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Winning the argument for change

As the new Government accepts what’s fuelling the crisis in NHS dentistry it’s time to move to rescue and reform.

Shawn Charlwood Photo 250X250
Shawn Charlwood Chair, General Dental Practice Committee
Wes Eddie Shawn Martin July 24 800X402

We can take some comfort that our talks with Wes Streeting MP, the new Secretary of State for Health and Social Care, was one of firsts.

It took place on his first Monday in the job, his first face to face meeting with any major stakeholder. 

Labour had repeatedly pledged to meet with us soon after the election on the task ahead: rescuing and reforming NHS dentistry. I am pleased to report that promise has been kept.

It’s a positive start and it reflects the status dentistry has attained during this election, and the work we’ve done over many years to shine a light on this crisis. It’s thanks to the members who’ve sent thousands of messages to candidates the length and breadth of England.

The result was that almost every day of the campaign dentistry was high on the agenda.

This meeting provided an opportunity for us to set out our stall to the new government. How we can start putting flesh on the bones of a short-term rescue package and longer-term reform of the service.


The fact the NHS is broken is now official government policy.

Obviously, the Health Secretary doesn’t need to tell dentists that. We’ve all known that NHS dentistry is broken and has been for a generation. 

However, in terms of securing the necessary response, the first step towards saving NHS dentistry is admitting we have a problem.

So it was refreshing to hear an honest appraisal of the scale of the challenge we face, and that failed contracts and underfunding have fuelled the current crisis.

This recognition - this important change of tone - is a starting point that could be the key to breaking the impasse on fundamental reform of the service.

With agreement on the problem, we can now work towards solutions.


From our meeting, it was clear that we have a number of shared ambitions. We discussed the need for immediate actions to be taken to rescue and rebuild NHS dentistry.

I took the opportunity to make the case for putting record breaking underspends to work. We can  increasing the minimum UDA value to £35 and enhancing the New Patient Premium without a penny of new money.

It’s quite simple. Hundreds of millions in clawback can ensure thousands of struggling NHS practices remain sustainable.

This would be an interim measure, while negotiations are concluded on fundamental reform of the NHS contract.

Government has a chance to offer a statement of intent on dentistry.

Show there’s a light at the end of the tunnel for struggling NHS contractors. That the cavalry actually is coming. Enough to give those thinking twice about their futures reason to stick with the programme while we wait on needed reform.

The new Government’s priority is also to deliver its manifesto pledge to provide 700,000 urgent appointments. We are happy to work with ministers to implement the sessional schemes that have proved a success locally as a national approach.

This gave us a chance to stress the invaluable role private dentistry plays in meeting patients’ needs within our system. Dentistry is a mixed economy, and Labour have talked at length about the role the independent sector could play in their plans across the NHS. 


After many years when tweaks to a broken system have been all that’s been on offer, it is encouraging to hear government now talk about the need to reform the contract.

I made plain, as you would expect, that the UDA has to go, and the sooner the better.

We urged the Health Secretary to look to the prototypes for inspiration in designing a reformed contract. Those trials were not perfect, but dentists and patients were positive about the experience. There is important learning that must inform the development of a new contract.

Our proposal for a patient-centred, prevention-focused, capitation-based contract has widespread support from the cross-party Health Select Committee to the respected Nuffield Trust thinktank.

Last December the Trust said this service faced the greatest crisis in its 75-year history. Now we’ve reached NHS dentistry’s 76th birthday little has changed.

The Trust stressed that successive governments’ approach to dental policy – one of “muddling through” - was no longer viable. We couldn’t agree more.

Action on dentistry can’t be another line on a pledge card come the 2029 election. We need to see bold and urgent action towards reform, while there’s a service left to save. 

This won’t be achieved over night, but with commitment from both sides we can make progress, and at pace.

There was clear openness to continue ongoing engagement between the BDA and the Health Secretary and his ministerial team to explore how we can bring about that change. We will, as ever engage constructively, pursuing the best deal for the profession and our patients.

I take absolutely nothing for granted. We will hold this Government to account as we did the last. These initial talks were positive, but we now need to see words followed up with actions.