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A 'bonkers' system: the contract in press and parliament

Blog Author Eddie Crouch

Blog Date 13/09/2017


Bonkers – it's the only word I could pick to describe the system set out to deliver NHS dentistry in England.

We all know the issues. A contract that sets quotas on patient numbers, and fines dentists when they don't hit targets, doesn't pay them if they want to do more. A model that asks patients to pay more, just so Ministers can pay less. A policy that prefers patients to stay away, but is happy to foot the huge bill when they end up in hospital under GA.

It's NHS in theory, but in practice ministers are not equipping us to be a truly national service.

The BBC revealed shocking research that showing just half of dental practices in England currently accept new adult NHS patients.

Analysis of 2,500 dental practices on NHS Choices and follow up phone calls revealed 52% of dental practices are accepting new adult patients, and just 60% accepting new child NHS patients.

We often see these stories, and  I know some colleagues can take these apocalyptic headlines the wrong way, particularly when they involve those rare cases of patients resorting to DIY dentistry.

And to be clear we are on the side of the patients who want access to NHS dentistry, and the practitioners who want to provide it.

We take issue with a NHS contract that penalises dentists, fails on prevention, and a government that seems content with patients staying away. A system that is, for want of a better word, bonkers .

So we are delighted that MPs are picking up the baton. On Tuesday Bradford MP Judith Cummins lead a debate on access to NHS dentistry in the Commons. Dentists are victim, not villain, and she quite rightly observed that we have been forced by the powers that be to make impossible decisions.

Cummins's patch in Yorkshire looks like ground zero for this emerging crisis. According to the BBC research only 1 in 20 practices in Bradford are accepting new patients, and none in areas like Halifax.

The region offers a taste of where the service across England could be heading, unless we change course. So I want to thank every MP – particularly all those from Yorkshire seats -  who spoke so passionately in parliament about the importance of oral health to their constituents.

Health Minister Steve Brine told members that prototypes for a reformed contract will have to prove they can increase access before government will consider rolling them out. How that lofty ambition can be achieved with a flat-lining budget is anyone's guess.

These access figures aren't inevitable. They are the results of Ministers trying to keep costs down, we they could be securing the real savings that would come from strategic investment in Britain's oral health.


Eddie Crouch

BDA Principal Executive Committee member


Dental contract reform

We are campaigning for a dental contract that puts prevention first - find out what the issues are and what we have been calling for.