Dental services have fallen into decay. Extracted from the NHS, they have been prey to the marketisation of healthcare, and today an NHS dental appointment is as rare as hens’ teeth.

In 2006, the dental contract was set to encourage dentists to undertake NHS work, and would still allow flexibility for those that chose to work in private practice too.

At its core, interventions were measured by Units of Dental Activity (UDAs) and payments received on an agreement of how many UDAs you would deliver.

Although English healthcare spend was only £35 per person, in Wales it was £47, £55 in Scotland and £56 in Northern Ireland pre-pandemic. Practices then had to hit their target, and not exceed it.

As with all services today, the contract is significantly underfunded and dentists practice privately to cross subsidise their NHS work to make it a worthwhile endeavour.

But it hasn’t worked and dentists had to throw in the towel; Government sat back, people suffered.

Then came Covid and lockdown.

Naturally dental interventions spray aerosol particles, so dental services moved online. DIY fillings, advice and pain relief was all that could be offered. Meanwhile dentists tried to keep their staff paid and their businesses afloat, and like others work out how best to care for their patients on zoom.

Eventually an emergency service emerged but dental services have never recovered. Government have just ramped up the pressure with higher expectations on delivering on a failed contract. Many practices are handing the contracts back. Some simply inform their patients, that they are now private, and are open to receive their custom.

Like my postbag, Healthwatch York noticed a sharp rise in correspondence from residents saying they cannot find a dentist. From their research, they found one practice accepting NHS patients in York, not to see a dentist, but to join the 2000 strong waiting list.

So well done to the dentists who have survived, but I know it’s getting harder, dentists are leaving the profession, waiting lists are growing, and oral health is deteriorating, rapidly.

In 2018, it took 45 per cent of York residents over two years to find a dentist. Back then 84 per cent of people had an NHS dentist. Last year this fell to 59 per cent. Of those without a dentist, 71 per cent couldn’t find an alternative. The only orthodontic practice in York for children has a two-year waiting list for an appointment.

Locally it could take five years to see someone, so what are you meant to do? Go private? Really? At those costs? Some have embarked on DIY dentistry, literally pulling teeth. Some have travelled afar, and some have costed travelling to Eastern Europe.

First, we need the contract to end on March 31, 2022. It has failed. Government must build a National Dental Service, putting the mouth back into the body of the NHS, free at the point of need, never on the ability to pay; this is urgent.

But we also need a workforce plan. Last month, the British Dental Association survey showed that more than 40 per cent of dentists plan to change career or seek early retirement in the next year. We need dentists, hygienists, technicians, nurses and receptionists.

We’ll need a new Dental School, and I have made the case in Parliament that this should sit alongside York and Hull’s outstanding Medical School, since it will attract dentists and meet workforce needs.

The service must urgently reconnect with schools with supervised toothbrushing and regular check-ups. As oral healthcare is also vital among older people, and poor oral health can lead to malnutrition, we need a community programme too for the elderly and other vulnerable groups.

Finally, we need good data. It is quite staggering that Government doesn’t collect this.

Last Thursday’s debate in Parliament on dentistry showed I was not alone in making this call. Government are failing. They have no vision. There is no plan.

In 1948, the Labour Party set out its NHS vision. Special attention was given to the “Care of the Teeth”. It stated, “You need no application form. Just call, by appointment, on the dentist of your choice when you need them.”

Let’s get back to a proper national health service, free at the point of need, that cares for everyone. This is what I will fight for. It is what we need.

  • Rachael Maskell is the Labour MP for York Central