NHS Dentistry Crisis Makes the Financial Times
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- Published: Wednesday, 08 May 2024 09:42
- Written by Peter Ingle
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In a story based upon its own analysis, the Financial Times has concluded that £150 million of the dental budget remains unspent and that it was also experiencing a “recruitment crisis.” That such a respected paper, a UK go-to for all matters economic, has published a story explaining to its influential readers the woes of NHS dentistry, confirms that awareness of the crisis is not restricted to dental teams and patients unable to find treatment. The paper goes on to describe the shortcomings of the NHS dental contract, describing it as “broken".
The FT calculated that in the last year £147 million of contract money had been taken back from English dentists that had missed their UDA targets. It explained to its financially astute readers that this left dentists struggling to meet costs and that many were switching to private work at the very time that there were staff shortages and long waiting lists.
BDA Chair Eddie Crouch, was quoted, saying that: “Underspends do not reflect any lack of demand for NHS dentistry — but are the result of struggling practices unable to hit their punitive targets. “ He pointed out that, “Practices in the same high street receive different levels of payment, and the BDA stresses that underspends are highest in areas where UDA rates are lowest,” which must have made baffling reading to the FT’s typically educated, and financially literate readership. Indeed readers of a paper characterised as having a centrist to centre-right, neo-liberal readership, may have wondered how successive Conservative administrations had spent fourteen years in charge of such a system.
The FT’s analysis of NHS Business Services Authority data, looked at GDS contracts. There were major regional variations, for example in Somerset repayments were more than three times higher than the England average of 5.5 per cent, with 17 per cent of funding returned in 2022-23. Across the South West, the share of money repaid increased from 7 per cent in 2018-19 to 13 per cent in 2022-23. There were regional variations in UDA value, so that in parts of the south west, dentists were paid a quarter less per UDA, compared to the best funded area in North East London.
The paper referred to the Commons Health and Social Care Committee description of the UDA contract as, “not fit for purpose“ as well as its call for “urgent reform.”
The example of Dr Jenna Murgatroyd, chair of the Local Dental Committee for Cornwall and Isles of Scilly, was given, where her practice had fallen 1,000 UDAs short of its target. This was partly as the result of two dentists moving away in the past year to provide private dentistry. The effect of mixed practice dentists, altering their ratio of private and health service work, was that they were spending less time on NHS treatment. Using data from NHS Digital the paper explained that average hours spent treating NHS patients in England fell almost a tenth from 27.3 hours a week in 2018-19 to 24.8 in 2022-23. According to Jenna Murgatroyd: “We have seen a rise in dentists in the last year forced into leaving the NHS to work privately and it would take a complete overhaul of the contract for morale to change. We are penalised for taking on new patients, because they take more of our time and yet we are paid virtually the same amount of money to care for them”.
The paper’s story finished by giving the Department for Health and Social Care (DHSC) the opportunity to comment. The DHSC said that practices were already accepting new patients as a result of the “dental recovery plan”, and referred to the promise to create up to about 2.5million more appointments this year. The £20,000 “golden hellos” to dentists willing to work in underserved areas and rolling out mobile dental vans to rural and coastal areas were also mentioned. The NHS spokesperson had said it had this year announced fresh support for practices to deliver on contractual obligations and improve delivery.
By the time of publication the sleight of hand used to justify the claim that more practices were taking new patients had been exposed. Similarly the rowing back on dental vans was already known.
The uncritical reproduction of such widely discredited DoH comments, represents a poor return to FT subscribers paying up to £785 a year.
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