Dentist leaders hit out at government plans to ‘handcuff’ graduates to NHS work

Dentistry leaders have hit back against proposals to force trainees to work in the NHS after qualifying, warning “handcuffing’’ workers will not address the growing crisis in the service.

The British Dental Association (BDA) said it was deeply concerned following the publication of the government’s workforce plan for the NHS, which commits to increasing trainee dentistry posts by 40 per cent to 1,100 by 2031-32.

The organisation is challenging proposals to “tie in” newly qualified dentists to spend a minimum proportion of their time on NHS patients after graduating.

The BDA has warned the flagship strategy will not address the worsening number of dentists choosing to stop NHS work, which is leaving whole areas of the country without access to care, with reports of patients being left to pull their own teeth.

It warned the plans could even drive students to leave the UK and train elsewhere.

In April this year in evidence to a Commons inquiry, Healthwatch England said there was a “crisis” in access to dentistry that is impacting those in the most deprived communities and leaving pregnant women unable to access free NHS dental care.

The NHS workforce plan, published on Friday, said: “We do more to support and encourage qualified dental professionals to spend a greater proportion of their time delivering NHS dental care.

“One approach we will consider with the government is to introduce incentives or other measures, such as a tie-in period, that encourage dentists to spend a minimum proportion of their time delivering NHS care in the years following graduation.”

In a Downing Street briefing, Rishi Sunak was asked whether more dentists should work in the NHS rather than doing private work and whether there was anything in the plan that would help achieve that.

He replied: “The simple answer is yes and yes. We are exploring the possibility of introducing what’s called a tie-in for dentistry. Around about two-thirds of dentists after they have finished their specialty training end up not doing work in the NHS.

“That’s something that we want to look at and it may be that the appropriate thing to do is to introduce a tie so that people are performing more NHS work after they qualify.

“Of course, they’ve benefited from a very significant subsidy from the taxpayer worth hundreds of thousands of pounds so that seems a reasonable approach.

“We are also funding an expansion of dental training places.”

However, the British Dentist Association chair Eddie Crouch has said the government should “not handcuff the next generation to a sinking ship…It’s an exercise in futility – training more dentists who don’t want to work in the NHS.”

The BDA spokesperson said the current NHS dentist contract is “the number one [issue] driving staff out of the workforce”.

The NHS workforce plan does not mention plans to reform the contract with dentists. The NHS contract, imposed in 2006, gives dentists a set fee based on a target for the number of patients they treat. However, the BDA says the contract does not consider increasingly complex patients who take longer to treat.

In a recent survey of dentists, the BDA said more than half reported reducing their NHS commitments since the start of the pandemic and 74 per cent said they planned to reduce NHS work.