NHS

Dentists effectively told to keep NHS afloat out of their own pockets, says BDA

The British Dental Association has said government has effectively told the profession it cannot afford NHS dentistry, as it prepares to impose an approach to pay that will leave a gaping hole in the service’s budget which practices across England will be expected to fill.

Despite having publicly accepted the independent pay review body’s recommendation of a pay increase of 6%, the Department of Health has refused to reflect the soaring operating costs of delivering NHS care. It is imposing a rock bottom uplift of 3.23% to cover expenses leaving a total uplift in NHS contract values of just 5.13%.

Based on survey data measuring the costs facing practices, the BDA estimate a total uplift of 8.3% would be required as a bare minimum, simply for the service to stand still with the promised 6% pay rise. The uplift leaves a gap of over £100m in the NHS budget that already struggling practices will have to plug out of their own pockets. The BDA say its warnings to Ministers that this will only accelerate the drive to the private sector – as practices endeavour to remain financially viable – have gone unheeded.

The professional body stress it will be effectively impossible for practices to pass on recommended pay increases to their teams, further escalating the chronic recruitment and retention problems in the sector, that are leaving millions unable to access care.

In its dialogue with government the BDA say officials categorically accepted that its figure of 3.23% is not based on hard evidence of the levels of costs facing practices, but simply reflects what the Government felt it could afford. In a break from its usual model of using CPI inflation to establish the costs of delivering NHS dentistry – which would have generated an uplift of 8.7% – the Department chose another measure – the GDP deflator – which appears a cynical measure designed purely to keep costs down.

Dentist leaders say this approach risks fatally undermining the forthcoming ‘recovery plan’ for NHS dentistry, expected for imminent publication. In July the Health and Social Care Committee described the state of the service as “unacceptable in the 21st century”, and set out recommendations to government for real, urgent reform, alongside a call for the coming recovery plan to be underpinned by necessary funding.

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said: “If Government can’t afford NHS dentistry, dentists can’t be expected to prop it up out of their own pockets. This penny pinching will derail the promised ‘recovery plan’. It’s an insult that will force practices to increase private work simply to stay afloat.”

BDA: 4am queues for NHS care risk becoming the new normal

Dentists: 4am queues for NHS care risk becoming the new normal

The British Dental Association has urged government to step up as Leigh, Greater Manchester, joined the growing list of communities where struggling patients have queued from the break of dawn to secure access to NHS dentistry.

Daily queues starting as early as 4am have been reported outside the Avenue Dental Centre in Leigh town centre, which offers appointments to all NHS patients on a first-come-first-serve basis.

This follows reports from Faversham, Kent, last month, where a practice received 27,000 calls for just 60 NHS slots, and in Kings Lynn which in May saw queues of more than 300 also form from 4am.

Wannabe patient Leah Price, who requires regular dental treatment as a result of Chron’s Disease, photographed the scenes. Leah told local media: “the people working in the NHS are trying their hardest.

“But in this country, people should not be camping outside a dentist at 4am on camp chairs just to get on the NHS patient list, it’s wrong.

“Dental treatment is just as important at the end of the day as other health issues and I’m just in disbelief that this is where we are at.

“I wasn’t expecting to be added to waiting lists that are two years long and to be within a chance of being seen, I need to camp outside.

“I also have a child that I have to take to school, so waiting outside for hours isn’t an option for me, it’s a mess.”

A recent Health and Social Care Committee inquiry described the state of the service as ‘totally unacceptable in the 21st century’, setting out fundamental changes centred on reform of the dysfunctional NHS contract dentists work to. The BDA has urged the government to sign up to this reform plan, which it has characterised as an ‘instruction manual’ to save NHS dentistry. A recovery plan for the service – pledged by government in April – has yet to be published. Dentist leaders warned that without fundamental reform the exodus of dentists from the NHS will grow, and the service will not have a future.

Analysis undertaken by the BDA of recent government data indicates unmet need for dentistry in 2023 stands at over 12 million people, up a million on 2022 figures, and now well over one in four of England’s adult population. Over six million adults tried and failed to get an appointment in the past two years, and 4.4 million simply did not try because they thought they could not secure one. Those put off by cost are now equivalent to over 1.1 million adults, those on waiting lists estimated at around 600,000.

Figures are now nearly three times pre-pandemic totals. In 2019 unmet need sat at over 4 million people, or nearly one in ten adults.

BDA Chair Eddie Crouch said: “These scenes have no place in wealthy 21st century nation, but risk becoming the new normal for millions of patients.

“The Conservative Party will gather in Greater Manchester in little under a month. Ministers need to come armed with solutions to this crisis or NHS dentistry won’t have a future.”

NHS dentistry: No return to ‘business as usual’ for struggling service, says BDA

The British Dental Association has stressed latest official figures show there is no prospect of NHS dentistry bouncing back to pre-Covid levels without radical and urgent change.

NHS Dental Statistics 2022/23, published today, show the service is still struggling to return to pre-pandemic norms, with the 32.5 million courses of NHS treatment delivered sitting at just 82% of the 39.7 million provided in 2018/19. The professional body warns limited gains in the last year will not take the edge of an ever-growing backlog, as patients present with higher levels of need, the result of ongoing access problems.

Just 18.1 million adults in England were seen for NHS dental treatment in the 24 months up to June 2023, 17.5% lower than the 22 million seen in the 24 months up to June 2019. Just 6.4 million children were seen in the 12 months to June 2023, down 9% on figures for 2019.

Minor tweaks to the discredited NHS contract fuelling the crisis in NHS dentistry were rolled out during this financial year. The BDA say that the fact the number of dentists delivering NHS care has continued to fall – down 121 on last year – reflects to the wholesale inadequacy of these changes. 24,151 dentists are recorded as performing NHS work in 2022/23, over 500 down on numbers before lockdown.

The recent Health and Social Care Committee inquiry described the state of the service as ‘totally unacceptable in the 21st century’, setting out fundamental changes centred on reform of the dysfunctional contract. The BDA has urged the government to sign up to this reform plan, which it has characterised as an ‘instruction manual’ to save NHS dentistry. A recovery plan for the service – pledged by government in April – has yet to be published.

Dentist leaders have long warned that without fundamental reform the exodus of dentists from the service will grow, and the service will not have a future.

This month a dental practice in Faversham, Kent, received 27,000 calls and saw patients queuing overnight to compete for just 60 NHS places.

Eddie Crouch, Chair of the British Dental Association, said: “We’re seeing the limits on the recovery and this government’s ambition. Demoralised dentists are walking away from a broken system, while millions struggle to access the care they need. NHS dentistry can come back from the brink, but only if Ministers turn the page.”

First cohort of Oral Health Practitioner Apprentices complete their courses

The first cohort of Oral Health Practitioner Apprentices received their awards in May, making them the first recipients of the Royal Society of Public Health Diploma for Oral Health Practitioners. 

This Oral Health Practitioner apprenticeship, alongside a Dental Practice Manager apprenticeship and an Orthodontic Therapist apprenticeship, is designed to support recruitment and retention within the dental nurse workforce as well as help to free up time and resources. The Oral Health Practitioner apprentices, of which there are seven in total, are now fully qualified to work as oral health practitioners delivering care and treatment to patients alongside dentists in practice.

This new and innovative programme is the only formal qualification of its kind, with a strong emphasis on not only oral health education and promotion, but also the links between systemic disease and oral health, connecting this apprenticeship to the NHS Long Term Workforce Plan which has a strong emphasis on investing in prevention.

The dental nurses came from dental practices and salaried dental service in the Thames Valley and Wessex region. 

The apprenticeship was delivered by a team from the Workforce Training and Education Directorate of NHS England.

The curriculum focus is on the following knowledge areas:

  • An understanding of common medical conditions and how they can impact on oral health and wellbeing
  • Head and neck anatomy, physiology, the prevention of dental caries and periodontal disease
  • Diet, nutrition, hydration, and their links with systemic and oral health
  • An understanding of differing patient group needs across the life course and the management of patients with learning disabilities, dementia and mental health conditions. 
  • The theories that underpin models of learning in individuals and groups to change behaviour.
  • Theories and concepts of motivational interviewing
  • Supporting behaviour change with individuals ( e.g. in a dental surgery) and with groups (e.g. health and social care professionals, ante natal groups etc)

They also acquired the following skills,

  • Performing intra oral skills in taking plaque scores, impression taking, intra oral scanning, application of topical fluoride, intra and extra oral photography
  • Carrying out brief clinical preventive advice interventions and targeted group interventions
  • Provide both oral and general systemic health advice such as smoking cessation
  • Able to provide behaviour change advice and support to individuals and groups across the life course with different cognitive abilities.
  • Provide motivational interviews.
  • Undertake standard NHS health checks for diabetes and blood pressure

Michael Wheeler, Dental Workforce Advisor at NHS England and Course Director, said: “This apprenticeship is one of three that is designed to support recruitment and retention within the dental nurse workforce, the others being the dental practice manager and orthodontic therapist.

“For dental practice owners and salaried dental services, it provides a better trained workforce to embrace flexible commissioning at a local level especially in delivering oral health education and promotion. 

“The oral health practitioner apprenticeship will allow individuals to further progress to become dental hygienists and dental therapists, for which an apprenticeship route is currently being explored by NHS England and the Institute of Apprenticeships and Technical Education.

“This apprenticeship is designed to support widening participation into dental hygienist and dental therapist training and contribute to the ambition to increase training places by up to 40% by 2031 / 32 which is set out in the NHS Long Term Plan.”

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.

Jason Wong named interim CDO England

Jason Wong, who has served as Deputy CDO England since June 2020, has been named as Interim Chief Dental Officer England as Sara Hurley prepares to depart from the role of CDO England at the end of June.

Sir Stephen Powis, NHS National Medical Director, confirmed the news, stating: “Representing the entire dental profession across England, the role of the Chief Dental Officer is a joint appointment between Department of Health and Social Care and NHS England, with their base in NHS England.

“I am pleased to inform you that Jason Wong will take over from Sara on an interim basis while we recruit for a permanent replacement.”

Recruitment for a permanent CDO England will begin soon.

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

Scottish Dentist juniors to join strike action

The British Dental Association has announced that dentists in Scotland employed under the same contract as junior doctors, will join their medical colleagues in a 72-hour walkout, the dates of which are yet to be confirmed, if BMA ongoing negotiations with the Scottish government do not result in a credible pay offer.

The overwhelming majority of voters (91%) from this small but important cohort backed industrial action, on a turnout of 79%.

British Dental Association Chair Eddie Crouch said: “Our members stand ready to do whatever it takes to secure a fair deal on pay. Just like their medical colleagues these dentists aren’t worth a penny less than they were a decade ago. We are hopeful that a negotiated settlement can be found. But our members will take strike action if the Scottish Government fail to come back to the table with a serious pay offer.”