NHS ‘Recovery Plan’ unworthy of the title

The British Dental Association has said government failure to embrace fundamental reform of NHS dentistry risks condemning a generation to decay and widening oral health inequality.

The professional body says the Recovery Plan, is incapable of even beginning to honour Rishi Sunak’s promise to ‘restore’ NHS dentistry, or in any way meet the Government’s stated ambition to provide access to NHS dentistry for ‘all who need it’.

The plan sets up a ‘new patient premium’, which will give a bonus to dentists seeing a patient that hasn’t undergone treatment in two years – £15 to first see them, £50 if the need significant work done. It also raises the minimum Unit of Dental Activity (UDA) value from the current level of £25.33 to £28.

The professional body had strenuously made the case for the Government to ensure dentists treating higher needs new patients that require more time in the chair, do not end up providing NHS care at a financial loss. It warns progress does not go anywhere near far enough to stop dentists – who operate as contractors not as NHS employees – being forced to cover costs out of their own pockets, particularly for treatments like dentures or crowns that require laboratory work.

There is no new money for this New Patient Premium, and so any new patients seen are just recycling the same limited pot of money. Factoring in late uplifts to contracts already promised by Government the BDA estimate less than 900 of the approximately 8000 NHS contract holders in England are likely to benefit from the higher UDA rate.

The £200m in ‘new’ money pledged is less than the half the underspends in the budget expected this year, the result of practices struggling to hit their punitive government targets. The BDA stress the ‘ring fence’ promised by Ministers to protect the dental budget remains an exercise in semantics, and that budget raids will remain the norm in cash-starved Integrated Care Boards.

Any additional investment will barely begin to compensate for a decade of frozen budgets. Last month Department of Health and Social care accounts revealed the service’s £3bn budget has barely changed in a decade, with no effort to keep pace with demand, or rising costs. In real terms the budget has been cut by over £1bn since 2010.

The plan falls well short of the criteria set by the Health and Social Care Committee in its damning inquiry into dentistry. The BDA believes it singularly fails offer MPs’ call for the “scope and ambition… to immediately address the crisis of access people across the country are experiencing.”

The Government has ruled out reform of the discredited contract fuelling the exodus from the NHS. The Committee had stressed “fundamental reform of the dental contract is essential and must be urgently implemented, not only to address the crisis of access in the short-term, but to ensure a more sustainable, equitable and prevention-focussed system for the future.” In the absence of any meaningful change the BDA describe the package as amounting to little more than an exercise in ‘rearranging the deck chairs.’

With oral health inequality now widening the BDA has also said pledges merely to consult on preventive programmes like water fluoridation in the North East are close to meaningless, and that frontloaded investment in tried-and-tested schemes like supervised brushing are needed now.

Police have recently had to break up crowds of hundreds attempting to get on the books with a new practice in Bristol. In the face of ongoing access problems new BDA surveys indicate 8 in 10 dentists have treated patients that have undertaken some form of ‘DIY’ dentistry since lockdown, amid reports of life-threatening dental sepsis surging, and British nationals even choosing to head to the Ukraine for care.

Leaks to the Daily Telegraph indicated that government was attempting to limit the political damage the crisis is doing in the coming General Election. The BDA stress the inadequacy of this plan will effectively ensure dentistry remains a major issue on the doorstep. The professional body will be working alongside the Daily Mirror and 38 Degrees to mobilise the public, to push for real change. https://38d.gs/SaveNHSDentistry

Shawn Charlwood, Chair of the British Dental Association’s General Dental Practice Committee said:

“This ‘Recovery Plan’ is not worthy of the title. It won’t halt the exodus from the workforce or offer hope to millions struggling to access care.

“Nothing here meets Government’s stated ambitions, or makes this service fit for the future.

“Ministers wanted to stop dentistry becoming an election issue. By rearranging the deckchairs they’ve achieved the exact opposite.

“The crisis will remain a burning issue in communities across this country until we get real change.”

Matthew McGregor, CEO at campaign 38 Degrees, which has joined forces with BDA and The Mirror to host the petition, said: “The public can see how NHS dentistry has been left to rot by the Government. They’re disgusted to hear about people forced to pull out their own teeth, or fly to warzones for treatment – they can see the system isn’t working.

“Dentists say the so-called rescue plan isn’t good enough, and we know the public will believe them rather than swallowing Rishi Sunak’s spin.

“Our petition unites the public’s voice with the voice of dentists, in telling the Government to fix this toothless plan now. Anyone who cares about fixing our broken dentistry system, and the nation’s teeth, can sign now, at https://38d.gs/SaveNHSDentistry.”