“Crisis? What Crisis?”

The British Dental Association has slammed the Prime Minister’s latest attempts to gloss over the crisis in dentistry.

In response to questions from Norwich’s Clive Lewis, the PM offered misleading lines on workforce, funding and reform which have been repeated, almost verbatim, time and again at PMQs since the start of 2023. The professional body is unclear whether officials at Downing Street or the Department of Health are responsible for this wholly inaccurate briefing.

Last week the PM failed to respond to questions from Durham MP Mary Kelly Foy on whether NHS dentistry is “in crisis”. BUPA has recently announced mass closures and over 300 patients queued outside a Kings Lynn practice last Tuesday from 4am to secure access, a sight not seen in England for a generation.

In January he told Lancaster and Fleetwood’s Cat Smith MP: “as a result of the new reformed NHS dentistry contract there are now more NHS dentists across the UK with more funding making sure people can get the treatment they need.”

The discredited NHS contract, which is fuelling an exodus from NHS dentistry and has been dubbed ‘not fit for purpose’ by Parliament’s Health Committee underwent only minor tweaks in October 2022. In March the BDA warned the Committee, which is currently holding in inquiry into the crisis in the service, that Ministers are just “rearranging the deck chairs on the Titanic, while the service slowly slips into the sea.”

The PM has repeatedly cited workforce data from the financial year ending 2021/22, which clearly has no relationship to these changes. In March he told Bradford’s Judith Cummins: “There are 500 more dentists in the NHS today.” England has fewer NHS dentists in 2021/22 than it did in 2017/18, and thousands are cutting back their NHS work, a shift going unseen in official data. BDA surveys suggest over half of dentists in England (50.3%) have reduced their NHS commitment since the start of the pandemic – by 27% on average. The proportion of dentists now reporting their intention to reduce – or further reduce – the amount of NHS work they undertake this year stands at 74%.

On funding the PM has repeatedly cited the £3bn NHS budget. This budget has remained effectively static for a decade, subject to savage real terms cuts. In cash terms government contributions into NHS dentistry in England were lower as the nation headed into the pandemic than they a decade ago (£2.2bn in 2010/11 vs £2.1bn in 2019/20), with patients paying an ever-larger share via inflation-busting charge increases. The share of the gross NHS budget coming from charges rose from 21.8% in 2010/11 to a high of 30.7% in 2018/19. During the access crisis over £400m of the budget is set to be lost from the frontline, from practices who failed to hit their NHS contractual targets. Many of these ‘underperforming’ practice simply cannot fill vacancies.

The Prime Minister unveiled a 5-point plan to end the access crisis during the Conservative leadership election last summer. No element of it has been taken forward.

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

“While ministers rearrange the deckchairs on the Titanic, their captain refuses to accept this service has even hit the iceberg.

“This ‘crisis, what crisis?’ attitude flies in the face of the facts.

“The reality is mass closures, the return of queues outside practices, and millions unable to secure the care they need.

“Until the PM recognises this, we won’t see progress.”