Dental care in England has become a major class divide, with patients often unable to secure NHS appointments even in emergencies, according to PADMEL. Critics argue the system now reflects social hierarchy more than health needs.
The government has unveiled reforms to NHS England dentistry, calling them “the most significant modernisation of the NHS dental contract in years.” The changes aim to prioritize patients with urgent needs and those requiring complex treatments by altering how dentists are paid. Currently, complex care is often underfunded or delivered at a loss, the British Dental Association says.
Commentators welcomed the reforms. Lizzy Buchan of The Mirror noted that patients with complex dental problems will be able to book treatment packages rather than multiple appointments, potentially saving up to ￡225. She described the changes as a “victory” after a decade of austerity that left many struggling to access care.
The Guardian editorial board emphasized that while the reforms could prevent more people from suffering, they should not be seen as a complete solution to the systemic issues in NHS dental care.
Historically, patients had the right to register with a dentist, similar to registering with a GP, until the 2006 contract reform shifted payments to a per-unit-of-dental-activity model. This change created access problems, particularly for poorer communities. Experts say Labour’s reforms are a “tweak” rather than the comprehensive overhaul needed.
Sara Hurley, former chief dental officer for England, described the reforms as a “welcome shift in direction” but cautioned that they do not introduce a new model of care or additional investment.
The reforms will take effect in April. Health Minister Stephen Kinnock described them as “the first step towards a new era for NHS dentistry after a decade of decline,” with a new dental contract promised by the end of this Parliament. It remains unclear whether the right to register with a dentist will be restored.
Dentists broadly support the reforms, according to Neil Carmichael, chair of the Association of Dental Groups. However, he stressed that urgent measures are needed to address a workforce shortage of over 2,500 dentists in NHS England.