As ‘King of the North’ Andy Burnham is sworn in as leader of the Labour Party and our next Prime Minister, what are the prospects for NHS dental contract reform during his tenure? Nigel Jones shares his thoughts.
The short answer to whether we will see meaningful reform is possibly, but probably not immediately or dramatically.
When Andy Burnham becomes Prime Minister, there are a few reasons NHS dentistry could receive more attention than it has under recent governments. However, the fundamental challenges would remain.
Unlike most of the PMs of the last 10 years, Andy Burnham has held the position of secretary of state for health (as it was in his day) and has a long-standing interest in NHS reform. In fact, I have first-hand experience of his work in the Labour government of the noughties, as between April 2006 and October 2007, I had a role in Greater Manchester supporting one of the Independent Sector Treatment Centres introduced as part of Tony Blair’s attempts to reform the NHS. Throughout that time, Andy Burnham was at the department of health as minister of state for delivery and reform. So, his commitment to reform of the NHS with a greater emphasis on prevention is long-standing.
What improvements could we hope for?
Greater focus on access and inequalities
Burnham’s record as mayor of Greater Manchester has centred heavily on tackling health inequalities and improving access to healthcare services. His focus on prevention and early help resulted in the announcement in March 2026 that Greater Manchester was being designated as a ‘prevention demonstrator’.
This was as part of a government trial, as the statement said: ‘To tackle health inequalities, end the NHS postcode lottery and close health inequality gaps within and between regions, so everyone lives well for longer.’
This involved the appointment of an ICB chair who would also serve as a health commissioner for the mayor as part of a partnership between the NHS, local government and the voluntary sector. This mindset could mean that there is more political attention on ‘dental deserts’ and underserved communities.
Greater willingness to reform NHS services
His experience in Greater Manchester has already shown him the benefits of policies focused on better access to care, prevention and early intervention. A study published in The Lancet in 2022 found that, following the devolution of health and care, healthy life expectancy rose faster in Greater Manchester than other areas before the pandemic. This could become the template for major healthcare reforms, including closer integration of health and social care services.
So, with all his talk of devolution, a Burnham government might be more willing to look at structural changes to the NHS rather than small tweaks. Which could be accompanied by reform of dental services too.
Better understanding of healthcare politics
As I’ve already said, unlike many Prime Ministers, Burnham has actually run the Department of Health before. He’ll be more aware than most of the need to ensure the Treasury supports any changes he wants to make to the way the nation’s healthcare is delivered. That experience should equip him with a better understanding of the workforce, funding and contract issues facing dentistry than most political leaders which, hopefully would lead to better outcomes.
What might not change quickly?
The NHS dental contract problem
The biggest issue for many dentists working within the NHS remains the contract. The Health and Social Care Committee first made recommendations for reform following the Steele report in 2009 as it was deemed not fit for purpose. Another Health and Social Care Committee in 2023 expressed its frustration that none of its predecessor’s recommendations had been acted upon and urged that ‘a fundamentally reformed contract must be implemented at the earliest possible stage’.
Burnham would be our third Prime Minister since July 2023 and, although there were tweaks to the contract in April this year, we have still had no meaningful reform. It has been repeatedly delayed, and changing Prime Minister would not automatically solve that.
Funding constraints
It’s well known that regardless of how much goodwill there may be towards contract reform in the DHSC, it is the treasury that holds the purse strings. Burnham has already pledged to adhere to the current fiscal rules so the prospects of additional funding being found for NHS dentistry may be low down his list of priorities. Especially as he already faces a deficit of £4.7Bn by 2030 to cover the Defence Improvement Plan.
Growth of mixed and private dentistry
Even if NHS access improves, it’s debateable whether this would arrest the long-term shift towards mixed NHS/private models. This is likely to continue because patient demand for cosmetic, preventive and elective treatments extends beyond what the NHS provides.
The move to private dentistry also allows dentists to spend longer with their patients helping them to build a relationship based on trust. This can help ensure that consent for treatment is truly informed and may guard against complaints or litigation should anything go awry, which can have great appeal.
So, while Burnham may be more sympathetic to NHS dentistry than many political leaders, the underlying pressures that drive practices to introduce private dentistry are unlikely to disappear. In fact, continued uncertainty around reform may encourage even more practices to add private income streams to provide them with some degree of certainty while they wait for long-promised contract changes.
Could Burnham buy more time?
Of course, he may well fox us all as there is the possibility that Burnham may choose to capitalise on his current popularity and call a snap election before he has the chance to disappoint. If that returns him with a decent majority then, with five more years, he could have greater scope to be bold with NHS reforms including dentistry, as he knows they are necessary.
Although, as I have said, prospects of extra funding may appear bleak, there could be a remote possibility that some may be forthcoming. There is considerable strength of opinion among MPs about the need for ‘something to be done’ about NHS dentistry as many of them are harangued daily by constituents unable to gain access to dental care. Burnham is likely to change the current Treasury team so it may not be beyond the realms of possibility that, despite the overall financial challenges facing any PM, extra money could be released to placate those MPs.
Of course, all of this is pure speculation. Andy Burnham takes up his role with a huge weight of expectation upon him. It remains to be seen whether he delivers on his promises. We live in interesting times.
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