A similar scheme in Scotland offers £25,000 over two years. The plan aims to increase dentist training places by 40% which could boost the workforce from mid-2030. A consultation will begin on adding fluoride to water systems to help strengthen enamel, starting in North East England. Mobile dental teams will deliver fluoride varnish treatments to 165,000 pupils attending schools in deprived areas. Nurseries will also teach children to brush their teeth.
Will it be backed by extra cash?
Ministers have refused to confirm whether the £200 million pledged as part of the plan will be genuinely “new” funding”. The NHS dentistry budget for England has remained around £3 billion during the last decade. Once inflation is factored in this has resulted in around a £1 billion real terms funding cut. The BDA suspects the £200 million will be diverted from a £400 million “underspend” in its budget last year. Until now this has been quietly syphoned off to other areas of the NHS. This underspend - expected to hit £500 million this year - occurs because money is clawed back from struggling dental practices who do not hit treatment targets, usually due to lack of staff. This adds to a vicious cycle pushing more dental practitioners to go private.
If an NHS dentist treats more patients than their target then they receive no payment for it - effectively capping the numbers able to access a dentist. The BDA says: “The New Patient Premium is not new money and is simply recycling existing contract value, meaning any new patients seen as a result of this initiative will come at the expense of existing patients being able to get an appointment.” OECD data indicates that the UK spends the lowest proportion of its health budget on dentistry of any European nation. England has the lowest spend per capita of any UK nation. Its £3 billion budget is also increasingly made up of patient charges after the Government implemented huge above-inflation fee rises for everything from check-ups to fillings. A check up now costs £25.80, up from £16.50, and a filling £70.70, up from £45.60. This has meant less well-off patients putting off treatment that nips problems in the bud, contributing to worsening oral health of the nation.
Will this make it more likely I will get an NHS dentist?
Experts insist that without more dentists then NHS access will not improve. Trade unions and trade bodies have been unanimous that the Government plan does nothing to tackle the exodus of NHS dentists going private. The plan does not reform the NHS contract which results in an effective cap on the number of patients an NHS dentist can see. The Health Select Committee concluded last year that the contract, which pays dentists for NHS 'units of dental activity' (UDAs), is not fit for purpose and needs to be scrapped. Dentists also get paid the same for delivering three or 20 fillings, often leaving them out of pocket.
It has created a situation where the most complex patients - who are most in need - are often the least welcome at NHS dental practices. NHS dentist numbers remain around 24,000 in England but the data does not differentiate between someone performing a single filling on the NHS and a full time NHS dentist. BDA polling shows 50% have reduced the proportion of NHS work they do just since the start of the pandemic. Just 1,000 more dentists would deliver 750,000 extra appointments - but this would require more funding.
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