Call for legal minimum NHS dentist staffing levels

Senedd Members called for legally binding minimum staffing levels in NHS dentistry amid concerns services face an existential crisis.

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, proposed a bill to establish a minimum baseline of dentistry staff across Wales based on population need.

The bill would introduce a duty for health boards to calculate and take all reasonable steps to maintain dentistry staff levels, according to the motion debated on April 30.

Mr ap Gwynfor warned NHS Wales dentistry services are “staring down the barrel” of an existential crisis “and without urgent action it’s unlikely to survive for much longer”.

He pointed to a near-40% reduction in dentistry work within the NHS over the past decade.

‘Denialism’

Mr ap Gwynfor, who represents Dwyfor Meirionnydd, warned so-called dental deserts are “spreading at an alarming pace”, with access to NHS treatment becoming a scarce luxury.

“Desperate times demand a willingness to consider radical alternatives,” he said.

“Now more than ever, we need to break free of the irresponsible denialism and complacency that this [Welsh] Government has displayed towards dentistry in the NHS for many years.”

Siân Gwenllian, who commissioned a report into the case for a dental school in north Wales, said the proposed bill would place a duty on ministers to develop a workforce plan.

The Plaid Cymru politician said: “Only 36% of the population received dental treatment via the NHS in the Betsi Cadwaladr health board area.

“The figure across Wales is 44% which shows the situation is even worse in north Wales.”

‘Squeezed out’

Her colleague Llŷr Gruffydd warned of a three-tier system, “which increasingly sees patients being squeezed out of NHS care and having to opt to pay privately or … go without”.

Mr Gruffydd told the Senedd that six dental practices in his North Wales region have handed back their NHS contracts over the past six months.

“I’m afraid that the trend shows no sign of abating,” he said, expressing concerns about Rhos dental practice, near Wrexham, introducing a £230-a-year preventative service.

Mr Gruffydd claimed: “So, once again, this Labour government’s actions are actually pushing more people into having to pay for basic dental care even within an NHS practice.”

Welsh Lib Dem leader Jane Dodds supported the motion which would seek to emulate the Nurse Staffing Levels Act 2016 introduced by her predecessor Kirsty Williams.

‘Crucially important’

Jeremy Miles, Wales’ health secretary, pointed out that most dentists are commissioned via private businesses rather than employed by health boards as with nurses.

He told the Senedd: “They are accountable for their own businesses and do ensure that their staffing levels are adequate to meet the needs of the contract. The independent nature of this arrangement is crucially important for the profession.”

Mr Miles said regulations that underpin the contract include a requirement to ensure adequate staffing, with financial sanctions available if providers fail to do so.

Recognising the challenges facing NHS dentistry in Wales and across the UK, he argued: “To improve NHS dentistry and to improve access … we must deliver a new general dental services contract. This, in fact, is the single most important thing that we can do.”

Mr Miles said proposed reforms would bring NHS dental services into the 21st century.

Senedd Members voted 28-2 in favour of the motion, with 17 abstentions but the proposal is unlikely to proceed without Labour ministers’ support.