OPINION: Urgent reform needed to stop dental industry decaying

Steff Aquarone says nearly 1,000 dentists left NHS dentistry in England last year

Steff Aquarone says nearly 1,000 dentists left NHS dentistry in England last year - Credit: Getty Images/iStockphoto

Some MPs in Norfolk have rightly said that we need more dentists. But their proposed solution of a dental training college misses the point.

Dentistry courses last five years, plus up to two years of supervised practice, so even if more money were ploughed into training tomorrow, it would take years before the results affected the current shortage.

Besides, the whole system is broken.

Dentistry was in crisis before Covid-19, with NHS commitments on the wane and many younger dentists simply not seeing a future for themselves in the service.

The government urgently needs to bring forward long overdue reforms to the NHS dental contract, which was established in 2006.

The contract limits the number of NHS appointments available, even though dentists often have available time slots to fill. It prevents dentists from seeing NHS patients when they need to be seen, and expects them to meet higher patient targets when there are local closures - often without the full payment required.

It also includes perverse disincentives that mean dentists can be paid similar rates for doing one filling as they are for extensive dental work. NHS contracts can end up being handed back because they become unviable.

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Dental health has improved over the past two decades; fewer older people are resorting to a full set of false teeth, and more working age people are in customer-facing roles where they are more conscious of their appearance.

All of this means the demands on the system are greater – and yet, government seems to have decided that access to an NHS dentist isn’t a universal right for every person and that only those with the most urgent dental emergencies are seen.  Fewer routine appointments will simply lead to more emergency fixes later on.

Government also plans to bar non-UK-trained dentists from practising in the UK from 2023 even though 22% of dentistry care and treatment is provided by dentists from the European economic area.

Swift action is needed to reduce the impact that Brexit will have on those who have received their training in the EU but whose qualifications are no longer going to be recognised in the UK.

This can be done by looking at international dentistry qualifications. The overseas registration examination only has 500 places available annually in the UK and the Association of Dental Groups has recommended the numbers should be increased, and the examination offered in candidates’ home countries.

Then there is the issue of funding. After a decade of savage cuts to public services, the Government must provide adequate resources as a matter of urgency to reverse the alarming decline of NHS dentistry and guarantee its long-term sustainability.

A recent, time-limited, £50 million injection nationally will fund less than 1% of the 40 million appointments that have been lost since the start of the pandemic.

The British Dental Association has described the government’s response to the crisis as one of “soundbites instead of straight answers.”

Nearly 1,000 dentists left NHS dentistry in England last year, but this is just the tip of the iceberg.

Two thirds of dentists in England have indicated they are set to reduce their NHS commitment, with more than a third stating they plan to go fully private in the next year. Less than half are confident their practice will continue to provide any NHS services from April 2022.  

As Wera Hobhouse MP said: "The current crisis will not improve unless we make it viable for dentists to provide NHS treatments and make NHS dentistry a place where people want to work.

"Dentists in my constituency have told me that they want to provide NHS treatment but just cannot make it viable under the current conditions.”

A new system is needed now and should be one that prioritises prevention, is patient-centred and reflects modern dentistry.

Steff Aquarone is parliamentary spokesperson for North Norfolk Liberal Democrats