Almost a third of people in England use private dentists amid NHS dental crisis | Dentists

Almost a third of people in England now use private dentistry and there has been a sharp increase in the number of poor families having to pay for fillings and tooth extractions.

The health service’s patient watchdog said the scarcity of NHS care meant the proportion of people seeking private dental services rose from 22 per cent in 2023 to 32 per cent at the end of last year.

Healthwatch UK warns that the reliance on paid treatments is so serious that dental care is becoming an expensive, “one-stop” (private only) service for more and more people.

It is worrying that the percentage of people who identify as financially distressed and use private dentistry has almost doubled in recent years, from 14% to 27%.

Those who do this will be given a “double punishment”, the watchdog added. This is because dentists charge much more for private work than for NHS work; for example, on the NHS there is a charge of £64 for an examination that costs just £27.40. Many low-income patients, as well as all pregnant women and new mothers, may also lose out on the free NHS dental care they are entitled to as healthcare patients because they cannot find a dentist to treat them.

“Our findings are a warning that for some people there is only one tier of dental care – specialist dental care,” said Rebecca Curtayne, Healthwatch UK’s acting head of policy, public affairs and research. “The most vulnerable people in our society are bearing the brunt of the ongoing shortage of dental appointments in the NHS.

“Too many low-income people are forced into private care that they struggle to pay for, or are denied treatment altogether. The system is failing those who need it most.”

Healthwatch’s findings are based on a representative survey of 2,593 adults it conducted last October and November to inform its annual report on patients’ healthcare experiences, which will be published later this week.

Ministers should tackle the access crisis by giving everyone the right to see an NHS dentist, just as everyone has the right to be on the list of GP surgeries, Curtayne says. Legitimate NHS patient advocate Healthwatch is being abolished as part of Wes Streeting’s controversial reorganization of the NHS in England.

The patients’ association said the major shift towards private dental care showed that NHS dentistry now “exists in name only for many people”.

“This report provides further evidence about the state of NHS dentistry and this double penalty for people on low incomes shows a systemic failure with real humanitarian consequences,” said Rachel Power, chief executive of the charity.

“This isn’t just about the cost of dentistry. The lack of affordable dental care harms physical health, leaves people in constant, sometimes agonizing pain, and can have a heavy impact on mental and emotional health.”

Power added: “Healthwatch’s warning that we are sleepwalking towards a single-tier, costly system is one we should all take seriously. Where getting dental care means paying privately for it, NHS dental care is available in name only for many people.”

The Competition and Markets Authority last week launched an investigation into the UK’s £8.4bn private dental market “to ensure it works well for UK consumers”.

Explaining her decision, Sarah Cardell, managing director of the competition watchdog, said: “Going to the dentist is an important part of health and wellbeing. But we are concerned that many of us may be uncertain about costs, availability, treatment options and what they are entitled to. For some, seeking private dentistry is a choice, but for many it is a necessity.”

The CMA’s estimate of the number of people using private dental care in the UK (one in five) is significantly lower than Healthwatch’s figure of 32% in England.

The review will examine access to private dentistry, competition within the sector and “significant” price increases caused by surgeries in recent years. For example, between 2022 and 2024, the cost of an initial check-up has increased by 23% to £80, while the cost of a check-up has increased by 14% to £55.

Dentists are blaming ministers for the inaccessibility of NHS dental care services. They say the NHS pays them so little to do certain types of work that they are running at a loss and are having to cross-subsidize £400 million a year to pay for these treatments.

The British Dental Association (BDA), which represents dentists, claims that “this funding gap… inevitably puts some pressure on private pricing”. “The government has a responsibility to fund NHS care appropriately to prevent people being forced into private treatment.”

Responding to last week’s announcement of the CMA investigation, BDA chairman Eddie Crouch said: “Those who are left without a choice, who feel they have to go private, are there entirely because of the choices the Treasury has made.”

BBC announced Last week, dentists in England said they were doing so little NHS work that they had returned £936 million of money allocated to them to carry out procedures in the past two years.

A Department of Health and Social CCare spokesman said: “As this report shows, this government has taken over an NHS dental service that had been left to decay for over a decade. We strongly believe that everyone should be able to get dental care, not just those who can afford it.”

“We took immediate action to fix this, delivering a further 1.8 million treatments in the first seven months of this year, benefiting more children and the poorest. We are also reforming the dental contract to treat more patients and focus more on prevention. We are determined to end two-tier care and make dental care accessible to everyone.”