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​The Postcode Lottery of care: 90-mile treks for dentist as £20m lost from NHS services

27 September 2018


Welsh Assembly Members looking at the future of NHS dental care will hear today that £20 million has been pulled out of local NHS dental services, as patients travel further or wait longer for care.

The British Dental Association Wales will tell the Health, Social Care and Sport Committee that patients across Wales are now facing a 'postcode lottery' of care – fresh analysis of data from the official NHS Direct service shows that new patients are facing wholly unacceptable journeys to see an NHS dentist, with residents in Aberystwyth facing a 90-mile round trip. New patients in Newtown face 80-mile journeys, while even those in the Welsh capital Cardiff face a nearly 30 miles trek.


BDA analysis from last year showed that only 15% of NHS practices are taking new adult NHS patients, with just 28% accepting new child patients. 

Dentist leaders have said the perverse NHS dental contract system has fuelled access problems. Freedom of information requests reveal that £20 million has been lost from local NHS dental services in the last three years, where practitioners are unable to meet the tough targets set by government in their contracts. This money, known as 'clawback', is not reinvested to meet demand for NHS dental services.

While BDA Wales has praised initiatives like Designed to Smile, which has narrowed deep health inequalities among young children, it has criticised the Welsh Government for failing to apply these effective preventive principles to wider strategy and reform of the failed NHS system.

Ministers are advocating modest 'tweaks' to the current target-driven NHS contract - which effectively caps patient numbers - rather than root and branch reform. The model has fed recruitment and retention problems across Wales, with recent official data revealing morale in the profession has fallen to its lowest levels since 2000 and more than half of dentists considering leaving the profession.

Tom Bysouth, Chair of the BDA's Welsh General Dental Practice Committee, said:

"The Welsh Government talks about prevention, inequalities and sustainability. But we require deeds not words to guarantee the future of this service and end the postcode lottery of care.


"It's utterly perverse that £20 million has been lost from local services, while some patients are travelling 90 miles to see a dentist under the NHS. Sadly, it's the inevitable result of a failed system, where officials bank on dentists missing their targets just so they can plug holes in other budgets. 

"Wales has secured major breakthroughs investing in prevention among children, with health inequalities narrowed and a chance to shave millions off treatment costs. What's missing is the willingness to apply that logic to fixing the rotten system at the heart of this service.

"Any progress hinges on the Welsh Government honouring its pledges and delivering real reform. We need a model that puts patient care ahead of tick boxes and targets, that can guarantee access for all who need it."


BDA Wales

BDA Wales campaigns for the interests of all dentists working in Wales. With our elected committee members, we negotiate on behalf of the profession on terms and conditions, pay and contracts: join us.