NHS dentistry becoming less and less accessible

Far fewer people see an NHS dentist than before a large-scale reorganisation of dentistry service, according to official figures. Data released yesterday by the NHS Information Centre showed that a total of 27.3 million patients — equivalent to 53.7 per cent of the population — saw an NHS dentist in the two years to December 2007. This compares with 28.1 million (55.8 per cent of the population) in the two years to April 2006, when the Government’s new dental contract was implemented. The contract’s aim was to increase access and simplify dental charges.

The report also showed wide variations across England in who gets access to an NHS dentist, with greater disparities among adults than children. Among adults, the proportion who had seen a dentist in the 24 months up to December 2007 ranged from 38.9 per cent in the South Central Strategic Health Authority area to 58.3 per cent in the North East. There was also a wide variation in the number of children who have access to dental services, with 73.4 per cent seeing a dentist over the same period in the North East compared with 64.8 per cent in London.

Recent surveys have suggested that scores of patients are being forced to pay for private dental treatment because of a lack of practitioners willing to carry out NHS work.

Current guidelines from the National Institute for Health and Clinical Excellence (NICE) suggest that people should see their dentist either every six months or at intervals of up to two years, as the practice sees fit.

The British Dental Association said the figures offered fresh evidence that ministers had failed to achieve their stated aims with the contract. Peter Ward, its chief executive, said: “They have failed to improve access to care for patients and failed to allow dentists to provide the modern, preventive care they want to deliver. “Instead, this contract encourages sporadic, episodic treatment rather than the long-term, continuing relationships that dentists and their patients value. “The Government must heed these statistics and work with patients and dentists to find constructive solutions to the problems with the reforms behind this decline.”

Experts said that patients who did not have regular check-ups could be storing up health problems. Ben Atkins, of Rocky Lane dental practice in Manchester, said: “If people are not going to the dentist regularly, they are not going to pick up warning signs and the small problems that can develop into serious problems such as tooth loss, abscesses and even cancer. Holes can develop in dental enamel in as little as a few months. They can be easily corrected with a filling, but if not checked early, they can cause greater decay down to the nerves.”

Conservatives said the figures suggested that 338,000 people lost NHS dentistry in the past three months of 2007 — equivalent to 3,674 a day. The information centre confirmed that the number of patients seing an NHS dentist “had been falling consistently over the past few years” and that this fall had been greatest between September and December last year. Mike Penning, the Conservatives’ health spokesman, said: “These figures are yet another damning indictment of Labour’s appalling management of NHS dentistry. The fact that over 300,000 people lost their dentist in three months alone shows just how bad things are getting.”

A survey of 5,000 patients and 700 dentists last year concluded that the quality of care patients had received since the introduction of the contracts has worsened. Among dentists, 45 per cent said they were not accepting any more NHS patients while nearly three quarters said that they were aware of patients declining treatment because of the cost. However, 93 per cent of patients receiving NHS dentistry said that they were were happy with the treatment provided.

Norman Lamb, Liberal Democrat health spokesman, said that the dental contract had been an “abject failure”. He added: “We need an urgent review into why reforms undertaken just two years ago have completely failed to improve access.”

Barry Cockcroft, the Chief Dental Officer, said: “Since the dental reforms, we have made expanding NHS dentistry a national priority and have invested an extra 200 million this year to help strengthen local services and open more practices. “The information centre access figures do not reflect the new services that are opening all the time. Rather, the figures are retrospective and include the temporary decrease in access which occurred following the transition to the new system in 2006.”

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