The new figures show average combined health service and private taxable income for all self-employed dentists in Northern Ireland fell by 4.2% from £68,000 in 18/19 to £65,100 in 2019/20. This is part of a long term trend. Associate dentists have seen their pay fall in real terms by 36% since 2008/9, and by 43% for practice owners. And these figures largely pre-date 20/21 data, which has been perhaps the most disruptive period for dentistry in living memory.
Practitioners who are most committed to providing Health Service dentistry have seen their incomes hit the hardest. Associates with Health Service earnings above 75% have the lowest average taxable income at £49,700. This compares with an average taxable income of £94,500 for Associates with 25% or less earnings from Health Service dentistry and a larger Private income.
The combined impact of a decade of inadequate fee uplifts, the removal of commitment payments and the stagnation of health service item of service fees have brought us to a point where future health service viability hangs in the balance.
When post-pandemic, patients across Northern Ireland are already struggling to access dental services, these figures should serve as a wake-up call.
Before Covid struck, Health Service dentistry had been run into the ground. Colleagues are facing the greatest oral health problems in the UK with their hands tied by a decades-old contract model that rewards failure, and chronic underfunding in wholly inadequate fees that no longer make any financial sense.
Our position is clear. We want to avoid a complete collapse of Health Service dentistry. For that to happen, we need a new contract model that works for both the general public and practitioners alike. For our patients’ sake, the downward trajectory needs to be reversed before any more dentists conclude there is no future in the Health Service they have been so committed to.
If Health Service dentistry is going to survive this pandemic, the time to give practitioners confidence that it has a future is now.