NHS faces ‘exodus’ of dentists
Long-term problems exacerbated by Covid
Mark Jones, a Unite workplace representative has helped kick start
a national campaign for more funding for dental care. It comes after residents
of a small rural Suffolk village lost their last remaining dental practice that
provided dental treatments on the NHS.
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, who prior to
entering Parliament was the National Officer for Health at Unite, 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 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.
The number of dentists providing NHS care in England
fell from 23,733 at the end of 2020 to 21,544 at the end of January this year.
A BBC article on the crisis, 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.”
Residents of Suffolk village Leiston lost on April 30th last year its last remaining dental practice that
provided dental treatments on the NHS.
The closure of the MyDentist practice sparked outrage around the town and
surrounding villages, and the Toothless in Suffolk campaign was then launched
by local resident Steve Marsling and his friend Mark Jones, who is a Unite
workplace rep at UK Power Networks, to bring back an NHS dentist for Leiston.
Steve Marsling and the 'Toothess' campaign team have met with the Head of NHS
Commissioning several times to press for immediate action in Leiston and
provide access to NHS dentistry, but the results of these discussions have yet
to bear any fruit.
“It’s nothing short of a
disgrace. A national disgrace.” says Steve, and added, “NHS commissioners are
employed to ensure NHS treatments are provided where there’s a need, and yet
they are seemingly incapable of fulfilling their responsibilities.
"Their understanding of the severe consequences this
dental crisis is having on the health of patients, both young and old, is
limited.”
British Dental Association Chair Eddie Crouch said:
“Leiston offers a taste of where NHS dentistry is heading unless the government
steps up.
“A whole community denied access to basic healthcare, with charities that
normally operate in the developing world left to pick up the pieces.
“We will only see progress if Ministers turn the page on a decade of failed
contracts and underfunding.”
Meanwhile, Toothless
campaigns have started this year in Huntingdon, Newcastle and Manchester.
People in other towns and cities have also made contact with the national
campaign.
As the campaign
spokesperson for Toothless England, Mark Jones, said: “We are demanding an NHS
dentist for everyone and treatment free at the point of use, with free routine
check-ups and preventive treatment. We want reforms to the dental contract to
encourage dentists to provide NHS treatments and an end to NHS dentistry
privatisation.
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.”
Allison Fewtrell, a South Manchester resident, said:
“The Toothless 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.”
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