Practice Makes Perfect – the point of no return for NHS dentistry?

Nigel Jones debates the current political climate and why oral health inequality should be a massive concern for us all.

Another month and another sign that, if we’ve not already reached it, we are very rapidly approaching the point of no return for comprehensive NHS dentistry available to all.

At the beginning of the year my team spoke to the England-based holder of an NHS contract worth well in excess of seven figures. He explained that he had been put on notice by his associates that, unless something significant changed within the next six months, they would be leaving to take up one of the many attractive opportunities available to them in private practice.

That notice period is now up. He has reluctantly concluded that he will have to return his contract and convert the practice to private care.

No number of commitments to long-term contract reform or to quick wins redistributing an inadequate budget are going to change that reality. And it’s hard to see how efforts to entice more dentists in from overseas, or to expand the number and role of therapists and hygienists can happen quickly enough to make a material difference to the challenge of retaining NHS associates.

Delay the inevitable

And if there is still hope among the powers that be that dentists will be insufficiently brave to take the step of leaving the NHS, that could be a very forlorn one as the number of success stories is mounting. Practice owners are creating private practices at a scale and speed that would have seemed impossible pre pandemic.

The turbulence engulfing the government is clearly unhelpful as it can only add further distraction and delay, despite the unprecedented urgency of the situation.  And while I know the collapse of NHS dentistry will only be one of many challenges facing the new Prime Minister when he or she takes office, it will be a big one.

The risk of the working poor being squeezed out of dental care and the impact that will have on oral health inequality should be a massive concern for us all, whether or not we stand to benefit from the current circumstances.

That should not mean sacrificing one’s mental and physical wellbeing to simply delay the inevitable. But it should mean doing all we can to continually raise the issue up the political agenda.

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