NHS Dentistry. A Toothless Tiger
The Conservative government has created a toothless tiger out of NHS dentistry, by cutting funding in real terms by almost a third. As a result our long-term health is being sabotaged.
We all know the drill with getting a dentist appointment these days. Often it will involve a long wait and to find out the cause of the pain an examination fee is often attached with a huge cost. Today over one million patients are unable to get an appointment with an NHS dentist. This is leaving people in pain without the care they need primarily due to labour shortages in the NHS and dental practices.
The future now looks as promising as a botched root canal with many dentists reducing their commitment to providing NHS services, and many others leaving all together. A recent motion was debated on by peers in the House of Lords. They highlighted that national health dentistry is no longer meeting people’s needs, and is in desperate need for reform to increase availability, access and funding.
In today’s day and age desperate adults are shockingly finding themselves resorting to DIY dentistry. Others in West Yorkshire have found waiting lists so long they have had to resort to pulling out their own teeth. For those living in Barrow-in-Furness, you may find yourself undertaking a 90 mile round trip to an NHS dentist. If lucky enough to get an appointment, if one at all. Take Portsmouth for example, where the collapse of a private organisation has left the city without a single dentist offering to take NHS patients.
Sad times.
Despite being one of the richest countries in the world the biggest worry of all appears to relate to the availability of treatment for children, especially those living in areas of social and economic deprivation. Some parts of the UK see the prevalence of tooth decay in five year olds reaching as high as 34%. Tooth decay is one of the most common single reasons why children between the age of five and nine are admitted to hospital. Even though 90% of cases are preventable. Last year the Labour Party found evidence that children in severe pain were waiting up to half a year to be seen. On average waiting 253 days at some of the worst performing hospitals.
Lord Storey recalled the days when as a young school head teacher the local Labour council introduced dental milk for kids, containing fluoride, which parents could choose between over ordinary milk. He stated how 99% of parents chose the dental milk and the annual visit by the school hygienist saw marked improvements in children’s teeth. Dental milk and annual school check ups are not as prevalent as they once were, and Lord Storey made calls for the expansion of such programmes nationwide.
According to Baroness Gardner of Parkes the beginning of the end for national health dentistry started in 1988, upon the introduction of examination fees for dental services. Kenneth Clarke crushed any debate on the matter having stood firm on bringing in the introduction, going onto use financial privilege to ram through the changes. As with all services price can deter people using the service. Research shows how NHS charges deter patients in need and its incredibly dire impact such policies have on the most vulnerable people in our society. It does not make sense to me why our oral health is privatised, while other health needs are free at the point of service.
Lord Colwyn, a former dental surgeon, told the Lord’s that more and more studies confirm a healthy mouth is a gateway to a healthy body. And that tooth decay and gum disease are increasingly becoming linked to a heightened risk of serious health issues such as heart problems and diabetes. Tot that end, only half of the adults in England have seen an NHS dentist in the last two years, with more than four in ten children in England not seeing one for over a year.
Two stark statistics come to the fore when considering this issue:
- Funding per capita has fallen by 29% in real terms for NHS dentistry
- Patient charges have outstripped inflation at 5% for each of the past 4 years
Such funding issues come as a triple whammy when combined with the flawed funding mechanism found in NHS dentistry, namely payments made in Units of Dental Activity (UDAs). Dentists inevitably find the rate of pay lower than the cost. This leads to scarcer availability. For example, each practice is given an allocation of UDAs to treat children. Once the dentist practice has used up the UDAs then they cannot treat any more children. No wonder dentists are shunning work from the NHS.
Lord Storey noted the madness of how many affluent areas will have UDAs left, which are returned to the treasury. On the other hand, deprived areas can run out after six months. If the system could review allocations, which can then be redistributed, more children can be reached.
Preventing access to NHS dentistry only leads to costs rising in other parts of the NHS, which are often not best placed to deal with them. It is a false economy to allow those having sleepless nights and lost working days, resultant from treatable tooth pain, wait so long to be seen. Blair had made a pledge for “access for all” to an NHS dentist. While he failed to deliver on that pledge due to ineffective contracts, it should still remain the ambition of any future Labour government.
By continuing to treat NHS dentistry as a Cinderella service, and not giving it the importance it deserves, the current government is sabotaging our long-term health. Urgent reform is needed to the dental contract, with such such changes likely to garner cross-bench support in the House of Lord’s. Let’s hope some sense prevails in the Commons.