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Rationing of dental care is not what NHS dentists signed up to

We have backed cross party calls for "radical reform" of NHS dentistry in Wales.

In its new report on dentistry, The Senedd Health Committee has stressed the need to appropriately measure unmet need for NHS care, and for the Welsh Government to review whether the current levels of funding are appropriate for the service to achieve what's needed in terms of reducing the backlogs.

The Senedd report quotes extensively from our written evidence and the oral evidence given by the Chairs of the BDA Committees for the General Dental Service and Community Dental Service. We support the principle of government contract reform, which is needs-led preventive care.

However, as cited within the report, warn "there is no magic fix to a problem that lies fundamentally in underinvestment". The Welsh Government's unwillingness to invest in NHS services and improve access amount to rationing.

The report references research by the BBC last summer which throws into sharp focus that NHS access for new patients in Wales is the worst in the UK. Almost no practices are accepting adults who phone for an appointment because waiting lists are already too long.

This flies in the face of claims by the Health Minister of 112,000 'extra' or 'new' appointments being made available through the reform measures. The reality is this number simply describes stipulated provision for 'new' patients, often with greater clinical needs. The Health Minister claims "the system is working" but seems oblivious that such assigned provision necessitates a sharp drop in access for practices' historic patients.

Last month Russell Gidney, Chair of the Welsh General Dental Practice Committee, issued an open letter to the Chief Dental Officer for Wales stressing a growing number of dentists and practices will leave the NHS. It has become increasingly apparent the untested targets come without the necessary financial mitigations expected within a pilot scheme.

The lack of recognition by the Health Minister of the financial risk involved in piloting the reform measures was patently evident when she said "Obviously, if we're going to pay people to do a job, they need to deliver on that job, and if they don't deliver on that job, yes, we are going to clawback money."

This has shaken the profession's confidence and is likely to inflame an already smouldering situation.

End-of-year reconciliation now threatens many practices with significant clawback against a backdrop of galloping inflation; neither of which were envisioned a year ago. The take-up of the reform offer will likely be reduced for the year ahead; with an anticipated uptick in contract hand-backs and contract reductions.

Russell Gidney, Chair of the British Dental Association's Welsh General Dental Practice Committee said: "Ministers have dressed up the rationing of care as an access boost. Taking away services from hundreds of thousands of existing patients to provide for new ones is not progress. It's just stretching an inadequate budget and hoping for the best."

"What we are yet to see is genuine reform underpinned by sustainable investment. Practices are leaving the NHS simply to remain viable, and without change many patients will be left with no options."