The shortage of appointments is hitting those on low incomes the hardest, and so we have backed calls from Healthwatch England for urgent and fundamental reform of NHS dentistry to be delivered by next year.
Around 3000 dentists have left the NHS since the onset of the pandemic, an exodus fuelled by the discredited contract NHS dentists work to. Healthwatch has stressed a new system must be in place before formal responsibility for dental services passes to the 42 new Integrated Care Systems in April 2023, following the passage of the Health and Care Act.
The current NHS contract funds care for little over half the population and sets perverse incentives to dentists, rewarding them the same for doing one filling as ten. While the BDA is now in negotiations to reform the service it remains concerned about the extent of the government’s ambitions. Ministers have declined to set a date for when the dysfunctional system will end, and offered no assurances that adequate funding will be put in place to underpin the rebuild of the service.
We have long warned that charges discourage low-income patients, and have morphed from a ‘contribution’ towards the cost of care to a substitute for meaningful state investment. Direct government contributions fell by a quarter in real terms from 2010-20, with inflation-busting patient charges hikes plugging the gap in a flatlining NHS budget. Lower patient numbers during the pandemic saw Treasury contributions reach historically high levels to maintain operations in the service, and we believe that pressure to 'balance the books' is now driving decision-making across government.
Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said:
"For over a decade this service has been running on empty, our patients paying more just so the Treasury can pay less. Choices made by Government mean dentists are now walking away from the NHS, while millions go without the care they need. A problem made in Whitehall needs to be fixed in Whitehall, with real reform and fair funding."
"We are committed to levelling up health outcomes - including on dental issues - across the country" reads the response from The Department of Health and Social Care. We're clear that requires a sustainable, long-term approach to investment, and a decisive break from the failed NHS contract.
NHS dentistry would require an additional £880m per year simply to restore levels of resources to 2010 levels. Uptake on a recent government pledge of £50m to provide 350,000 appointments by 1 April is understood to have been limited, with the majority of practices struggling to hit existing contractual commitments as they worked through the Omicron wave.