Ring Fence Blown Over

Ring Fence Blown Over

Storms Babet, Ciaran and Debi have disrupted travel, brought floods and destruction, blew over trees and damaged buildings. Now, we are told, a failure in industrial relations has destroyed a crucial protection for the NHS dental budget.

As the flood levels drop and roofs are fixed, a different type of storm may have shattered the virtual fence that was supposed to protect the NHS dental budget.

The much discussed ring fence around the dental budget appears to have finally succumbed, as the government looks to cover the costs of industrial action in the NHS. According to the BDA there are credible reports that senior officials have given Integrated Care Boards (ICB) permission to use dental clawback money to help cover deficits in other parts of the NHS.

Clawback from contracts failing to hit their UDA targets exceeded £400 million for the year ended March 31st 2023 and there has always been concern that this sum of money would attract attention from other parts of the cash strapped NHS. After some hesitation, assurances were given that the money would remain in dentistry.

As ICBs took over dental commissioning, there were fresh worries that at the new local level, money might still be diverted from dental care. Addressing the annual conference of Local Dental Committees in June, the then CDO England, Sara Hurley, admitted that notwithstanding previous announcements, some ICS’s had “interesting” interpretations of ring fencing when it came to dental funding.

The BDA did not conceal their disappointment at the recent news saying that, “This couldn’t be further from the messages we’ve heard from the very top of government.” They quoted Dr Amanda Doyle, Director of Primary and Community Care at NHS England, telling the Health and Social Care Committee in April that "certainly now for 23–24 a ring fence has been applied by NHS England, so no ICB can spend a dental allocation on anything that is not NHS dentistry." 

The Prime Minister had also committed to the ring fence as part of his ‘5 Point plan’ for dentistry. At the time he said this would, “strengthen the protections around the annual NHS dentistry budget,” so funds would be “maintained exclusively for frontline dental services.”

Despite pressure from the BDA and even its own MP’s the Government has failed to deliver their promised recovery plan, which was expected to make effective use of clawback monies.

Following the Health and Social Care Committee inquiry into NHS dental care, MPs had set out recommendations to government for permanent ring fencing, and for real, urgent reform, alongside a call for any recovery plan to be underpinned by necessary funding. The Government’s response to that inquiry is now two months overdue.

General Dental Practice Committee Chair, Shawn Charlwood said: “Once again NHS dentistry is being treated as the Cinderella service. When we desperately need ambition and investment, officials are raiding our budgets, robbing Peter to pay Paul.”

In the same week that the dental budget looks set to lose money, The Times ran a leader on dentistry entitled: “The Times view on the decline of NHS dentistry: Open Wide.”


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