Dental charges: Patients delaying treatment

With NHS dental charges in England set to jump by an historic high of 8.5% today (Monday April 24), the British Dental Association has warned government that costs are now shaping the clinical choices made by millions of patients.

The professional body has urged Ministers to follow the lead of public opinion and break with its long-term strategy of using charge increases as cover for cuts in government spending on NHS dentistry.

A new survey by YouGov of adults in England shows:

• Nearly a quarter (23%) report delaying or going without NHS dental treatment for reasons of cost
• 45% say the price shapes the choice of treatment patients opt for, more than those following the clinical recommendations of their dentist (36%)
• An overwhelming majority support a break from the government’s current model of ramping up charges while reducing government spending. 38% say dentistry should be fully funded by government through general taxation, effectively free at the point of delivery. 29% say funding from government should increase, while maintaining some patient charges. Similar levels of support are clear among all political allegiances, social classes, and regions. A further 16% say charge levels should remain unchanged
• There is strong support for extension of free NHS dentistry to groups not currently covered, with 82% saying exemptions should cover cancer patients, whose treatments can cause severe dental problems

In light of this evidence the BDA has urged the government to reject plans broadcast by Whitehall sources for a further 4% increase in charges next year, and to fully appreciate the impact charges have on lower income, higher needs patients. While some adult patients are exempt from charges, many on modest incomes still have to pay, including many recipients of low-income benefits such as Universal Credit. Dentist leaders warn that any repeat of these choices from government will inevitably widen already significant oral health inequalities.

The BDA has rejected claims from Minister Neil O’Brien that the increase “will raise important revenue for pressurised NHS budgets” stressing funds raised will simply become a substitute for state investment. NHS dentistry’s effectively static budget has remained at around £3bn for the best part of a decade, with patient charges forming an ever-greater share of the total pot. Direct Government spend on dentistry was lower as the country headed into the pandemic than it was in 2010.

The BDA told the Health and Social Care Committee inquiry last month that saving NHS dentistry will require a sustainable funding settlement. Since 2010 Spending on dentistry has failed to keep pace with both inflation and population growth. The UK now spends the lowest share of its health budget on dentistry of any European nation, with England spending the lowest amount per head of population of any UK nation.

The BDA stress no other UK nation has followed this model, with the latest hike following a decade of inflation busting rises. A band 1 treatment like a check-up will now cost £25.80 in England, but just £14.70 in Wales. A band 3 treatment like dentures will now cost £306.80 in England and just £203.00 in Wales.

BDA Chair Eddie Crouch said:

“This hike won’t put a penny into NHS dentistry, it will just force millions to think twice about needed care.

“Sadly, widening health inequality is a price this government seems willing to pay to cover for cuts.

“This is not a partisan issue. The public recognise this is not the way to fund a core part of our health service.”