Fundamental reform of NHS dentistry needed to end a ‘crisis of access’
Published: 14/07/2023
Following the conclusion of the Health and Social Care Committee’s inquiry into NHS dentistry, it has described the evidence of pain and distress due to being unable to see an NHS dentist as “totally unacceptable in the 21st century”.
Urgent and fundamental reform of NHS dentistry is needed if people are to receive the dental care they are entitled to. MPs cite frustration that recommendations for reform made by their predecessor committee 15 years ago have still not been implemented. They brand the current contract, which pays dentists for NHS ‘units of dental activity’ (UDAs), as not fit for purpose.
The report finds common misconceptions among the public about entitlement to NHS dental services and calls for action to address this. MPs endorse comments given by Neil O’Brien, the health minister, in evidence that it was the government’s ambition to ensure that everyone who needs an NHS dentist can access one. The committee calls for the government to set out urgently how it intends to reform the dental contract to deliver on the ambition expressed by its minister.
The cross-party inquiry has also supported the case for permanent ring-fencing of the dental budget, so money is not lost from the frontline. The committee also stresses that the government’s forthcoming recovery plan must be underpinned by necessary funding.
Steve Brine MP, chair of the Health and Social Care Committee, said, “Rarely has an inquiry been more necessary than this one. To hear of someone in such pain and distress that they resorted to using pliers to extract their teeth demonstrates the crisis in NHS dental services. The problem is compounded by people being unaware of what they’re entitled to and a contract that is unfit for purpose when it comes to paying dentists for treating NHS patients. Today we register in the strongest terms possible our concern for the future of NHS dental services and the patients who desperately need access to them.
“Declining levels of NHS dentistry activity should have been sounding alarm bells, as should a projected budget underspend of £400 million.
“What’s particularly frustrating is that recommendations made by our predecessor committee 15 years ago to reform the dental contract have still not been implemented. Yet contract reform alone is unlikely to bring back dentists who have already left the NHS or are considering leaving in the near future.
“We endorse the government’s ambition to ensure that everyone who needs an NHS dentist can access one. Belatedly, now is the time to deliver it.”
Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, said, “From reform to funding, the committee has provided an instruction manual to save NHS dentistry. The real question now is whether government or the opposition are ready to use it. Failure to act will condemn this service to oblivion.”
Neil Carmichael, chair of the Association of Dental Groups, said, “With access to NHS dentistry now one of the top issues in MPs constituency postbags, the inquiry has provided the opportunity for politicians on a cross-party basis to map out a future for NHS dentistry which will improve access.”
“Access to NHS dentistry and dental deserts in England have become a doorstep issue in by elections across the country this month. This cross party report provides a blueprint for parties to address the issue in their manifestos for the General Election. The solution to the workforce crisis is clear – the Government needs to act now to recruit more overseas clinicians and invest in the long term in our dental schools to boost dentist numbers.”
Louise Ansari, chief executive of Healthwatch England said, "Healthwatch England welcomes this report from the committee, which has accepted the evidence we gave in person to MPs that there is a crisis of access and affordability in NHS dentistry and that 'everyone should be able to access an NHS dentist when they need one, wherever they live'. We also welcome the call for a national information campaign to tackle misconceptions about 'registration' with dentists.
"Ultimately, only a fundamental and fully resourced dental contract reform can tackle these deep-seated problems, and we call on the government to publish its dental recovery plan urgently.
"NHS dentistry is the second most common problem that the public report to Healthwatch, with more than 400 local reports from across England in the past three years exposing experiences of people suffering in pain, performing DIY dentistry and struggling to pay the costs of treatment."
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