Foreword:

On December 19, a BBC news report pointed out that the traditional model of dental care in the UK's National Health Service (NHS) is "gone forever."

(Image source: Screenshot from BBC website)

Sensitive, anxious, and reflective.

In fact, the topic of "NHS in trouble" has been circulating on social media for quite some time. At the time, The Nuffield Trust (an independent think tank specializing in how to improve the NHS) stated in its latest think tank report:

"NHS dental services have been cut so drastically that it is in the most precarious position in England's 75-year history. Decades of policy negligence have made NHS dental unsustainable, and proactive action is urgently needed to prevent further decline."

This sharp rock stirred up a thousand waves.

Since 2000, British households have increased their spending on dental services significantly, from approximately £1.4 billion to over £3.7 billion in 2017. According to statistics, there were 36,394 practicing dentists in the UK in 2020, ranking fourth in Europe.

So,

What exactly has the UK dental market gone through in recent years?

Why is the NHS facing a dental shortage despite the increasing number of dentists every year?

This article is"A Lament for NHS Dental Services: The NHS Dental Crisis May Be Fully Exposed" (Part 1)

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below:

01. NHS Dental: A Large-Scale "Crowdsourcing System"

Let me give you a brief introduction first: British healthcare is divided into...Private sectorandpublic systemThe latter is the National Health Service (NHS), a public health insurance system in England within the United Kingdom of Great Britain and Ireland.

Since its founding in 1948, the NHS has grown into one of the world's largest healthcare systems, aiming to provide services to all citizens of the United Kingdom.From cradle to graveThe NHS provides basic healthcare services, most of which are free. A friend of mine, Leo, who studied in the UK, told me that he went to the NHS for a minor abrasion. Although it was an emergency and no appointment was needed, he still waited for over three hours.

"A GP appointment is a general practitioner, but I've heard the skill levels vary greatly. Some doctors even Google how to treat patients while they're there..." Leo said. The long waiting times for appointments have left Leo dissatisfied with the NHS's free healthcare system. "It would be best to buy commercial health insurance so I could go to private hospitals; that would be much more convenient."

"Free healthcare" is a very attractive benefit, but NHS dental services are not free for most adults. Traditional NHS dental services include subsidies and free services for certain groups.

People who meet the following criteria are eligible for free NHS dental care:

• •Children under 8 years old, or those under 19 years old who are receiving full-time education;
• •Pregnant or have given birth within the past 12 months;
• •Treatment is received at an NHS hospital and performed by a hospital dentist (but may require payment for dentures or bridges).
• •Receiving low-income benefits, or being under 20 years of age and a dependent of someone receiving low-income benefits.

In addition, eligible low-income individuals and those with NHS medical expense certificates can also receive free NHS dental care. If an appointment is successfully made, NHS dental services will be subsidized.

Note! This is on the premise that the reservation was successfully made.

In general, the NHS provides universal healthcare coverage through a network of community primary care services and dedicated NHS hospitals. NHS primary dental services are one of the four pillars of the NHS primary care system (the other three pillars being general practitioners, primary eye care services, and community pharmacies).

NHS dental services include primary, community, secondary, and tertiary dental services.The NHS primary care services operate on a "contractor" model, with services provided by contractors (private dental clinics) that have contracts with the NHS.

According to a report by The King's Fund in October this year, there are approximately 11,000 independent dental care providers in England, of which about three-quarters are private dental care providers with contracts to provide NHS services.These private dental clinics offer both publicly funded and privately funded services.

For dental clinics, the key is to be flexible and adaptable.

(Image source: Screenshot from the King's Foundation website)

However, the UK's NHS system, which once seemed like a "win-win" situation for both supply and demand, is now facing the reality that the British public struggles to access NHS dental services comprehensively and universally—in addition to difficulties in making appointments, there are significant regional disparities in NHS dental services.

Dentists are concentrated in cities and around dental hospitals and schools, putting vulnerable groups at risk of unequal access to oral health services. People living in impoverished areas or other vulnerable groups still struggle to access NHS dental services.

02. From "Trend" to "Decline"

In accordance with the economic theory of "scarcity," the allocation of oral healthcare resources has also left some shaded areas in what was once a "sun never sets" land.The radius of medical services and the density of dentists are both gaps that exist between the public and oral healthcare resources.

As mentioned earlier, the Nuffield Trust's latest report discusses:The accumulation of problems, including the COVID-19 pandemic, deflation, dental shortages, funding constraints, oral health inequalities, and Brexit, has plunged NHS dental services into crisis.

(Image source: Screenshot from the King's Foundation website)

Let's look at a simple set of data first:

① In 2022, the number of dental treatments provided by the NHS was nearly six million fewer than before the COVID-19 pandemic;

② Actual funding for dental treatment in 2022-2021 was £500 million less than in 2014-2015;

③ There are widespread problems with making dental appointments, especially among Black and Asian communities;

④ The number of children with cavities has increased significantly over the past 10 years, especially among children living in impoverished areas.
...

Let's look at it over a longer timeline:

Since the turn of the millennium, British households have increased their spending on dental services significantly, from approximately £1.34 billion in 2005 to over £4.7 billion in 2017. However, compared to 2017, spending on dental services in 2018 decreased slightly by volume, to approximately £3.4 billion.

British household spending on dental services declined for three consecutive years from 2018 to 2020, hitting a low point in 2020 before slowly recovering in a V-shaped pattern, finally returning to 2014 levels by 2022.

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On the supply side:

Regarding dental care institutions, a 2022 BBC investigation found that nine out of ten NHS dental care providers in the UK no longer accept new adult patients, meaning that NHS services are no longer seeking new patients but only maintaining existing ones.

As the think tank report was released, the UK Labour Party also published its latest analysis of the NHS: eight out of ten dental care providers are not accepting new NHS patients. This is an improvement compared to data from the BBC's survey the previous year, but it is still a cause for concern.

Some people need to drive hundreds of miles for treatment, and some don't even try to pull their own teeth. This is corroborated by a statement released by the UK Health and Social Care Council in July 2023.More and more people are having their teeth extracted at home because they cannot access NHS services.

once"Only love and teeth are irresistible."Now facingSo close, yet so far.With dentists available, the public had to become self-sufficient.

In response, Shawn Charlwood, chair of the Dental Practice Committee of the British Dental Association (BDA), stated that this think tank report..."It reads like the final rites of passage for NHS dentists."。

In terms of career choices, dentists have voluntarily reduced their treatment services within the NHS. Unfortunately, for several years, the British government has failed to take proactive measures to prevent this trend from spreading.

If this "trend" becomes too deep, it can easily turn into a "decline" if left unchecked.

All of these,

Is it a systemic problem with the UK's NHS? Or is it an administrative oversight?

Is the gatekeeper "silent"?

Or is it simply a product of the times?

We will analyze this in the next article.

Welcome to read:

"A Lament for NHS Dental Services: The NHS Dental Crisis May Be Fully Exposed" (Part 2)

The following section is exclusive content for Platinum members. Click here to read.

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