Health bosses consider forcing dentists to work for the NHS

British dentists could be forced to work for the NHS for years after completing their studies under radical schemes being considered by the government.

This proposal, unveiled today by Prime Minister Rishi Sunak, aims to help the thousands of Britons struggling to see an NHS dentist, with some areas being deemed ‘dental deserts’ as there is only one in 13,000 people .

The shocking crisis has forced Britons to queue at 4am just to get the chance to register with an NHS dentist, pay a premium to go private, or go without and risking undertaking their own dreaded DIY dentistry with household tools.

Mr Sunak, who unveiled the idea at the launch of the highly anticipated NHS Workforce Plan, said it was ‘reasonable’ to expect dentists to work for the taxpayer for a period of time as their training is subsidized by £100,000 .

He revealed that only one in three dental graduates end up working for the NHS.

But representative groups of dentists disapproved of the idea, accusing ministers of ‘handcuffing the next generation of dentists to a sinking ship’ without addressing the issues that drove them out of the NHS in the first place.

London recorded the lowest percentage of adults to see an NHS dentist in two years, according to NHS Digital data. The North East and Yorkshire recorded the highest rate at 41.8 per cent

Speaking today, Mr Sunak said his government is well aware of the difficulties Britons face in obtaining affordable dental care.

“We are aware of the challenges in NHS dentistry,” he said.

Pressured by what he was doing about it, the prime minister said officials were considering what he called a “connection period” for dental graduates.

The move would force them to work in the NHS for a period of time, something he says most dentists avoid.

‘Around two-thirds of dentists after completing their specialty training end up not doing any work on the NHS,’ said Mr Sunak.

‘That’s something we want to look at and it may be appropriate to introduce a tie-in so that people do more NHS work after they qualify.

Mr Sunak said this was ‘only fair’ as these dentists had benefited from a ‘very substantial’ taxpayer grant worth ‘hundreds of thousands of pounds’ to complete their training.

Although he has not specified a fixed time period for this link, the NHS Workforce Plan itself defines it as ‘years’.

However, it also states that graduates only need to work in the NHS for a ‘minimal portion’ of this period, not all of them.

The British Dental Association (BDA), which represents dentists working in the UK, denounced the whole concept, describing it as ‘deeply concerning’.

BDA chairman Eddie Crouch said: ‘Ministers need to make the NHS a place where young dentists would want to work. Don’t handcuff the next generation to a sinking ship.’

Instead, he said ministers should address the issues that make NHS work so unattractive to dentists in the first place.

“Looking at the details doesn’t change our view that the government is trying in vain to fill a leaking bucket,” he said.

‘There’s no point training more dentists who don’t want to work in the NHS.’

NHS dentistry has been in crisis for years, with industry leaders saying the sector is chronically underfunded.

Dentists claim it is no longer financially viable to offer NHS procedures under the current contract due to a lack of government investment.

One of the main problems is that under a previously controversial contract, NHS dentists were paid per job, not for the amount of work required.

This effectively meant they got the same funding for a patient who needed one filling as they did for a patient who needed three, despite the last one taking much longer.

This, combined with poorer wages compared to the lucrative private sector, long hours and stress, has led them to flee health care, dental authorities claim.

Although the dental contract was recently reformed as part of the government’s effort to improve access to NHS dentistry, industry associations say these have not gone far enough.

London recorded the lowest percentage of children seen by an NHS dentist in England: 40.6 per cent.  The rate was highest in the Northwest, where nearly half of children (49.8 percent) saw a dentist at least once every 12 months

London recorded the lowest percentage of children seen by an NHS dentist in England: 40.6 per cent. The rate was highest in the Northwest, where nearly half of children (49.8 percent) saw a dentist at least once every 12 months

Half of dentists (50.3 per cent) have reduced their NHS work, according to the BDA, which warned more will follow as the sector plunges further into crisis.

How much does NHS dentistry cost?

There are 3 NHS loading bands. But NHS dental costs will rise by 8.5 per cent from April 24, the biggest jump since the current cost system was introduced in 2006.

Band 1: £23.80

From April 24: £25.80

Covers an examination, diagnosis and advice. If necessary, there are also X-rays, a scale and polish, and a schedule for further treatment.

Band 2: £65.20

From April 24: £70.70

Covers everything in Band 1 plus additional treatments such as fillings, root canals and tooth extractions (extractions).

Band 3: £282.80

From April 24: £306.80

Includes all treatments from bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.

By comparison, check-ups can cost between £20 and £120 from private dentists, according to the consumer group Which?.

Dentures and bridges can also cost up to £2,520, it says.

NHS dental care has been in crisis for years, but the situation has deteriorated rapidly since the pandemic.

Figures suggest the number of Britons struggling to see an NHS dentist now rises to 7 million, about a quarter of all adults in England.

This figure has increased from 4 million in 2019.

In addition, about 6 million adults “tried and failed” to get an NHS dental appointment, while 3.6 million did not try, “believing that an appointment would not be available,” they said.

A further million people were also put off by the cost of NHS dental costs, and 500,000 more reported being stuck on waiting lists.

Two-thirds of people in England have also not seen a dentist for two years, according to the latest figures from NHS Digital.

Only 16.4 million were screened between June 2020 – in the early days of the pandemic – and June 2022, equivalent to 36.9 percent of the population.

The crisis is also particularly pronounced for children: less than half of children in some parts of England have seen an NHS dentist in the last 12 months, despite being entitled to free treatment.

Compounding the problem is that as more dentists leave the NHS, the remaining dentists are overrun by more and more patients, resulting in a domino effect.

Dentists say dental nurses can earn more working in supermarkets than for NHS treatment, also exacerbating staff shortages.

And it’s not just dental care that suffers, but other more deadly health problems as well.

There are fears that diseases such as oral cancer, which are often detected early by dentists during routine checkups, are being overlooked.

Last month, a 64-year-old British man who couldn’t get a dental appointment on the NHS was diagnosed with cancer after being forced to pay £50 to go private.

This chart shows the number of dentists who carry out NHS treatment each year.  The figure fell sharply during the Covid pandemic but has recovered slightly to just over 24,000 according to the latest data

This chart shows the number of dentists who carry out NHS treatment each year. The figure fell sharply during the Covid pandemic but has recovered slightly to just over 24,000 according to the latest data

The ambitious proposals are detailed in the first NHS Long-Term Workforce Plan, published today and backed by £2.4bn of government funding

The ambitious proposals are detailed in the first NHS Long-Term Workforce Plan, published today and backed by £2.4bn of government funding

Other aspects of today’s newly unveiled NHS Workforce Plan include tackling a staff shortage of up to 360,000 health workers.

Backed by a £2.4bn investment from the government over 15 years, the package of measures aims to address chronic staff shortages and rising demand from England’s growing and aging population.

It will do this by boosting training places for health professionals, reducing the time it takes to train a doctor, while also ending the NHS’s reliance on foreign recruitment.

The government claims the plan will also help reduce patient waiting lists.

But critics warn the blueprint has failed to address staff retention as much of the workforce is tired and burnt out due to the debilitating Covid pressure.