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Northern Ireland: GDS crisis raised with Stormont Health Committee

What is the plan for Health Service dentistry?

On Thursday, we briefed Members of the Legislative Assembly (MLAs) on the seriousness of the situation unfolding within Health Service (HS) dentistry.

We highlighted the impact decades of underfunding and inaction is having on practitioners and patients alike; practitioners have been pushed to the brink; and we warned that without an urgent plan from Stormont, HS dentistry may cease to exist.

Through our oral evidence, MLAs were left in no doubt as to the core reasons behind the patient access issues unfolding before us. The mismatch between soaring costs at practice level, and inadequate fixed fees which have no objective basis, and a failure of the Department of Health (DoH) to recognise and adequately mitigate our costs is at the heart for the current crisis unfolding in HS dentistry.

Government failure to deliver on promises to put GDS on a financially sustainable footing, or to effect substantive contract reform has brought the service to its lowest point. And, just as significantly, trust has been broken.

Without a plan, we are seeing a considerable reduction in HS activity; dentists’ intentions to further reduce their HS commitment are clear, and we know the Business Services Organisation are inundated with patient deregistration requests. Despite sticking-plaster approaches, an inability to grasp the nettle has brought HS dentistry to its knees.

MLAs know we have been warning for years what would happen if these issues were not properly resolved. With the DoH rejection of our costings data, their refusal to commission an external Cost of Service review, failure to implement a mechanism to quantify practice expenses, while routinely deploying their ‘affordability’ veto, it should be no surprise that such a one-sided approach has resulted in the exodus away from HS dentistry that is underway.

Nothing short of rapid, meaningful action on the part of DoH, such as starting to implement the Scottish model, will slow this down.

We know the health budget situation is extremely challenging, but until a service is designed with genuine cognisance of practitioner costs in mind, and how costs can fluctuate over time, the downward spiral will not only continue, but is likely to accelerate. It is clear the current funding model is broken.

We warned the committee that this may be one of the last chances we have to appeal for action to safeguard a future for HS dentistry. And again, we offered Scotland as a roadmap in stabilising the service.

Concluding our remarks with the words of one of our colleagues: ‘This is the last opportunity to save HS dentistry, please take it.’