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Welsh Access Crisis

20 August 2019

Welsh Access Crisis

The Welsh Assembly Government (WAG) has confirmed it will not make any fresh investment to solve the access crisis facing NHS dental patients, in its response to landmark recommendations from the Assembly's Health, Social Care and Sport Committee.

The Association discovered the WAG's long-awaited response to the report following an inquiry held last autumn by the Committee was quietly published online on the same day Boris Johnson became UK Prime Minister. While Ministers have accepted each of the key recommendations, it has formally set alongside each proposal 'Financial Implications – None' indicating it does not anticipate any new investment.

The committee's recommendations, set out in the report A Fresh Start: Inquiry into dentistry in Wales published in May, closely follow the case made by the BDA when it gave oral and written evidence last year, including breaking with the discredited NHS contract that has fueled access problems across the country, and sparked a crisis in recruitment and retention among dental staff. The contract operates a capped budget, with present funding set aside to treat around half the population.

Recent BDA research has shown that in April 2019 just 1 in 6 practices (55 out of 355 or 15.5%) across Wales were able to offer appointments to new adult NHS patients, with only 27% (96) practices taking on new child NHS patients. No practices were taking on new adults on the NHS and just a single practice taking on new child NHS patients in Hywel Dda Health Board covering Carmarthenshire, Ceredigion, and Pembrokeshire. These figures closely reflect the same picture of poor access for new patients that was seen in 2017.

The WAG's reforms to the NHS dental contract involve tweaks to the widely discredited target driven model. The Committee had also backed calls to ensure budget assigned to NHS dental care remains within the service, and for the Welsh Government's pioneering Designed to Smile programme to maintain the full provision for 5 and 6 year-olds and to be extended to cover older children.

Official figures have shown a 15% reduction in expenditure on all dentistry in real terms in the last six years, despite an ever-growing population. The Health Minister, in response to questions from Assembly Members, has suggested children unable to be treated by a high-street dentist, can instead go to a community dental clinic. The BDA has described this as pure fantasy – given all community dental clinics, which specialise in treating special needs patients, also face significant waiting lists.

The BDA has expressed scepticism that any of the recommendations to improve access and patient care can be meaningfully delivered on a cost-neutral basis, and that an absence of proper investment in these services is not sustainable.

Tom Bysouth, Chair of Welsh General Dental Practice Committee said: "The Health Committee set out a clear plan that could have taken NHS dentistry in Wales back from the brink. Sadly, the Welsh Government have come back with a blink-and-you'll-miss-it response. 

"Yes, ministers have signed up to every last recommendation made by the Committee. But that endorsement does not sit with a belief that dire access problems can be solved without a penny of new investment.

"We have whole counties now unable to offer appointments to new NHS patients. The crisis facing NHS dentistry in Wales won't be solved with a few warm words."



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