The Minister has shared with us an outline of the approach he has decided to take in relation to the long-awaited ‘Investment Proposals’ for 2025-26. While we await receipt of the detail, the following has been confirmed:
- £4.5m for continuation of the ‘30%’ uplift to fillings, extractions and root canal treatment, including agreement to adjust these codes also to reflect Doctors’ and Dentists’ Review Body (DDRB) uplifts
- Enhanced Child Examination to continue (£860,000 per year over the next three years totalling £2m)
- £1.6m for an additional payment ‘to reward Health Service work carried out’ - details to be confirmed
- £400,000 for expansion of the Happy Smiles Programme
- Cost of Service review to be completed in 2025-26.
DDRB
In addition, the Minister confirmed to us that he has accepted the DDRB recommendation of 4% for 2025-26. Wishing to avoid a repeat of last year’s delay, the Minister has taken the unprecedented step of issuing a Ministerial direction despite the £600m deficit in the health budget.
National Insurance
£2.5m is being allocated towards mitigating National Insurance contributions in General Dental Services (GDS). The Minister has agreed if the true cost to dental practices is higher, he would make up the difference.
Our response
These range of measures were confirmed this week following our urgent request for clarity from the Minister, and in the wake of an Assembly debate on access to dental care on Tuesday.
While we have acknowledged the severe budgetary context in which the Minister and his department are operating, and those steps he is taking at personal risk such as on National Insurance costs and his ministerial direction on DDRB, we are unable to commend these proposals to the profession.
Throughout this process, our representatives have been urging for maximum investment into GDS to enable practices to provide additional Health Service activity at reduced financial risk, to maximise patient outcomes and to safeguard practice sustainability against the context of a rapidly shrinking service. In short, to rebuild confidence that this service has a future.
Despite best endeavours by the Minister, what has been outlined apart from the £1.6m payment is largely a continuation of funding measures which have already been in place in 2024-25, and therefore what can be expected as an outcome is a continuation of the most rapid shrinkage of NHS dentistry seen anywhere on these islands, and even more difficulties for patients to access care.
As such, they will not adequately address the fundamental mismatch between fees set by Government, and the true cost to practices to providing modern dental care.
The Assembly is unanimous in support
Reflecting the considerable impact these issues are having on patient access to dental care across Northern Ireland, Members of the Legislative Assembly from right across the entire political spectrum were unanimous in their support for a motion calling for more to be done to support Health Service dentistry. Read the Hansard. or watch the proceedings (01:02).
We will continue to engage with the Minister and his Department on these matters, not least around the Cost of Service Review process. Our plea to the Executive, especially in the wake of the unanimous support for Health Service dentistry expressed across all parties in the Assembly yesterday, is for urgent and decisive action. Our very sad prediction is that without this and without adequate funding, the very future of this vital public service is at risk.
Assembly Motion on Access to Dental Care - resolved
That this Assembly expresses severe concern at the challenges many people experience in accessing dental care; notes the testimony from the British Dental Association that the shortfall between Department of Health fees for dentists and the cost of providing services means that many dental practices are not financially viable and are struggling to continue seeing NHS patients; further notes that early and preventative oral healthcare can help to improve health outcomes for patients and reduce demand for wider health services; calls on the Minister of Health to urgently develop, and present, proposals to increase access to dental services and address regional inequalities, alongside consideration of a new oral health strategy to address access to services and workforce challenges; and further calls on the Minister to conclude and publish the general dental services cost-of-service review as soon as possible.