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Pushing for urgency on reform

We are winning the argument on NHS dentistry: What we need now is a firm timetable.

Shawn Charlwood 650X650
Shawn Charlwood Chair, General Dental Practice Committee

The Government says it intends to work “quickly” on reform of NHS dentistry.

It is an important pledge. We have been waiting an age, and any serious reform process will take time. But the sooner it starts, the sooner we can turn the page on stories we have been seeing week in, week out.

We have set out to ensure the powers that be know there is real urgency here. Certainly, the crisis in NHS dentistry shows no sign of easing. The Government has set the right tone, and engagement to date has been positive. But we need to see government deepen and sustain that engagement. Deeds will need to match words.

A desert with no oases

Four year waiting lists. 97% of new patients unable to access care. Patients queuing from 02:30am. We have worked to ensure these stories have not gone unheralded.

Residents in Devon and Cornwall now face an average wait of 1,441 days just to get on the books with an NHS dentist. The service in the South West was in trouble long before COVID struck, but clearly we are not dealing with just a few “hotspots” anymore.

New data from the Office of National Statistics has shown that for new patients NHS dentistry has effectively ceased to exist. Patients the length and breadth of the country are seeing what life is like in a dental desert.

The experiences of NHS healthcare services in England found 96.9% of adults who do not have a dentist and who tried to access NHS dental care last month were unsuccessful. The data catalogued those who were in pain and found no relief, and those who ended up making fruitless trips to GPs or A&E.

These figures were published as more than 100 people began queueing as early as 02:30am just to get a place at a practice in Warrington. It echoed the chaotic scenes we saw in Bristol in February, and in Leigh and Kings Lynn last year.

High on the agenda

We have made it our business to ensure these stories have led the news, and informed debate at Westminster.

Green co-leader Adrian Ramsay, who represents a seat in the East of England where 99.7% of new patients are unable to access care, made the key point at Prime Minister’s Questions.

“My constituents want urgent action,” he said. “So when will the Government begin the critical negotiations on dental contract reform so that no one in the 21st century has to pull out their own teeth? Will it be by the end of this year?

Keir Starmer was concise. “We will put it right,” he said. “We will take the necessary steps, and we will work across the House to do so as quickly as possible.”

My team take absolutely nothing for granted here. The new Government has pledged to fix the broken contract fuelling this crisis, and we will only see progress once that promise is kept.

Cross party consensus

MPs on both government and opposition benches are taking our message up.

Dentistry was the central issue in a dedicated debate on the future of primary care this week. Again, the tone has changed. Yes, there were differences of opinion on how we move forward, but there were no denials on either side of the House that we are facing a crisis.

North Cornwall's Ben Maguire MP spoke for many members when he said "we must have NHS dental contract reform now—no more delays, no more excuses."

Norwich North MP Alice Macdonald told colleagues that “dentistry is a feminist issue”. She cited data from us and our friends at the Women’s Institute showing how 1.5 million new mums have missed out on free NHS care since lockdown, and any recovery here appears to have stalled.

Many stories were horrendous, with reports of desperate patients taking matters into their own hands.

MPs echoed our calls for a higher minimum UDA rate, to keep practices afloat while we wait on reform. For a real break from failed targets. And most importantly for a timetable.

The Government says it has an agenda to move from analogue to digital, from hospital to communities, from sickness to prevention. We are clear that dentistry is uniquely placed to deliver on that vision.

Ready to roll up our sleeves

Minister for Care Stephen Kinnock ended the debate with a collective call to “roll up our sleeves and get to work.” We could not agree more.

The Government’s stated goals, to make NHS dental work more attractive, boost retention and deliver a shift to prevention, are shared, and we are ready to work at pace. General Dental Practitioners thinking twice about their futures need some sense that there are dates in the diary, and a light at the end of the tunnel.

Solving this problem cannot become another line on a pledge card at the next general election. If we delay, there simply will not be enough of a service left to build back on.