The government is letting NHS dentistry sink – Rachel Reeves's spending review will decide its fate

14 February 2025, 16:40

You wouldn’t get very far as a baker if the cost of making your loaves exceeded what you got paid. It’s pretty basic economics.

And if our doctors and nurses were expected to pay for care out of their own pockets, our hospitals would surely collapse.

But somehow this is exactly what government expects from NHS dentists.

A decade of savage cuts means your typical practice now loses over £40 making a denture. Over £21 doing a root canal. Over £7 on a new patient exam.

Practices are covering these losses the only way they can - by doing more private work, or simply less loss-making NHS treatment.

Overall this amounts to an effective subsidy of hundreds of millions keeping a struggling service afloat.

Like our GP colleagues high street dentists are not employees of the NHS, we’re contractors.

We have to cover the costs of people, power, premises - before we even get to the materials and equipment we need to treat you.

And it is very clear to us the Treasury don’t value dentistry.

We were the first part of the NHS to cease being free at the point of use - a bright idea to pay for tanks and trucks during the Korean War that’s still with us in 2025.

The original purpose was to lower demand for care, but now it’s a substitute for decent investment.

Charges go up almost every year, well above inflation, but our budget has remained the same for a generation. Patients pay more simply so the Treasury can pay less.

The Chancellor claims she’s ‘going for growth’, but her policies are doing the exact opposite for dentistry.

The last budget heaped new costs on practices but offered nothing by way of support.

So it’s little surprise this service has ceased to exist for millions across this country.

Labour went to the polls with pledges to rebuild this service. To end scenes that belong in the Victorian era. People queuing round the block for care or pulling their own teeth out.But promises aren’t translating into action, and it’s the people holding the purse strings who are sitting in the way of change.

The crisis here has fuelled by a generation of austerity funding and failed contracts. The system we work to funds care for barely half the population – there was never enough dentistry to go round, and that’s a political choice.

It doesn’t reward the time treatments take or the costs we incur. We’re paid the same whether we do 3 fillings or 20. It’s totally illogical and fails the patients who need us most.

So reform is promised, but that has to come with sustainable funding.

Plans across Whitehall hinge on the coming Spending Review, and the Treasury’s priorities.

We’d remind Rachel Reeves that NHS dentistry has surged to become a real doorstep issue in recent elections.

Voters can’t comprehend why Ministers can’t fix a simple problem: that people in pain can’t get the care they need.

This Spending Review will sink or save NHS dentistry, and whichever way she goes the Chancellor will have to own it.

• Shiv Pabary is the Chair of the British Dental Association’s General Dental Practice Committee

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