The British Dental Association (BDA) has published an open letter to the chancellor, stressing that the government must extend the relief from National Insurance contributions offered to hospitals, to NHS primary care.

The professional body has said the government must soften the blow of the budget announced in October 2024, as it warns there will be a steep rise in costs for all dental practices with no corresponding support.

The BDA has said the treasury will ultimately dictate whether government pledges to ‘save’ NHS dentistry are delivered, with many practices already providing some NHS treatments at a financial loss.

Letter to the chancellor

“Dear chancellor,

We are writing on behalf of dental practices and practitioners across the UK following the budget released in October 2024.

The Nuffield Trust has warned that there is an access crisis to dentistry unlike any we have previously seen. This is a genuinely existential threat that has left millions of patients with no options.

The simple fact is the overwhelming majority of dental practices are small businesses, and the budget is set to significantly add to the financial pressures they face, whether they offer NHS, private or mixed care. For many practices, the rise in National Insurance contributions and the increase in the minimum wage will mean significant cost increases. For private focused practices, they will have little choice other than to pass those costs on to patients. That is likely to further impact patient decision-making about access to care. For NHS care, practices will be unable to pass on costs to patients.

Hundreds of NHS providers are already delivering NHS treatments at a financial loss. Failure to soften this blow will push more of them closer to the brink or with no choice other than to move away from NHS provision. Make no mistake, these cost increases will have an impact on access to NHS dentistry.

All dental practices need help in addressing the significant impact of this budget. As a bare minimum the public sector relief from National Insurance contributions should be extended to those providing NHS care. At a time when government policy is to shift focus from secondary to primary care, dental practices cannot be excluded from support offered to hospitals. Despite increases in headline investment in the NHS, there appears no support to insulate dental practices from these and wider significant increases in overheads.

Ministers have pointed to the increase in the Employment Allowance as a means of softening the blow for small business. But that relief is not available to those businesses focused on serving the public sector. Again, that very much represents an incentive for dental practices to provide more private and less NHS care. The government really does need to consider the impact of its decisions on healthcare provision.

We urge you to look at these issues as a matter of urgency, but longer term, we need to see a change in approach.

Labour pledged to “rebuild dentistry for the long term.” We welcomed that commitment, but the treasury will ultimately prove the arbiter on whether that mission has any chance of success.

Already, instead of promised investment to deliver manifesto pledges on urgent care, we have seen suggestions of a shift to recycle existing budgets. Meanwhile, pay awards that looked generous on paper look set to fail to reflect the soaring expenses colleagues now face, and are now seven months late with no timeline for implementation.

Practices are running on empty, struggling to recruit or retain staff. The real reform this service desperately needs – and your party has promised – will need to go hand in hand with fair and sustainable funding.

Eddie Crouch, chair of the BDA

Martin Woodrow, CEO of the BDA

Shawn Charlwood, chair of the General Dental Practice Committee”

Author: