NHS Dental Care: The Decline of a Public Service

With the looming threat of privatisation, the risks to public health should be cause for concern.

Image created via Midjourney

The threat of privatisation is something that has been looming constantly over British society. Time and time again, politicians, particularly from Labour, have expressed their concerns over the potential collapse and privatisation of the National Health Service.

Admittedly, with this constant chatter of imminent danger, it has become easy to become indifferent. The easiest conclusion to come to is: What on earth can I do about it?

With 13 years of Conservative rule, their distaste for public services has not been hard to miss and in many ways it seems unstoppable.

Yet the privatisation of the NHS is not something that is going to happen, it is taking place already. Often, it is only when it begins to affect us personally that we realise the extent of the problem.

For me, that was the case with NHS dental care. I was aware that the services were becoming harder to access and that going private would be faster, albeit more expensive.

Yet, I was determined to stick with my NHS treatment, always assuming that it would be there when I needed to access it.

It was only when I returned home from university that I was greeted with a letter stating that my practice was ditching NHS appointments altogether. The reasons cited were to do with improving patient experiences, stating that the decision would benefit the practice.

Within the same letter, the practice offered a new alternative that patients could sign up for, a monthly subscription plan that would allow patients to be eligible for a number of treatments per year.

Essentially, it was dental insurance accessible only to those who could afford the regular subscription fee. Unfortunately, for those in financially precarious positions, the loss of affordable NHS treatment will be deeply felt.

One of these individuals, who has been affected by the gradual privatisation of dental care is Beth, 21, who got in contact with me via Twitter.

Having moved house within the last year, Beth has tried to re-register herself with a new dentist, due to the myriad of problems she has been facing.

“I was struggling with my mental health and in turn, I sometimes didn’t even have the energy to look after my teeth. I tried contacting my previous childhood dentist when I was 18, but even then they were impossible to get hold of.”

Beth’s dental problems have since gotten more severe, “I’ve contacted around 16-20 dentists with some quite a distance away, and none of them have been able to provide an NHS appointment, only private ones.”

With her dental pain only increasing, dental hygiene has become increasingly difficult for Beth to manage, “Sometimes I don’t even brush my teeth anymore, it’s too painful, my teeth are very weak and many have holes, sometimes parts start to chip off.”

Due to her financial situation, Beth is unable to pay for private dentistry, and with the amount of work she expects she needs, she imagines the cost would be staggering.

She is potentially eligible for free dental care due to her personal circumstances, but this is only available through NHS dentistry, and not private practices.

It is unsurprising that Beth has given up trying in the recent months, having been met by the same responses citing long waiting lists and a lack of capacity. The hunt for affordable care has in brief, become futile.

Of course, it would be unfair to wholly blame the dentists or their practices, for they too have cited their frustrations with the decline in NHS dental care.

Under the broken NHS system, dental care is often underfunded and overstretched, in one extreme example, a dentist reportedly earned a mere nine pounds from a day’s hard work.

In response, in 2022, the government brought in new measures aiming to improve access to dental care, which means that ‘all NHS dentists will receive fairer payments for providing more complex dental care to those who need it most.’

Yet, according to a survey published by the British Dental Association in March 2023, over “half of dentists in England (50.3%) report having reduced NHS commitments since the start of the pandemic.” 74% of those who responded, “stated their intention to reduce - or further reduce NHS work.”

It is clear that despite the government’s attempted intervention, dentists are still not happy. Can we blame them? With recent protests and constant warnings from the media that the NHS is under threat, it is only logical for many dentists to make the jump to private.

The NHS is in dangerous territory, and under Conservative policies, public services will always face underfunding.

This development may seem inevitable but it is fundamentally unacceptable. Whilst it is easy to focus on the financial impacts, a focus on private treatments ultimately means that a myriad of dental problems will be untreated, or allowed to progress until it becomes an emergency situation.

Dental health is becoming a privilege, despite the fact that it is a basic and integral part of our general health. Infections that may arise due to a lack of treatment can prove fatal, spreading throughout the body and causing conditions such as sepsis.

This can lead to further strain on the already fragile emergency services, with problems being left to get worse before they can be treated.

The reality is that reform should have taken place long ago, as many dentists have long left the NHS behind.

Along with the pandemic, there has been a rise in DIY dentistry, where patients have become so desperate they have conducted their own dental work.

This is another risk, with lack of anaesthetic and proper sterilisation, this worrying development is a disaster waiting to happen, and can be another source of potential infection.

Having reached her limit, Beth’s attempts to get dental care have unsurprisingly, resulted in a sense of apathy. “Some of my teeth are completely dead now, so those ones don’t cause much pain anymore.”

“Honestly, I just think it's hopeless, they should make it more accessible to get dental care on the NHS. Even just a consultation would be better, as the longer it takes, the worse a lot of people’s teeth are going to get.”

This is the reality of the situation, and it’s a worrying trend that is emerging across various health sectors: preventative care has been placed on the backburner.

Psychiatric services have experienced this for a while, with many having to experience a suicide attempt or severe health crisis to get the help they need.

In a sense, dentistry is following in this same direction, preventative care is becoming increasingly unattainable and people are left to suffer the consequences.

This just another example of how essential services are being intentionally eroded, leaving individuals like Beth without proper access to the care they desperately need.