NHS faces ‘exodus’ of dentists

 

NHS faces ‘exodus’ of dentists

Big Issue North magazine article.

Long-term problems exacerbated by Covid

Patients take dental care into own hands

Two northern MPs have added their voice to calls for more funding for dental care amid fears that it is becoming increasingly difficult for adults and children to find an NHS dentist who will treat them.

The lack of access to dental care, which has been a concern for more than 15 years in some areas, has worsened during the pandemic, with dentists exiting the profession in large numbers, leaving it “hanging by a thread”, according to a British Dental Association (BDA) leader.

According to Healthwatch, the statutory body that represents patients, lack of access to NHS dentistry has “exploded as an issue for people over the last 18 months”. Patients needing urgent care are left in “excruciating pain” – with one reporting they had pulled out their own tooth – and many are forced to go private. Using NHS Digital data, last December Healthwatch said only 11 per cent of the more than 5,000 dental practices in England were accepting new adult NHS patients, and only 17 per cent took on new patients.

Regional inequality

The headline figure masked large regional and sub-regional variations. A quarter of North East and Yorkshire practices accepted adult patients. But in the North West and the South West, that figure dropped to 1 per cent.

Only 4 per cent of North West practices accepted children.

Healthwatch North Yorkshire found that of the 77 NHS practices in the area, only two would take on new adult patients for NHS treatment. Healthwatch Blackburn reported that all the 21 practices in its area on the NHS website were refusing to take on NHS patients for the foreseeable future. In May and June, Healthwatch York also found not a single practice taking on NHS patients.

 York Central MP Rachael Maskell has long warned of an NHS crisis in her constituency. Referring to a pre-pandemic Healthwatch report, she said: “46 per cent of people in York could not find an NHS dentist and 45 per cent of those searching had been looking for more than two years. I can testify to this from the amount of correspondence I get on the matter.

“In talking to the BDA, around 30 per cent of dental nurses are unvaccinated so could leave the profession by the end of March, and many dentists are leaving NHS dentistry or the profession altogether.”

Heightened by pandemic

Although the crisis has been heightened by the pandemic – with dentists forced to drastically reduce the appointments they can offer because of the need for restrictive PPE and distancing measures – it stems from the 2006 introduction of a controversial new contract for dentists paying them for activity rather than patient numbers.

As far back as 2007, Big Issue North reported that just 13 per cent of surgeries in the North West were taking on new patients – despite the new system being meant to create more places. And in Leeds, nearly a quarter of the city’s 138 dental practices had gone private.

 Now, according to analysis of NHS data by the BBC, almost 1,000 dentists in England and Wales left the NHS last year. The BBC quoted one patient, forced to wait for treatment for over a year, who used a metal file and superglue to perform her own treatment.

That exodus is “just the tip of the iceberg”, according to the BDA, which warned that “NHS dentists who have never contemplated working outside the system are now looking to the exit”. Its December survey suggested over 40 per cent of dentists are now likely to change career or seek early retirement in the next 12 months.

Over half stated they are likely to reduce their NHS commitment. One in 10 thought their practice will close in the next 12 months. The government has imposed a target of resuming 85 per cent of pre-Covid activity but there was no increase in spending for dental care in Chancellor Rishi Sunak’s package of extra NHS funding in his budget of October last year.

“Years of failed contracts and underfunding have meant a growing number of dentists no longer see the NHS as a place to build a career,” said Shawn Charlwood, chair of the BDA’s general dental practice committee. “The pandemic has upped the ante and we are now facing down an exodus.

“Integral to healthy society”

“Ministers have failed to grasp that we can’t have NHS dentistry without NHS dentists. Rather than punishing colleagues, we need a service that recognises and rewards commitment. Millions stand to lose out if the government fails to deliver needed reform.”

 Increasing public support for an NHS dentist for everyone is leading to a growing number of campaigns across the North. The launch late last year of the Toothless in Suffolk campaign led to a national organisation being formed.

Toothless in England spokesperson Mark Jones said: “The public’s oral, general and mental health has continued to suffer in the face of a dental crisis brought about by successive years of government neglect and underfunding by the Treasury of a critical NHS service.” Toothless in England is demanding an NHS dentist for everyone and treatment free at the point of use, with free routine check-ups and preventive treatment. It wants reforms to the dental contract to encourage dentists to provide NHS treatments and an end to NHS dentistry privatisation. Toothless campaigns have started this month in Newcastle and Manchester. People in other towns and cities have also made contact with the national campaign.

Allison Fewtrell, a South Manchester resident, said: “The campaign is resonating with Greater Manchester communities, and people have contacted us with a variety of problems. Some can’t get an affordable dentist and have had no treatment for years. Others have suffered with problems that are preventable with regular dental care. People have endured chronic toothache and lost teeth.”

Kim Johnson, MP for Liverpool Riverside, said: “I regularly receive e-mails from constituents asking where they can find an NHS dentist for themselves or – quite often – their children. I cannot give them any options.

“I would like a return to free dental care and increased services, especially for children. Dentistry should be integral to ensuring a healthy society.”

Government response

In response to a series of questions, a Department of Health and Social Care spokesperson (DHSC) said: “We have taken unprecedented action to support NHS dentists throughout the pandemic by providing full income protection for practices unable to deliver their usual level of activity.

“Children, who continue to be eligible for free NHS dental treatment, are being prioritised alongside vulnerable patients and those with urgent dental needs. “Nearly half of all dental treatments – over 17 million – were provided free of charge in 2019-20.”

According to the DHSC, dental charges contribute towards the running costs of the NHS and NHS England has a duty to commission dental services to meet local need. Where a patient cannot get access to an NHS dentist, NHS England is expected to provide help in doing so.

MARK METCALF