In 2024 the previous Government consulted on proposals to introduce a ‘tie-in’ for NHS dentists.
Simplifying things a great deal, an NHS dentistry tie-in would mean that, if you train at a dental school in England, after graduation you will be required to deliver a certain amount of NHS dentistry over a defined period or face a penalty.
What we told the Government back then about tie-ins
The BDA responded to that consultation at the time and told the then-Government that an NHS tie-in would make NHS dentistry less attractive as a career. We said clearly that ministers risked making NHS dentistry a place you served your time, before moving on, rather than a place you’d choose to build a lifelong career. There is every chance a tie-in would actually reduce the amount of NHS dentistry delivered over the course of a dentist's professional life.
We also said very clearly that the focus should be on paying dentists fairly for their NHS work through a reformed contract, not forcing them to work in a broken system.
We were, and remain, opposed to the principle of a tie-in for NHS dentistry.
The BDA’s response to the 2024 consultation was built on extensive discussion across our elected committees, and a direct survey of almost a thousand members including current dental students. Alongside the formal consultation response, we made informal representations to Government that highlighted the problems with the policy.
The current state of affairs on tie-ins
Things have moved forward now, or possibly backwards, depending on your point of view. The party may have changed, but the Government remains committed to tie-ins.
As part of our roles representing students and young dentists, and alongside other senior elected members - we recently met with Government to discuss their current proposals ahead of a formal consultation exercise that is anticipated shortly.
At that meeting, we told Government that any NHS dentistry tie-in would not achieve its aims, and would worsen the workforce crisis in dentistry.
Tie-ins would shred the credibility of the Government’s stated objectives for dentistry.
And once again, we called on the Government to develop a workforce policy and an NHS contract for dentistry that is focused on making the NHS somewhere dentists want to work.
It is striking that the current tie-in proposals appear to establish a principle under which public expenditure on the education of a healthcare professional enables the state to direct how that individual’s labour is used. Will other professions face similar proposals in the future?
This is a completely different situation from, for example, a policy in which a healthcare professional agrees to a specific obligation in return for a defined benefit – for example, ‘golden hellos’ or similar schemes.
So, where does this leave us?
We will, of course, continue to talk to the Government to try and secure the best possible outcomes for the dental profession and the public.
Already, we have secured a commitment that no current dental student will be affected and that the NHS obligation will be for part, not all, of the graduates’ working week.
But neither the public nor dentists are served by reducing the attractiveness of NHS dentistry at a time of historic low morale in the profession and the ongoing recruitment and retention crisis.
We will therefore keep working on your behalf - and on behalf of all future dental students - to make NHS dentistry something that dentists can rely on as a sustainable and rewarding career path.
Historically, most dentists have worked for the NHS willingly throughout their careers. That should not change for dentists because of failures to reform the contract or to implement a proper workforce planning policy.
With political instability putting the prospects of contract reform at risk, these tie-ins could become a handcuff to a broken system. We’re committed to making sure that isn’t the case.