To consider the following Motion in the names of Councillors P A Davies and A Smith;
“This Council notes that:
1) NHS dentistry operates differently from other aspects of NHS healthcare. Most dentists are not employed directly by the NHS but operate as independent contractors. In practice, this means that dentists purchase and equip the surgery, hire staff and pay all the running costs (such as wages, materials and insurance) in order to provide an NHS dental service;
2)
Dentists enter into agreements with NHS England to
provide a certain number of treatments per year. The contract gives
NHS dental practices targets to hit, and this is known as units of
dental activity (UDA). If dental practices do not hit their
targets, they risk losing a significant part of their NHS
funding;
3)
Dentists are paid by the NHS according to a points
system. They are effectively paid the same for the delivery of a
check-up as they would be for performing root canal work, despite
the latter requiring far more work and taking much
longer;
4)
There is a
shortage of dentists in England. According to NHS figures, the
number of dentists providing NHS care in England fell from 23,733
at the end of 2020 to 21,544 at the end of January this year. This
means that the NHS now has the smallest number of dentists it has
had for over a decade. It is also a local problem, with Kirklees
losing 11% of its dentists, meaning that it is the among the 25
most affected areas nationally.
This Council believes
that:
1) Access to NHS dental care and treatment has become enormously limited and this is a huge issue. Many people across Kirklees and England have been forced to go private and are battling to get treatment as practices stop seeing NHS patients. Many people travel miles outside their areas to access NHS treatment and some have even travelled overseas for treatment. Sadly, there has been a rise in do-it-yourself dentistry, which is enormously risky and can be harmful to dental health;
2) Dental care is an essential part of health care and should be available to all, yet oral health inequality is widening across Kirklees and across the country. A shortage of NHS appointments and treatment is particularly affecting those on low incomes the hardest, as well as patients with high levels of need, including those who are vulnerable. A lack of access to NHS dental care has real implications; it is deepening health inequalities and resulting in a rise of health issues, such as tooth decay, gum disease and oral cancer;
3) Dental surgeries have been forced to scale back their services. In part this is due to recruitment and retention issues, as well as NHS dental care services being underfunded and overstretched. There are staffing shortages which has been exacerbated by Brexit and Covid-19. Many dentists are unhappy with the NHS dental contact, according to the British Dental Association, and this may also a significant factor;
4) The current NHS dental contract is unworkable and is not fit-for-purpose. The dental contract, introduced in 2006, has attracted criticism from a range of bodies, including the British Dental Association and patient groups. It effectively renumerates dentists solely on their activity, meaning that dental surgeries are incentivised not to deal with the most serious cases. It wrongly puts the focus on meeting targets rather than delivering good patient care. Over the last year, there have been some changes made to the NHS dental contract, but as the British Dental Association note, these minor changes do not go far enough in helping to tackle the current crisis;
5) In some cases, dentists are losing money to see patients, particularly those with high needs. Many newly qualified dentists are simply unable to cover the costs of providing NHS treatment. Many dentists are feeling pressure to go private in order to cover wages and equipment costs and to survive as a business; many are leaving the profession entirely;
6) There has been a worrying shift towards the privatisation of NHS dentistry. The current system is failing patients and dental teams and contributing significantly to access problems in Kirklees and across the country. The dental contract needs to be replaced with a more modern system which puts prevention at its heart and better reflects dentistry in the 21st century;
7) While a commitment to reform the current NHS dental contact has been an established goal of successive governments, progress has been slow and has not been substantive. The current government and NHS England must intervene and speed up dental contract reform. Urgent and fundamental reform is required to ensure that people can access the dental care they are entitled to. In addition, the government needs to provide sustained funding to tackle the underlying problems of dental access and affordability.
This Council, therefore, resolves that:
The Leader of the Council writes to the Parliamentary
Under-Secretary of State for Primary Care and Public health to
demand an urgent independent review of the NHS dental
contract.”
Decision:
Item not considered.
(Meeting terminated in accordance with Council Procedure Rule 16(2).)