Northern Ireland: our response to the DoH ‘Rebuilding Support Scheme’

16 March 2022

We were left bitterly disappointed at the outcome of latest talks with the Department of Health (DoH) on the new GDS funding arrangements to succeed the Finanical Support Scheme. The Rebuilding Support Scheme announced last week by DoH is totally inadequate and will do little to rebuild the shattered service. We're calling on you to reach out to your MLAs to amplify the voice of the profession.

 

The new Rebuilding Support Scheme will see a 25% enhancement apply to dental fees, as the Financial Support Scheme to mitigate the impact of Covid on dental practices is wound up from April. This represents a downgraded offer from a 35% increase that had previously been put forward, owing to budget uncertainties. It is also in stark contrast to the initial 70% enhancement that has been introduced in Scotland.

              

 Ciara Gallagher (left), pictured with Claire Sugden MLA, who we engaged with on GDS issues.

After an extremely tough two years in dentistry, we had hoped that the expected enhancement would enable practices to begin to rebuild the service. Throughout the pandemic, caring for unregistered patients, providing out of hours cover at weekends, and relying on short-term funding has caused a collapse of morale in the profession.

Ciara Gallagher, Chair of the Northern Ireland Dental Practice Committee (NIDPC) has made our position clear: "This scheme is such that we simply cannot stand over it or support it – our members expect and deserve more. Our warnings to the Department have been clear in recent months – yet we feel strongly that our words have fallen on deaf ears." 

“Practitioners have been left deeply disappointed by the Department of Health's decision, and worried for the future of the service, particularly those practitioners who are most NHS committed.” This latest scheme is another short-term stop-gap that offers practitioners little certainty, at a time when there is a crisis of confidence in continuing to offer Health Service dentistry. 

As Ciara Gallagher has outlined: "We have told the Department and HSCB in no uncertain terms what is required to provide safe, affordable Health Service dentistry – but years of real-terms pay cuts, combined with the massive impact of the pandemic, and now soaring costs have brought us to crisis point.

As the recent widespread media coverage including on BBC News and the Belfast News Letter of the BDA stance has made clear: Health Service dentistry simply cannot continue on this downward trajectory, where what is paid bears no correlation with the actual costs to deliver the service. Practitioners have had enough. 

The profession and its representatives have invested so much into ensuring NHS dentistry can emerge out of this pandemic, that patient care can continue, particularly for those who need it the most. We provided the Department with a counter-offer that clearly detailed what was required for a reasoned, sustainable, safe service. We are disappointed this has been rejected, and that the Department has steamrollered ahead with its 25% enhancement which fails to adequately reward or properly incentivise struggling practices.

At the very point in time when a new package should have been about incentivising GDPs to increase Health Service treatments and get through high patient backlogs, this scheme falls flat.

In order to maintain viable businesses, it is worrying that dental practice owners increasingly feel they are being pushed towards private practice. They will have no alternative. Associates – who often do the bulk of health service dentistry – will increasingly be driven into private practice, because working in the Health Service means their salaries will not reflect the years of learning, the cost of living or the university fees that need to be repaid.

Reverting to a situation where decisions are once again based solely around DoH budgetary constraints while ignoring the financial realities practitioners are facing, is repeating the mistakes of the past. It is for the Minister and his Department to explain how this will help move dentistry forward at this critical juncture.