Proposed compulsory NHS tie-in for new dentists – the profession reacts

We hear the thoughts from the profession on the government’s proposal for a compulsory NHS tie-in for newly-qualified dentists.

Last week, the government launched a consultation on an NHS ‘tie-in period’. This would require newly-qualified dentists to work in the NHS for several years following graduation.

The consultation will ask whether dentists should commit to delivering a minimum amount of NHS care or have to repay some of the training costs that are subsidised by the government.

According to the Department of Health and Social Care (DHSC), training a new dentist costs around £300,000, with £200,000 not repayable by the student. It said: ‘Of more than 35,000 dentists registered with the General Dental Council (GDC) in England, just over 24,000 delivered some NHS care in England in 2022/23.

‘This means nearly one-third of registered dentists are not contributing to NHS dentistry and may be working solely in private practice.’

As a result, the government hope this proposal will both increase access to NHS dentistry and ensure taxpayers benefit from the ‘investment’ of public money into training dentists.

But what does the profession think? Find out here…

Ken Montgomery, retired dentist

As a retired dentist who was funded by the government at the time, I completely agree that new graduates should spend an equal time working for the NHS as per the length of their course! No exceptions allowed!

I graduated as a Royal Army Dental Cadet and I was committed to five years on a short service commission. I strongly believe a similar scheme should be introduced ASAP!

The scheme should be extended to all suitable degrees and professions where appropriate. Perhaps the former education grant should be reinstated and paid for by compulsory NHS service!

Sharon Hartley, practice manager

I agree with this. I have worked in an NHS dental practice for over 40 years. It is such a struggle to retain dentists with the current system.

It would be advantageous to have an influx of dentists annually for the welfare of patients and to gain experience in a busy environment.

Atul K Shankar, dentist

Will they do the same for graduates in other professions who are ultimately remunerated by the state (nurses, teachers etc) but who could work elsewhere?

NHS dentists are self employed subcontractors who run their own businesses. Would a tie-in be regarded as a restriction of trade and unenforceable? Seems to me this will be a good way to put off many students from a university education as a way into a professional occupation. 

When the government realise how much it actually costs to run a practice and for the owners to earn a decent income (as qualified professionals who are taking all the business risks under a system which caps income potential) from it maybe then they will consider that we’re actually getting a good deal from this subcontractor relationship, we just need to change the contract to make the NHS more attractive system to work within and make pay more realistic to keep them within the system. 

No brainier really. But let them have their investigation instead of asking people who might already know the answer.

Hannah Moore, dental hygienist

Not the solution to the problem. Make changes to the NHS contracts so that dentists want to work in the NHS.

How can you force dentists to work under the NHS when they’ve paid tens of thousands out of their own pockets for their education? Other high-earning graduates such as lawyers are not expected to ‘give back’ to the community or work for less than they deserve, so why are doctors and dentists always expected to work for pennies?

As healthcare workers, we go into the professional because we care, but that compassion should not be taken advantage of like it is now across all of the NHS.

Neal Heaher, cosmetic dentist

The reality is this has always been the case because of vocational training pathways and the inability to have the skill set required to progress into the private sphere.

It’s only going to stop people emigrating and I bet that’s a small proportion.

Aidan King, dentist

I have been preaching this for the last two years but with a slight twist. I think it should be incentivised, as in do one year post foundation training and have a third of the student loan cleared, or do two extra and have two thirds cleared etc.

For this to work, the government may need super educational supervisors, as in experienced colleagues not seeing patients but having clinics with eight to 10 young dentists working under them. This will provide the NHS service to those that need it. Strict rules must be applied to patients, as in abusing the service by not turning up means you are no longer eligible to use the service.

It’s a great idea and I’m sure lots of wiser heads than me will be able to make this work.

Amanda Simmonds, dental nurse

I hope they do as a lot of new dentists just want to earn big money. And the NHS does not give them that.

It is sad that it’s aesthetics over health of teeth these days.

Eddie Crouch, British Dental Association (BDA) chair

Government plans to shackle graduates to a service facing collapse. It should be asking why experienced colleagues are walking away. 

A failed contract is pushing away talent every day it remains in force. Patients need NHS dentistry to be a place dentists would choose to work.

That requires real reform, not mere tweaks, carrots and not just sticks.

What are your thoughts? Send them to [email protected]

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