BDA

BDA: Government must pay interest on late uplifts

The British Dental Association has told NHS England that NHS contract holders must be provided with interest for unacceptably late implementation of contract uplifts.

The Statement of Financial Entitlement requires uplifts to be applied from 1 April each year, but these have not been paid on time since 2015/16. Last year the uplift was not applied, and backdated payments were not paid until January, nine months after it was due.

Now, following legal advice, the BDA understand that contract holders are due interest on late payments, under the Late Payment of Commercial Debts (Interest) Act 1998, for each of the years in which payments have been made late. The professional body is willing to support members in bringing forward claims for this interest.

Late payment of these uplifts causes real problems for dental providers, hindering cashflow and business planning, and causing problems for payments to associates who have left a practice before the annual uplift has been determined and applied.

The BDA estimate that contractors are owed over £12 million in interest for late payments in the last financial year and the late payments for the year to date would amount to more than £7 million.

“Late uplifts undermine NHS practices,” says General Dental Practice Committee Chair Shawn Charlwood. “NHS England need to do the right thing – unacceptable delays mean payments must come with interest.”

BMA and BDA ‘dismayed’ at real-terms pay cut for uniformed doctors and dentists

Responding to the pay award announced by the Government for doctors and dentists in the Armed Forces, which is 5% for 2023/24 and a £1,000 consolidated sum, BMA Armed Forces Committee Chair Colonel Mark Weir and BDA Armed Forces Committee Chair Surgeon Captain (D) (Retired) Mike Gall, said:

“Both the BMA and the BDA are dismayed by the headline announcement of a 5% pay award for the uniformed doctors and dentists, albeit with a consolidated further award of £1,000. Once again there has been universal failure from the review body to reflect the detailed recommendations made by the BMA and the BDA and the result is a pay cut in real terms during an extended inflationary period. Additionally, for the fourth year in succession, the Armed Forces’ Pay Review Body (AFPRB) award recommendations have failed to match even the derisory Review Body on Doctors’ and Dentists’ Remuneration (DDRB) headline recommendations and the AFPRB has again missed the opportunity to address the growing and alarming gap between uniformed dentists and their civilian contemporaries. This group of doctors and dentists provides vital treatment to the armed forces both at home and when deployed overseas and the review body announcement will leave them questioning whether they wish to continue serving, with all its sacrifices, when there are so many opportunities to work outside of the MoD. Armed forces doctors and dentists will only be able to conclude that they are being penalised yet again for their military status.

“In addition, the BMA and the BDA note the AFPRB recommendation for an internal review of the current medical and dental officer (MODO) pay spine to assess whether the baseline in-year remuneration remains correctly set in a competitive employment market. Both organisations must be allowed to contribute in detail to the current review being undertaken by the HQ Defence Medical Services.”

NHS dentistry inquiry: ADG welcomes proposal as BDA tells government to ‘act now’

The British Dental Association (BDA) has warned NHS dentistry’s future will rest on both government and opposition committing to the recommendations set out by the Health and Social Care Committee today. The Association of Dental Groups (ADG) has welcomed the MPs inquiry into NHS dentistry as “blueprint” for election manifestos.

The cross-party inquiry makes sweeping proposals to end the crisis in NHS dentistry, including:

  • Reform: The Committee stress that “fundamental reform” of the failed NHS contract fuelling the exodus of talent from NHS dentistry must be delivered urgently.
  • Prevention The Committee share the BDA’s view that the focus of a new system should shift from discredited targets to a system of ‘weighted capitation’ whereby dentists are rewarded for maintaining and improving their patients’ oral health and the focus is on long-term, patient-centred preventative care, with additional support for higher needs patients. This would provide an emphasis on prevention that doesn’t currently exist.
  • Funding: The Committee support the case for permanent ring fencing of the dental budget, so money is not lost from the frontline because of the penalties practices struggling to hit their contractual commitments currently face. The Committee also stress the government’s forthcoming recovery plan must be underpinned by necessary funding.
  • Integrated Care Systems. The Committee stress dentistry must have a voice in new structures, with a seat on boards. 

The BDA has wholeheartedly backed the damning judgment of the Committee that the system is “unacceptable in the 21st century” and share the view that “Government and NHS England have not fully grasped the scale of the challenge for the workforce, and the need to urgently provide compelling incentives to attract new and existing dentists to undertake NHS work.”

The recent NHS Long Term Workforce Plan has set out to expand the number of dental students by 40% but set out no concrete plans to stem the flow of talent from the workforce. The BDA described the move as an attempt to “fill a leaky bucket.” Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce – or further reduce – their NHS work.

In oral evidence the professional body stressed to the committee that all ministers were doing at present was “rearranging the deck chairs on the Titanic while the service slowly slips into the sea.” Minor changes to the discredited NHS contract were rolled out in October, that the BDA warn do nothing to halt the exodus from the service. The government has yet to honour its pledge to fast track a ‘recovery plan’ for NHS dentistry, that the BDA stress is essential just to stabilise the service ahead of wholesale reform.  

Contrary to repeat claims made by the Prime Minister, official figures secured last month by the BDA under freedom of information indicate just 23,577 dentists performed NHS work in the 2022/23 financial year, over 1,100 down on numbers pre-pandemic, a level not seen since 2012.

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 opposition are ready to use it. Failure to act will condemn this service to oblivion.”

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 Committee also concludes the current backlog of overseas clinicians waiting to sit the Overseas Registration Examination (ORE) is “unacceptable” and calls on the General Dental Council and the Government to “speed up the changes to the process of international registration for new applicants seeking to work in the NHS”.

Neil Carmichael, Chair of the ADG, 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.”

Iain Stevenson, Head of Dental at Wesleyan Financial Services, said: “Dentists are doing everything they can to support patients. But in reality, many practices delivering NHS care are hanging by a thread.

“They’re trying valiantly to recruit and retain staff, but at the same time being stung by punishingly high running costs. The operational headroom they have is razor thin, and conditions are so unfavourable that just one setback can quickly become near-catastrophic. For example, if many practices were to lose just one associate they’d face a long uphill battle to replace them, and in the meantime, weather increased waiting list pressure and financial strain – just pouring salt in the wound. It’s simply not sustainable.

“We’re seeing welcome attempts to address some of these issues, but the fear is that the problems are too entrenched and urgent to be fixed by short-term tweaks around the edges or ideas that will take years to come to fruition. We need a new vision for NHS dentistry, and we need it now. This simply isn’t a service that our society can lose.”

BDA: Government should expect no applause for real pay cut

The British Dental Association has warned the UK Government’s below inflation pay awards will undermine efforts to bring NHS dentistry back from the brink.

The government has accepted the recommendation of the Review Body on Doctors’ and Dentists’ Remuneration for a below inflation 6% uplift and follows widespread speculation Ministers would refuse to honour it.

There is still no confirmation on increases for practice expenses, and with the cost of delivering NHS care skyrocketing the BDA stress this will only fuel the exodus from the NHS. Official data shows real incomes for typical dentists have fallen by up to 40% – the highest levels in the UK public sector. From 2008/9-2020/21 real pay for a typical NHS dentist in England fell by 37%, from £67,800 to £42,847.

Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce – or further reduce – their NHS work. This movement is not being tracked by official data, which counts heads, rather than commitment, and gives dentists who do just one NHS check-up a year the same weight as an NHS full-timer.
While the NHS Long Term Workforce Plan has set out ambitions to increase the number of dental students by 40% there are no tangible plans on retention for the current workforce. Government pledges for a fast tracked ‘recovery plan’ for NHS dentistry have yet to bear fruit.

BDA Vice Chair Peter Crooks said: “The government should not expect applause for begrudgingly delivering a below inflation pay award to dentists and doctors. We’re seeing NHS dentists delivering NHS care at a financial loss. All this decision will fuel is the mounting exodus from this service.”

BDA: Workforce plan attempting to handcuff dentists to sinking ship

The British Dental Association has expressed deep concern that the new NHS Long Term Workforce Plan is setting out aspirations to tie dental graduates to a failed NHS system, with no tangible plans to reform the discredited contract fuelling the exodus from the service.

In proposals set out just for dentists the plan states “one approach we will consider with government is to introduce incentives or other measures, such as a tie-in period, that encourage dentists to spend a minimum proportion of their time delivering NHS care in the years following graduation.”

The plan set out aspirations to expand dentistry training places by 40% so that there are over 1,100 places by 2031/32. The BDA has described this move as an attempt to “fill a leaky bucket.” Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce – or further reduce – their NHS work.

British Dental Association Chair Eddie Crouch said: “Ministers need to make the NHS a place young dentists would choose to work. Not handcuff the next generation to a sinking ship. Seeing the detail, nothing changes our view that government is trying in vain to fill a leaky bucket. It’s an exercise in futility training more dentists who don’t want to work in the NHS.”

The professional body says it is also striking that dentistry appears to be the exception to the rule on reducing dependence on overseas labour.

The dental regulator, the General Dental Council, has recently gone on the record stating bringing in more dentists will not solve problems fuelled by broken contracts.

“Improving the throughput of those from overseas who want to be registered in this country is the right thing to be doing,” said GDC chair, Lord Toby Harris at the Annual Conference of Local Dental Committees earlier this month. “But it is not some magic bullet that will solve the problems in NHS dentistry.

“If the contractual terms by which NHS services are provided are unattractive to many dentists currently on the register, then there is no reason why those same terms will be any more attractive to new registrants – whether they are from overseas or who qualify here.”

The Government has consistently championed the import of overseas dentists. There are currently around 1,500 candidates waiting to sit Part 1 of the Overseas Registration Examination (ORE). While the BDA supports urgent action to deal with this huge backlog, it does not represent a solution to the access crisis.

BDA: Workforce plan latest attempt to fill a leaky bucket

The British Dental Association warn plans to boost dentist numbers represents an exercise in futility without first tackling the failed, underfunded systems driving practitioners out of the NHS.

The NHS Long Term Workforce Plan, set to be published tomorrow, is understood to state ambitions to train thousands more dentists by 2030.

The professional body stress the government has only brought forward minor tweaks to the discredited NHS contract fuelling retention problems, and with it the access crisis facing millions across England. In the absence of change, dentist leaders say any gains in capacity risk being lost, and at pace.

Over half (50.3%) of high street dentists responding to recent BDA surveys reported having reduced NHS commitments since the start of the pandemic. 74% stated their intention to reduce – or further reduce – their NHS work. This movement is not being tracked by official data, which counts heads, rather than commitment, and gives dentists who do just one NHS check-up a year the same weight as an NHS full-timer.

The BDA has long advocated a fully funded workforce plan to address the ongoing crisis in the service. However, with the NHS’s 75th birthday just days away recent government pledges for a fast tracked ‘recovery plan’ for NHS dentistry have yet to bear fruit. Contrary to consistent claims made by the PM that the number of NHS dentists has bounced back, official figures secured last month by the BDA under freedom of information indicate just 23,577 dentists performed NHS work in the 2022/23 financial year, over 1,100 down on numbers pre-pandemic, a level not seen since 2012.

British Dental Association Chair Eddie Crouch said: “This workforce plan is government’s latest attempt to fill a leaky bucket.

“Failed contracts and underfunding are fuelling an exodus from this service. There’s little point training more dentists who don’t want to work in the NHS.”

The dental regulator, the General Dental Council, has recently gone on the record stating bringing in more dentists will not solve problems fuelled by broken contracts.

“Improving the throughput of those from overseas who want to be registered in this country is the right thing to be doing,” said GDC chair, Lord Toby Harris at the Annual Conference of Local Dental Committees earlier this month. “But it is not some magic bullet that will solve the problems in NHS dentistry.”

“If the contractual terms by which NHS services are provided are unattractive to many dentists currently on the register, then there is no reason why those same terms will be any more attractive to new registrants – whether they are from overseas or who qualify here,” he added.

The Government has consistently championed the import of overseas dentists. There are currently around 1,500 candidates waiting to sit Part 1 of the Overseas Registration Examination (ORE). While the BDA supports urgent action to deal with this huge backlog, it does not represent a solution to the access crisis

BDA Scotland: Covid impact on scale unseen in any other part of NHS

The British Dental Association has warned MSPs the pandemic has had an unparalleled impact on NHS dentistry, that leaves the service facing an existential threat. 

As the professional body prepares to give evidence to the Covid-19 Recovery Committee inquiry into NHS dentistry today (22 June 2023), it has published new analysis showing the scale of the backlogs.

Initially closed to routine care, and then facing exacting Infection and prevention control guidelines that reduced patient throughput, lost capacity on the high street exceeds general medical practice and secondary care, resulting in backlogs that will take many years to clear:

  • Dentistry has lost over half (52%) of its capacity since lockdown, when comparing examinations delivered since March 2020 with typical levels pre-Covid.
  • For GPs, that figure is just over 30% (when looking at lost face-to-face appointments). It is just over 6% for hospital outpatients and in terms of volume, inpatient care appears to have already recovered lost ground.
  • By any measure captured in official data, whether it is examinations or Statement of Dental Remuneration (SDR) activity claims, Scotland has lost more than a year’s worth of NHS dentistry.
  • Ongoing access problems are fuelling backlogs, with patients presenting with higher levels of clinical need. In recent BDA surveys over two thirds (67%) of dentists cite higher needs patients requiring more clinical time as a key issue on return to ‘full’ capacity. The only comparable problems are those concerning recruitment and retention of dentists (61%).

Dentist leaders say it will be impossible to restore pre-pandemic activity without radical change. The low margin/high volume model the service works to was incompatible with working through the pandemic and cannot form the basis for a meaningful or sustainable recovery.

This leaves the service at a crossroads: with a contract that is unfit for purpose, underfunded, overstretched and facing the challenge of deep and widening oral health inequalities. BDA Scotland fear that an exodus of dentists from the NHS is already in motion. This shift is going unseen in official data, that counts heads not the amount of NHS work dentists do. These workforce statistics give an NHS full-timer the same weight as a dentist doing one NHS check-up a year.

Recent BDA surveys indicate only 1 in 5 (21%) of practices have returned to pre-Covid-19 capacity. The professional body say hard limits on restoring capacity, and the existential threats to NHS dental services require a proportionate response from the Scottish Government.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “Covid hit dentistry like no other part of the NHS in Scotland. We’re not asking for special treatment, just a proportionate response. One that recognises the scale of the backlogs and the existential threat to this service. NHS dentists are already walking away from a broken system. There can be no recovery without reform.”

BDA: Leeway on record breaking underspends won’t be enough for hundreds of practices

The British Dental Association has responded to news that NHS practices in England will be given some leeway from unprecedented underspends for the financial year 2022/23 that were set to take away more than 10% of the service’s budget.

NHS England has stated it will not recover funds for under delivery of contractual targets at the expected tolerance level of 96%, instead working to a revised lower performance tolerance of 90%.

The professional body has been doggedly calling for NHS England to take action to support practices who are struggling to deliver their contractual commitments, often simply as a result of being unable to fill vacancies. In the spring it speculated that more than £400m was set to be lost from the frontline as a result of clawback, a figure that was looking increasingly like a conservative estimate.

Some practices may now have leeway as a result of this change, having only just missed their target. However, dentist leaders stress a large number of practices will still face very significant clawback through no fault of their own, and that total clawback will likely break all records. It has renewed its call for funds to be ringfenced and used creatively to underpin the government’s pledged recovery plan for NHS dentistry.

This change only allows for activity to be carried over to the next financial year, it is not ‘written off.’ The BDA warn this will only store up problems for next year, particularly in the absence of needed reform to make the service sustainable. This is likely to be just a problem deferred for those many practices unable to significantly increase their activity this year.

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee, said: “With record breaking sums set to be lost from the frontline the government has moved the goalposts. It will come too late for the dentists that have already called time on NHS work. And it won’t be enough for the hundreds about to be pushed to the brink. Ultimately this will only delay the inevitable for countless struggling practices.

“What we are yet to see is a willingness to put these funds to work, making NHS dentistry sustainable. That should form the basis of any credible rescue plan.”

BDA: Exodus accelerates, with NHS numbers lowest in a decade

The British Dental Association has urged government to drop any pretence that NHS dentistry is on the road to recovery and finally deliver a meaningful rescue package, as the exodus from the service reaches new heights.

Freedom of information requests undertaken by the BDA indicate just 23,577 dentists performed NHS work in the 2022/23 financial year, down 695 on the previous year, and over 1,100 down on numbers pre-pandemic. The crash brings the workforce to levels not seen since 2012/13. [1]

These official figures are at odds with repeat claims from the Prime Minister that recent reforms have boosted dentist numbers [2], arguments also made by ministers and officials in evidence to the current Health and Social Care Committee inquiry into the crisis in NHS dentistry. [3] The BDA understands several MPs have already sought corrections to the official record, and there are now at least 7 instances where they have a basis to proceed.

The PM has stated time and again that 500 additional dentists recorded as delivering NHS work in the 2021/22 financial year reflect the success of recent government reforms. The minor tweaks to the discredited contract fuelling the current crisis were rolled out in October 2022, so do not even correspond to the year the PM chose to cite. The BDA believes that any ‘bounce’ in 2021/22 likely reflects the unique circumstances from the first year of COVID in which practices were closed from lockdown to June.

The professional body stresses that recent commitments to develop a ‘recovery plan’ for dentistry were made by government based on false assumptions that the workforce had ‘turned a corner’. It says there can be no more tinkering at the margins, and real commitment is now required to form the basis of a rescue package, simply to stabilise the service ahead of longer-term negotiations on wholesale reform.

The BDA believes that the clearest way forward is to utilise record-breaking ‘underspends’ in the dental budget to bring a degree of sustainability to practices on the brink. The BDA estimated in February that funds returned by practices not hitting their contractual targets would likely exceed £400m this year, or over 10% of the total NHS budget. The BDA now believe this was a very conservative estimate. Practices face huge financial penalties often as a result of being unable to fill vacancies.

The BDA says a new higher minimum Unit of Dental Activity (UDA) value could bring all practices in line with areas with the strongest access levels, give them the chance to fill vacancies, support retention and operate more sustainably in the face of soaring costs. The BDA stress any costs could be kept within the anticipated levels of clawback for 2022/23. A minimum UDA level of £23 was rolled out in October, lower than the current patient charge level of £25.80, and below the level required for most practices to cover their costs or attract new dentists.

In August the PM pledged a Five-Point Plan for dentistry, including commitments to ring fence NHS dentistry funding. [4] The BDA’s approach builds on this, and echoes observations made by Broadland’s Jerome Mayhew MP, who in a recent debate urged members to “follow the money”, noting that the best areas for access “spend nearly £80 per mouth per year on dentistry; in the East of England, the figure is £39—a full 50% less.”

The BDA stresses the fall in workforce numbers significantly understates the full scale of lost capacity within NHS dentistry. The government counts heads not NHS commitment. A recent BDA survey of dentists in England revealed over half of dentists (50.3%) had reduced the proportion of NHS work they did since the start of the pandemic – by more than a quarter. 74% indicated they plan to reduce – or further reduce – the amount of NHS work they undertake in the year ahead. [5]

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said: “Government needs to drop the spin, accept the facts, and provide a rescue package to keep this service afloat. “NHS dentistry is haemorrhaging talent, and further tweaks to a broken system will not stem the flow.

“The PM once called for this budget to be ring fenced. We face an access crisis, and with hundreds of millions set to be pulled away, funds must be put to work solving these problems. Ministers have a choice. They can help thousands of struggling practices fill vacancies and see patients, or just pass by on the other side.”

References:

[1] Number of dentists with NHS activity,

Data for 2011-12 to 2021-22 from NHS Dental Statistics. *Data for 2022/23 financial year from Freedom of Information request from NHS Business Services Authority. This is expected to form part of NHS Dental Statistics 2022/23 due this coming August. 

[2] Comments from the Prime Minister, Rt Hon Rishi Sunak MP

The British Dental Association had disputed wholly misleading claims on workforce numbers, funding and reform made since the start of the year. Even setting aside underspends of over £400m, the £3bn dental budget has remained almost unchanged for a decade, failing to keep pace with inflation and population growth, with patient charges forming an ever-greater share of total spend in the run up to COVID. The marginal changes to the NHS contract rolled out in November change none of the fundamental perversities of the target-based system. Dentists used to be paid the same whether they did 1 filling or 10. Now they are paid the same for 3 fillings or 10.

Wednesday 11 January 2023

Cat Smith (Lancaster and Fleetwood) (Lab)

There are no NHS dentists taking on patients in Lancaster and Fleetwood, and those constituents of mine who are lucky enough to have one are waiting months for an appointment. How long did the Prime Minister have to wait for his last NHS dentist appointment?

Prime Minister

As a result of the new reformed NHS dentistry contract, there are now more NHS dentists across the UK, with more funding, making sure that people can get the treatment they need.

Simon Lightwood (Wakefield) (Lab/Co-op)

Less than half of Wakefield’s children managed to see an NHS dentist last year. My constituent Mr Faqirzai’s six-year-old daughter has never seen an NHS dentist. She has 10 teeth that are black with decay and is often crying in pain. Her father feels helpless. He has called every dentist in Wakefield for a place but has not managed to secure one. More than 25% of five-year-olds in Wakefield already have visible tooth decay, so when will the Prime Minister stop dithering and take action to address our national dental emergency? (902917)

The Prime Minister

I am very sorry to hear about the case raised by the hon. Gentleman, and I am happy to look into that specific one more closely. As I said in answer to an earlier question, we have recently reformed the NHS dentistry contract, and the hundreds of millions of pounds more funding and more dentists should make a difference around the country, but I will write to him on that specific case.

Wednesday 8 March 2023

Mr Richard Bacon (South Norfolk) (Con)

The adjustments to the dental contract last November were a welcome step, but there is more work to do. Will the Prime Minister therefore keep this area under the closest review to ensure that constituents such as mine in South Norfolk and those of other hon. Members get the best possible dental care?

The Prime Minister

My hon. Friend raises an excellent point. I can tell him that we are continuing to invest in NHS dentistry, with £3 billion a year, and we have also enabled practices to do 10% more activity on top of their contracts and removed the barriers so that hygienists and other therapists can continue to work to their full skillset. The number of NHS dentists has increased by about 500 over the last year and we will continue to work with the sector to see what more we can do.

Wednesday 15 March 2023

Judith Cummins (Bradford South) (Lab)

Every child in the UK is entitled to free NHS dental treatment, but with 80% of practices not accepting children as new patients, is the Prime Minister proud of his record on our children’s dental health?

The Prime Minister

We are investing £3 billion in NHS dentistry. Because of the reforms to the contract, there will be about 10% more activity this year above contracted levels. There are 500 more dentists in the NHS today and, I think, almost a 45% increase in the amount of dental care being provided to children.

Wednesday 19 April 2023

Ed Davey (Kingston and Surbiton) (LD)

Tooth decay is the No. 1 reason that children over the age of four end up in hospital. Regular dental check-ups could prevent it, but too many parents cannot get one for their child. In the East Riding of Yorkshire, there are now almost 3,000 people per NHS dentist. In places such as Herefordshire and Norfolk, fewer than two in five children have been seen by a dentist in the past year. This is a scandal, so will the Prime Minister take up the Liberal Democrat plan to end this crisis and make sure people can get an NHS dentist when they need one? The Prime Minister The NHS recently reformed dentistry contracts, which will improve access for patients. Dentistry receives about £3 billion a year, and there were around 500 more dentists delivering care in the NHS last year than in the previous year. I am pleased to say that almost 45% more children saw an NHS dentist last year compared with the year before.

Wednesday 3 May 2023

Mary Kelly Foy (City of Durham) (Lab)

 Unable to secure an NHS dental appointment, my constituent Ray was forced to go private. It was then discovered that he had a large, aggressive tumour in his face and jaw, and 16 hours of gruelling surgery was required to remove it. If he had not been able to afford it, Ray might not be with us now. This is yet another chapter in the horror story that is the decay of dentistry on this Government’s watch, so does the Prime Minister accept that NHS dentistry is in crisis, and will he meet me and the British Dental Association to ensure that no one loses their life because they could not get a dental appointment—yes or no?

The Prime Minister

I am sorry to hear what happened to the hon. Lady’s constituent. That is why the NHS has recently reformed dental contracts to improve access. We now invest more than £3 billion a year, and there are more than 500 more dentists working in the NHS this year than last year. Discussions are ongoing between the Department of Health and Social Care and the NHS around dentistry, and DHSC is planning to outline further reform measures in the near future.

Wednesday 10 May 2023

Clive Lewis (Norwich South) (Lab)

Two years ago, I raised the case of a Norwich Army veteran who was in such agony that he was forced to pull out 18 of his own teeth because he could not get access to a dentist. The grim fact is that despite repeated promises from the Prime Minister, Norwich and Norfolk remain dental deserts. Dentists excel at extracting rotten teeth, so does the Prime Minister agree that the only way my constituents will see results is when this rotten Government are extracted from office and replaced with a Labour one?

The Prime Minister

I am very sorry to hear about the hon. Gentleman’s constituent. The hon. Gentleman will know that there are record sums going into dentistry and indeed 500 more NHS dentists working today. Because of the contract reforms that we have put in place, 10% more activity can happen, and the Department of Health and Social Care is currently talking about reforming the dentistry contract with dental practices to increase activity further.

[3] Comments from Neil O’Brien, Parliamentary Under-Secretary of State for Primary Care and Public Health at Department of Health and Social Care

25 April 2023. This evidence was made after the end of the 2022/23 financial year in which collapse of workforce numbers took place. 

To Health and Social Care Committee inquiry into NHS dentistry

Neil O’Brien: There are about 6.5% more dentists doing NHS work than in 2010; about 2.3% more than last year. We know that the number of people seen is up by about one fifth on the year to March, compared with the year before. There are not a fifth more dentists than there were a year ago, but they are doing more NHS work. Because of the nature of NHS dentistry, dentists are constantly able to choose between doing NHS work and the kind of Instagram dentistry that the CDO just talked about. We need to make NHS work attractive in that context. That is about contracts, about how much people are paid, and about fair payment.

[4] 18 August 2022, Statement ‘Restoring NHS dentistry’.

“Rishi will strengthen the protections around the annual NHS dentistry budget (approximately £3bn per annum), to ensure it is maintained exclusively for frontline dental services. As part of this ring-fencing exercise, commissioners in rural areas will be required to demonstrate how they are securing provisions for communities who do not live close to a dentist, including exploring mobile clinics and delivering services at alternative sites.”

Rishi Sunak said: “NHS dentistry is under unprecedented pressure with people unable to get the treatment they need, leaving them in pain or forced to fork out thousands for private care.

“My five-point plan will be activated on day one to free up dentistry professionals to do their jobs, encourage NHS trained dentists to stay in the NHS, and focus on prevention as that is always better than the cure.

“As Prime Minister, I’ll be focused on getting the British people more bang for our buck from our NHS.”

[5] BDA survey of 1,921 General Dental Practitioners in England, fieldwork December-January 2023

Cuts will take a wrecking ball to NHS dentistry in Northern Ireland

The British Dental Association Northern Ireland has slammed analysis by the Department of Health suggesting that cut of over £1/4 billion can be achieved without damage to services.

The document claims: “With a sustained effort across the HSC system, it is anticipated savings and efficiencies can yield in the region of £260 million.“. It adds: “While savings at this scale cannot be made without some impact, our analysis suggests measures up to this value can be delivered without long-term or irrevocable damage to services.”

The Department has confirmed the Rebuilding Support Scheme (RSS), which allows eligible General Dental Practitioners (GDPs) to apply for a 10% enhancement to the Item of Service fees claimed for Health Service treatment provided, will be cut at the end of the first quarter in 2023/24. Meanwhile, the DoH Budget Equality Impact Assessment (EQIA) also warns that as things currently stand, it will not be possible to offer a pay award in 2023/24, further undermining a service with chronic recruitment and retention problems.

The news follows a recent open letter by the profession, warning that cuts will have a devastating impact.

Ciara Gallagher, Chair of the British Dental Association’s Northern Ireland Dental Practice Committee said: “Whoever claimed that savage cuts can be delivered without damaging NHS dental services could not be more wrong. Cuts have consequences and these will be irreversible. Officials risk taking a wrecking ball to services patients across Northern Ireland depend on.”