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The Parliament Brief: the government might not meet target of 2.5 million extra NHS dentist appointments

The public health minister Andrea Leadsom told MPs that the figure attached to the dental recovery plan is unreliable.

By Harry Clarke-Ezzidio

Welcome to the Parliament Brief, where Spotlight, the New Statesman’s policy section, digests the latest and most important committee sessions taking place across the House of Commons and House of Lords. Previous editions can be found here.

Who? The Health and Social Care Committee held a one-off session on the NHS dentistry crisis, in light of the government publishing a “recovery plan” for the sector in February. Andrea Leadsom, public health minister, gave evidence to the committee alongside representatives from the Department of Health and Social Care and NHS England. Prior to Leadsom’s appearance, experts from the dental sector also gave evidence to MPs.

When? Tuesday 19 March 2024, 10.15am.

What was discussed? Most of the session focused on the potential effectiveness of the government’s strategy for NHS dentistry. The three core components of the plan are to make it more financially enticing for dentists to take on new NHS patients; to provide emergency treatment to those in under-served areas (termed “dental deserts”); and to introduce public health initiatives that focus on protecting the oral health of young people.

The plan is expected to cost £200m (funded through using unspent money in existing dental budgets, which would otherwise be siphoned into other parts of the NHS). It’s expected to generate more than 1.5 million additional NHS dentistry treatments, or 2.5 million appointments. 

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Why did this come up? Demand has long outstripped supply when it comes to NHS dentistry services. Swathes of dental practices across the country are unable to register any new NHS patients. Some people, unable to get an appointment, have resorted to conducting DIY dentistry at home – one in ten Britons have performed dental “procedures” on themselves, such as pulling out their own teeth.

So what did they say? Steve Brine, the Conservative chair of the committee, began by referring to a previous session the committee held on NHS dentistry last year with Neil O’Brien, the then public health minister. “We do want everyone who needs one to be able to access an NHS dentist, absolutely,” O’Brien had said at the time. In this week’s session, Brine began by asking Shawn Charlwood, the chair of the British Dental Association (BDA) (a trade union representing more than 15,000 members): “Are we at a place where… [O’Brien’s] ambition is on course to be met?”

“And [as] much as I’d like to say that we are on track to deliver that, you will not be at all surprised to know that we do not think that’s the case,” Charlwood said, adding that his hope for government-led reform was “pretty low”. “We waited nearly a year for [the government’s recovery plan],” he continued, “and my worry then was that with every day that passed, more colleagues [dentists] would pare down their NHS commitment or walk away entirely.”

Charlwood said the recovery plan contained nothing “to bring this service back from the brink and deliver the promise that was made”. He cited a survey the BDA carried out, which found that only 3 per cent of dentists believe that the government’s plans would improve patient access to NHS dentistry services. “Almost half [of those surveyed] believe it will do the exact opposite,” Charlwood noted, “and lead to their practice seeing fewer NHS patients.”

He added that the government has “given the impression” that it will skip over a key recommendation from the select committee’s previous dentistry inquiry, which is to reform dental “contracts” in order to make NHS work more financially attractive for private dental practices. It was initially introduced in 2006, and has barely been changed since. According to the government, any changes to the contract will be phased in from 2025.

Anything else? When Leadsom gave evidence in the second part of the session, she began by explaining that when she assumed her role last year, tackling “dental recovery was even more… urgent than [starting] contract reform”.

She added that the recovery plan will “free up significant numbers of appointments”. But, in reality, the number could fall short of the government’s target of 2.5 million extra appointments, the minister admitted. Leadsom said the figure was based on NHS modelling and “took into account the views of dentists”, but conceded that the target “has quite a high likelihood of not being reliable, as is the case with all modelling”.

“That’s quite an admission, minister,” said the Labour MP Paul Bloomfield, who posed the question on how the government got to its headline figure. “Forecasting is not an exact science,” replied Leadsom. “That doesn’t undermine the fact that the modelling comes out with a number of 2.5 million; I am merely being cautious in saying that it could be more, it could be less.” 

What next? As this was a one-off session and not part of a wider inquiry, there are no further evidence sessions planned. The committee published a report on the NHS dental crisis last summer, where it called for “urgent and fundamental reform”.

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