The Dentist Magazine.

Pay cuts add to decade of under investment

Published: 05/04/2017

The British Dental Association (BDA) has said underinvestment in dentistry is bringing NHS services to the brink, as the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) announced its recommendation of a below inflation pay uplift of 1 per cent for dentists in 2017/18.

The BDA has said that the report has comprehensively failed to recognise the impact that a collapse of 35 per cent in earnings since 2006 has had on investment in dental practices. NHS dentists in England have not received any direct capital investment in recent years, while GPs have continued support through a five-year £900m fund, with an additional £56m fund for practice resilience, including support for GPs suffering burnout and stress.

The BDA has lamented the underinvestment and lack of government strategy and action on oral disease. Recent analysis from the Royal College of Surgeons has shown a 24 per cent rise in the number of tooth extractions performed on nought to four-year-olds in hospitals in England over the last decade.

Comment from around the UK

Henrik Overgaard-Nielsen, chair of General Dental Practice at the BDA, said, “At the same time that child tooth extractions are surging, the Government seems intent on making NHS dentistry unsustainable. Dentists have seen a 35 per cent drop in earnings in the past 10 years. Today’s uplift does nothing to address – let alone reverse – a drop that’s already impacting on our ability to deliver the improvements in facilities, equipment and training our patients deserve. 

“We’re living in uncertain times with the fall in the value of the pound, the rise in the cost of materials and the spiralling costs of regulatory compliance, and all compounded by the chronic underinvestment in NHS dentistry.

“This is a devastating blow for dentists’ morale and these deep and sustained cuts have long ceased to be a question of ‘pay restraint’ or ‘efficiency savings’."

Robert Donald, chair of the BDA’s Scottish Dental Practice Committee (SDPC), said,“The 1 per cent award is extremely disappointing and does nothing to address the crisis of morale among Scotland's GDPs. It guarantees that we remain the lowest paid dentists in the whole of the UK.

“While our earnings have been driven into the ground costs, associated with red tape and an overbearing regulatory regime, are spiralling out of control.

“Ministers need to know that dentists have had it to the back teeth in terms of doing 'more with less' and I fear that there is no give left in the system without compromising patient care.”

Katrina Clarke, chair of the Welsh General Dental Practice Committee, said, “If the Welsh Assembly is serious about improving the nation’s oral health then it must start by putting its money where its mouth is instead of relying increasingly on inflated patient charges to fund NHS dentistry.

"NHS dentistry in Wales is being stretched to breaking point. We are already facing a recruitment crisis and, even more worryingly, we are seeing practices closing –thereby making it harder for patients to access dental care.

“There is no further scope for savings, and this increase will not stop more practices closing. NHS practices increasingly cannot balance the books given the spiralling costs of running dental practices.”

David Johnson, chair of the Welsh Committee for Community Dentists, said,“This ongoing pay restraint is not only demoralising for hard working dentists but underinvestment in community services could have lasting consequences for oral health provision for the most vulnerable people in Wales.”

Peter Crooks, chair of the Northern Ireland Dental Practice Committee, said, “The uplift recommended by the DDRB does nothing to arrest the long-term decline in GDPs' real incomes which continues to jeopardise investment across the service.

“It’s not surprising that dentists’ morale and motivation in Northern Ireland is at worryingly low levels and linked to working longer hours and carrying out more health service work. This cannot be sustained indefinitely or on goodwill alone.  

“The current political impasse and budget uncertainty in Northern Ireland is concerning. Whatever the political outcome, it is clear that failure to act and invest in dentistry will have lasting consequences for oral health provision in Northern Ireland.”