The Nation’s Conscience Speaks
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- Published: Tuesday, 09 September 2025 10:09
- Written by Peter Ingle
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Times may have changed since the Yes Minister episode where Jim Hacker explained that The Guardian is read by the people who think they ought to run the country. Nonetheless when it comes to dentistry the house style is not to run an expose on Turkey Teeth but offer a “Guardian View” editorial, setting out what in the paper‘s opinion, needs to be done.
A little over a year into the new government, it has done just that. It starts punchily with: “Gaps in access to dentists mirror other health inequalities. And ‘golden hellos’ won’t solve the problem on their own.”
The paper begins with the recent analysis from the Local Government Association (LGA) which highlighted the major differences in availability of dental services across council areas, described as a “dental divide.” There is recognition of the LGA’s failure to demonstrate a specific correlation between the numbers of NHS dentists and young children with tooth decay.
Despite this it adds to a body of research showing that people in poorer areas are generally less well provided for, and cites the number of dentists per head in deprived, as compared to affluent, areas.
The paper recognises that health inequalities are nothing new and that equitable distribution of healthcare, which it describes as one of the greatest of all social goods, was Labour’s aim when setting up the National Health Service. But the number of people living in deep poverty has increased and healthcare costs and expectations have risen. As a result the variation in health experiences and outcomes between people from different socioeconomic backgrounds have become more starkly apparent, including a widening gap in life expectancies.
There is an acceptance that deprivation is not related to the provision of all NHS services. For example data on diagnostic waits suggests a fairly even picture. But along with A&E admissions, which are nearly twice as high in the poorest communities, dentistry is an area in which geographical differences are troubling. This matters all the more given the recognised links between poverty and other diet-related health problems, including obesity.
Health Secretary, Wes Streeting’s, pledge to reform the NHS dental contract within this parliament, and introduce a “tie-in” obliging dentists trained in the UK to work in the NHS for three years after qualifying, is noted. But the paper does not consider this enough, observing that it is hard to see how services in deprived areas will be improved unless funding for NHS dentistry is increased to the point where practices are viable without the cross‑subsidy provided by private patients. The Guardian should perhaps be congratulated for being one of the few commentators on UK dentistry that has at least acknowledged the basic economics behind the access crisis. As a result it is hardly surprised to note that: “Currently, dentists’ reliance on (private) fees is a strong incentive to work in areas with plenty of such patients.”
While the reallocation of £2.2 billion of NHS funding to poorer parts of the country, announced by the government in June, should make a difference to dentistry as well as health overall, that depends on oral heath getting a fair share. If gaps both in access and outcomes are to be narrowed, then funding for dentistry will need to be prioritised. There is recognition of the poor take up of the once much vaunted “golden hello” scheme of one‑off payments, intended to encourage dentists setting up practices in underserved areas.
Private practices may both nod their heads in agreement and worry, as they read the Guardian’s concluding paragraph: “A far higher proportion of dentistry than healthcare overall is delivered in the private sector. Another lesson to be drawn from “dental deserts” is about what happens when market forces, and not democratically accountable policymakers, are in charge.”
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