England now lagging behind rest of UK nations on spending as charge hikes conceal cuts

02 April 2019

As NHS dental charges in England rose yesterday by an inflation busting five per cent, the British Dental Association called for honesty from ministers on how the system has been used to slash state spending.

 The BDA are responding to the rise by launching a poster campaign running in NHS practices across England to inform patients, as 29 Labour MPs led by Bolton’s Yasmin Qureshi accused health secretary Matt Hancock of a “betrayal of patients” over the funding shortfall.

The increase will see the cost of a routine check-up increase by £1.10 to £22.70, and for a set of dentures increase by £12.80 to £269.30.

Charges were introduced in the 1950s to discourage patients from seeking care, but in recent years have become a proxy for state investment, increasing their share of total spend from just over 20 per cent to nearly 30 per cent of NHS dentistry’s budget since 2010. Government contributions in England have fallen by over £500 million in real terms in the same period, with charge hikes plugging the gap.

BDA analysis of official accounts in all four nations shows that this approach has seen England tumble from front runner to last place on state investment. In 2006 ministers in England set aside over £35 per capita for dental care, more than any other UK nation. England now stands at £36 per capita, with Scotland investing nearly 50 per cent more into care (£52.73 per head) and Northern Ireland two thirds more (£57.47 per head). Factoring in inflation, spending in England has fallen by £12 per head in real terms since 2010.

The BDA now estimates England is just a decade from the point where charge revenue overtakes state contributions as the principal source of funding for the service.

Official surveys have shown one in five patients have delayed treatment for reasons of cost. The BDA posters are a pastiche of official materials which sport happy families and are sent to practices every spring to mark increases in treatment costs. Underfunding is feeding a recruitment and retention crisis that left an estimated million new patients unable to secure an appointment last year.

The BDA’s chair of General Dental Practice, Henrik Overgaard-Nielsen, said, “Our patients deserve to know these charge hikes won’t put a penny into frontline services. They will pay more just so ministers can pay less.

“Charges are designed to discourage attendance, but now serve as cover for savage cuts. England has thrown away leadership on oral health, and the result is a service on the brink and a million patients unable to find an appointment.

“Unless ministers change course within a decade our patients will be putting more in at the point of delivery than government. The service will be NHS in name only.  
 
“Every year NHS England provides dentists with posters sporting images of happy families, seemingly delighted to see cuts in government spending. Dentists are offering patients the unvarnished version.”