'Unsustainable as a business': Leading Cumbrian dentist warns NHS dentistry is gone

Chair of the North Cumbria Local Dental Committee, John Lewis, is calling on the Government to improve NHS contracts so more practices don't go private.

It comes after Goodwin and Associates Dental Practice, Cockermouth's last NHS practice, announced it make the change at the end of the month.

There are only a handful of NHS dentists in Cumbria accepting new patients.

Many patients across the region have told ITV Border they now have no dental care.

The Chairman of the North Cumbria Local Dental Committee, John Lewis, a dentist in Penrith, says the problem is both the NHS contract and recruitment problems.

"Cumbria is known as a dental desert," he said.

"Dentists like to work in the areas near where they qualified.

"We're a long way from a full dental hospital or a full teaching hospital.

"You lack that security of having support, having a network and Cumbria is remote."

"In 2006, when the new contract appeared, a lot of practices in Cumbria reduced their NHS commitment, but retained it for children," continued Mr Lewis.

"It's national policy not to allow children's-only contracts anymore, so the practices that have converted have all tried to retain their children's contracts, but they've been rejected."

'It's a very, very difficult decision'

Dentists are private businesses and those with NHS contracts provide dentistry on behalf of the NHS. Many dentists say the NHS contract, largely introduced in 2006, is unworkable.

Mr Lewis says the problem is both the NHS contract and recruitment problems.He says dentists have been agonising over the decision to go private and many don't want to do it.

"It's a very, very difficult decision," he said.

"There are a lot of people out there who want NHS dentistry, and there are a lot of people who can't afford private dentistry, but that's why the system has to change."

The recruitment crisis is affecting many professions and it also affects private dentistry, but Mr Lewis explains it's worse for NHS dentists, since the amount they can earn is less, for greater stress due to the target-based system.

Mr Lewis is the Principal Dentist for Ghyllmount Dental Practice in Penrith, which went largely private 19 years ago.

He says for the one-fifth of his practice's work that is NHS, it accounts for 2.7% of his total practice income.

He says, "It's unsustainable as a business."

Mr Lewis says under the NHS contract, "what the practices are paid is based on what we earned in 2004 and 2005.

"That's 20 years ago and they haven't gone up drastically since that point.

"So I could do a filling on a child and I'll be paid £75 for it, whereas my colleague across the road would be paid £105 for doing exactly the same treatment and it's become unsustainable."

He argues the funding formula means practices are worse off if they work in a high-needs area or where there's not been a dentist for a while, since these patients tend to have more problems, which means doing more work for the same pay.

A spokesman for the Department for Health and Social Care said, "We have worked closely with the British Dental Association and others to reform the dental contract in 2022, including paying dentists more for treating more complex patients.

"We have seen improvements, with 1.7 million more adults and 800,000 more children seeing a dentist last year compared to 2022.

"We continue this work with industry to develop further reforms that will properly reflect the different care needs of patients, fairly remunerate practices, and expand and support the NHS dental workforce.

“Our new £200 million dental recovery plan will create an additional 2.5 million appointments over the next 12 months. It will offer cash incentives to take on NHS patients and £20,000 golden hellos for dentists who work in underserved areas."

But Mr Lewis says: "The £200 million is not new money, it's recycled money from dentists that have not completed their contracts.

"The Golden Hellos have been available in Cumbria for over a year and there hasn't been a single applicant for them.

"Dumfries and Galloway is offering a higher golden hello than Cumbria does, so why would people not just go across the border?"

'NHS dentistry is gone - and will never fully come back'

He claims a tender has been put out for nine new NHS practices in Cumbria, with funding of £9.9 million, but "as far as I'm aware, no one has taken that up because the tenders are time-limited, they're for seven years.

"So if I was going to set up a new practice, equip it, staff it, I've got seven years to get a return on my investment before that contract ends, and no bank is ever going to lend me the money for that, and no business would ever open knowing they were limited to seven years of operation."

This area's NHS says it's taking steps to protect, retain and stabilise local dental services, but dentists warn "NHS dentistry is gone - and will never fully come back".

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