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NHS charges: time to change course

Blog Author Henrik Overgaard-Nielsen

Blog Date 06/09/2016

How much will our patients have to pay in charges, when the term ‘NHS dentistry’ ceases to have much meaning?It’s a question we’ve been grappling with over the summer. Early in the year we lead criticism of the government’s latest increases to dental charges in England, which went up 5% in April, and will go up by a further 5% next April.

It’s not simply that our patients are having to put in more. It’s that government has settled on a way of ensuring it has to pay in less.

Setting patient charge income aside, direct funding for primary and general dental services in England has fallen by some £170 million since 2010. We’ve looked at where these trends are heading. It means that if ministers don’t change course a third of the dental budget will be coming from charges by the next General Election. It means we’re heading to point where charge revenue ends up exceeding direct investment from government within a generation.


Does it have to have to be this way? No. Only in England is the proportion of spending drawn from charges surging. Wales has frozen fees, and the proportion of budgets drawn from charges has fallen across the board over the last decade.




This argument matters.

We know that cost drives many patients away from treatment. The Adult Dental Health Survey showed just over a quarter of adults say that the type of dental treatment they opted for has been affected by the cost of this treatment – and almost one-fifth say that they had delayed dental treatment for the same reason.

The patients who avoid visiting their dentist with conditions like tooth ache or abscesses aren’t simply grinning and bearing it. Studies have estimated over 600,000 are trying to get help from their GPs.

It’s madness. Our colleagues in medicine are already overstretched. These visits come with a £26 million price tag, and more often than not end with a referral back to an NHS dentist.

NHS charges have ceased to be a mere ‘contribution’ towards the cost of NHS dentistry. They are a quite simply a tax on health. They were designed back in the 1950s to lower demand for dentistry, and in the 2010s they have become a substitute for adequate government investment.

Now we want to know what our members – and their patients – think. We are sending out posters to all our members in England. You can visit

This is an important message. I hope you will join me, and share it.

Henrik Overgaard NielsenHenrik Overgaard-Nielsen

Chair, General Dental Practice Committee



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