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Dental services have fallen into disuse. Extracted from the NHS, they have fallen prey to the commodification of healthcare, and today an NHS dental appointment is as rare as chickens teeth.
In 2006, the dental contract was established to encourage dentists to take up NHS work, and would still allow some flexibility for those who also choose to work in private practice.
Basically, procedures were measured by Dental Activity Units (DAUs) and payments received on an agreement on how many DDUs you would deliver.
Although healthcare spending in English was just £35 per person, in Wales it was £47, £55 in Scotland and £56 in Northern Ireland before the pandemic. The practices should then reach their target, not exceed it.
As with all services today, the contract is grossly underfunded and dentists practice privately to subsidize their NHS work to make it a worthwhile business.
But it didn’t work and the dentists had to throw in the towel; The government sat down, the people suffered.
Then came the Covid and containment.
Naturally, dental procedures spray aerosol particles, so dental services have moved online. Do-it-yourself fillings, counseling and pain relief were all that could be offered. Meanwhile, dentists have been trying to keep their staff paid and their businesses afloat, and like others, they’ve found the best way to care for their patients on Zoom.
Eventually an emergency department came into existence, but dental services never recovered. The government has just increased the pressure with higher expectations on the delivery of a failed contract. Many practices postpone contracts. Some simply inform their patients that they are now private and that they are open to receiving their clientele.
Like my mailbag, Healthwatch York noticed a surge in correspondence from residents saying they couldn’t find a dentist. From their research, they found a practice accepting NHS patients in York, not to see a dentist, but to join the waiting list of 2,000 people.
Well done to the dentists who survived, but I know it is getting harder and harder, dentists are leaving the profession, waiting lists are getting longer and oral health is rapidly deteriorating.
In 2018, it took over two years for 45% of York residents to find a dentist. At the time, 84% of people had an NHS dentist. Last year, that figure fell to 59%. Among those who did not have a dentist, 71% did not find an alternative. York’s only children’s orthodontic practice has a two-year waiting list for an appointment.
Locally, it can take five years to see someone, so what are you supposed to do? Go private? Oh good? At these costs? Some have gone into DIY dentistry, literally pulling teeth. Some traveled far, and some cost trips to Eastern Europe.
First, we need the contract to end on March 31, 2022. It failed. The government must build a national dental service, putting the mouth back into the NHS body, free when needed, never on the ability to pay; it’s urgent.
But we also need a workforce plan. Last month, the British Dental Association survey showed that more than 40% of dentists plan to change careers or take early retirement next year. We need dentists, hygienists, technicians, nurses and receptionists.
We will need a new dental school, and I have argued in Parliament that it should coexist with the outstanding medical school in York and Hull, as it will attract dentists and meet manpower needs .
The service must urgently reconnect with schools with supervised tooth brushing and regular check-ups. As oral care is also vital for the elderly and poor oral health can lead to malnutrition, we also need a community program for the elderly and other vulnerable groups.
Finally, we need good data. It is quite amazing that the government does not collect this.
Last Thursday’s debate in Parliament on dentistry showed that I was not alone in making this call. The government fails. They have no vision. There is no plan.
In 1948, the Labor Party set out its vision for the NHS. Particular attention has been paid to “Care of the Teeth”. He said: ‘You don’t need an application form. Simply call, by appointment, the dentist of your choice when you need it.
Let’s go back to a real national health service, free in case of need, which takes care of everyone. This is what I will fight for. This is what we need.