An historic collapse in dentists' earnings across the UK is jeopardising the long term recovery of the service from the COVID pandemic, says the British Dental Association.
BDA analysis of new official figures on earnings and expense levels in NHS dental practice show high street dentists in England have seen taxable income fall by nearly 40% in real terms over the last decade. The story is replicated across the UK nations, with real terms falls in Wales, Scotland and Northern Ireland of well over a third since 2009.
The new 2019/20 figures capture the period just before the first lockdown. Above-inflation uplifts have remained the exception rather than the rule since the financial crash, with across-the-board cuts in pay in both cash and real terms.
Unlike their medical colleagues NHS dentists do not typically receive any capital investment from central government, with profits funding all improvements in equipment, training and facilities for NHS practices. While devolved governments have provided millions to invest in new ventilation systems, to help increase patient numbers while maintaining strict infection prevention control measures, there have been no parallel commitments from Westminster. Practices are also facing mounting costs for clinical waste and essential equipment, without comprehensive support.
The BDA has warned continued pay restraint will only accelerate the drift away from NHS dentistry. Recent surveys have indicated nearly half (47%) of dentists in England indicate they are now likely to change career or seek early retirement in the next 12 months should current COVID restrictions remain in place. The same proportion state they are likely to reduce their NHS commitment.
The historic driver of low morale in the sector remains the discredited target-based NHS dental contract imposed on the profession in 2006, which has proved incompatible with providing care during the pandemic.
Prior to COVID unmet need for NHS dental services was already estimated at over 4 million, or 1 in 10 of the adult population. Over 30 million NHS appointments have been lost since the first lockdown in England alone.
Shawn Charlwood, the BDA’s Chair of the BDA’s General Dental Practice Committee said:
“This lost decade on pay will inevitably undermine NHS dentistry’s recovery.
“Government has taken the ‘do more with less’ mantra to the nth degree. Every penny of investment in this service comes from dentists’ own pockets. This historic squeeze has left practices unable to deliver needed improvements in facilities, equipment, and training, even before the added costs of COVID arrived.
“The pandemic has exposed the rotten foundations this service is built on, with failed systems and underinvestment leaving millions unable to secure the care they need.
“Dentists need to see this service as a place they’d chose to build a career. From discredited contracts to flat lining pay, no one should be penalised for working in the NHS.”
Taxable income or net profit for Practice Owners, England, Wales, N. Ireland, and Scotland, nominal and real, 2008-2020
Taxable incomes for Associates, England, Wales, N. Ireland, and Scotland, nominal and real, 2008-2020