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Dentists: Welsh Government must show it’s not aping Westminster on charge hikes

The British Dental Association Wales has warned the Welsh Government’s unprecedented increase in charges for NHS dentistry must protect vulnerable patients and put new funds to work securing better access and a more sustainable service.

The professional body believe the hike announced today is set to be the largest single increase in charge levels in the 75-year history of the NHS. From 1 April 2024 a band 1 treatment like a check-up will increase from £14.70 to £20.00, a 36.1% increase. A band 2 like a filling will increase from £47.00 to £60.00, a 27.7% increase. And a band 3 like dentures will increase from £203 to £260.10, a 28.1% increase.

Urgent care charges will more than double from £14.70 to £30.00.  The BDA say this could leave the Welsh Government only paying £6 toward that NHS care with the patient paying around 85% of the cost of that service.

The BDA has previously been complimentary of the ‘restraint’ exercised by the Welsh Government. It says the Cardiff Bay administration now risks aping the tactics of the Westminster Government, who for 14 years have used inflation busting hikes to reduce state contributions within a flat budget. A 4% increase in charge levels was announced yesterday.

While some adults are exempt from charges, many on very modest incomes still have to pay fees in full. The BDA anticipate the impact could be profound given the depth of socio-economic and oral health inequalities within Wales, and that reforms to current exemptions from charges should be urgently considered to provide a safety net for low income, high needs, fee paying patients.

The professional body has commissioned extensive polling in England demonstrating how charges make patients delay or avoid treatment and encourage choices based on affordability rather than clinical recommendations. Work in 2023 found nearly a quarter (23%) of respondents in England delayed or went without NHS dental treatment for reasons of cost. 45% said the price shaped the choice of treatment they opt for. There are widespread reports across the UK of patients declining restorative dentistry and choosing cheaper extractions.

Dental charges do not go to dentists and are explicitly designed to reduce demand for services. Their introduction in 1951 – to help offset the costs of the Korean War - prompted the resignation of NHS founder Nye Bevan from the then Labour Government.

Russell Gidney, Chair of the Welsh General Dental Practice Committee, said:

“If this money doesn’t end up providing better and more sustainable care then the Welsh Government will be following the Westminster playbook. Forcing patients to pay more, so they can pay less.

“Charges hikes should never provide cover for cuts. Any increases will inevitably force patients on modest incomes to delay dental care or avoid it entirely, and a proper safety net needs to be in place.

“Cardiff Bay must not go down a path that will widen already scandalous oral health inequalities.”